Some children with ADHD experience difficulties with sleep, including settling at bedtime and staying asleep.

For some children, bedtime can be the point at which their busy brain finally has space to process everything that happened during the day.

They may appear full of energy at bedtime even though they're actually tired.

They might also find it difficult to move away from stimulating activities, follow a multi-step bedtime routine or stop doing something they are enjoying.

This doesn't necessarily mean your child isn't tired.

We'll look at their daytime routine, evening stimulation, activity levels, bedtime expectations and what helps their body and mind move towards sleep.

If bedtime starts at 7.30pm but your child doesn't actually fall asleep until 9.30pm or 10pm, it can be incredibly frustrating.

You're probably wondering, “Why aren't they tired?”

There may be more going on than simply needing an earlier bedtime.

Some children with neurodivergence can experience difficulty winding down, sensory sensitivities, anxiety, differences in their sleep-wake rhythm or difficulty transitioning from one activity to another.

We'll look at when your child is actually becoming sleepy rather than assuming that the bedtime on the clock is automatically the right bedtime for them.

The aim is to work with your child's individual sleep needs while creating a predictable and manageable pattern.

Absolutely.

For some children with neurodivergence, their bedroom can contain things that you barely notice but that feel overwhelming or uncomfortable to them.

It could be:

• A ticking clock

• The hum of a radiator

• Street noise

• A particular type of bedding

• Pyjamas that feel uncomfortable

• The temperature of the room

• Light coming through the curtains

• A particular smell

• A sibling making noise

• White noise that is irritating rather than calming

Sensory differences involving light, sound, temperature and touch can all affect sleep.

Rather than assuming your child is refusing to sleep, we need to consider whether their environment is making sleep genuinely difficult.

Sometimes a small environmental change can make a surprisingly big difference.

Night waking can be particularly persistent for some children with autism.

Your child may wake and immediately need a parent, become distressed if their usual routine has changed, struggle to return to sleep or remain awake for a long period.

Possible contributing factors can include sensory discomfort, anxiety, difficulty resettling, environmental factors and differences in sleep-wake rhythms.

We'll look at what happens before, during and after the waking rather than treating every night waking in exactly the same way.

If your child's sleep has changed suddenly or there are concerns about their health, breathing, medication or other symptoms, it's important to discuss this with the appropriate healthcare professional.

A child who wakes in the middle of the night and is then completely awake can leave the whole family exhausted.

Your child may want to play, talk, watch television or simply get up and start their day.

This can happen for a number of reasons, including their sleep schedule, body clock, anxiety, sensory factors or difficulty transitioning back into sleep.

The answer isn't necessarily to keep your child in bed for hours insisting that they sleep.

We'll look at their overall 24-hour sleep pattern and consider what might be contributing to the long period of wakefulness.

Melatonin is something many parents of children with autism, ADHD or other neurodevelopmental differences ask about, particularly when their child is taking a long time to fall asleep or waking frequently.

In the UK, melatonin is a prescription-only medicine. It is not an over-the-counter sleep supplement that you can legally buy from a health food shop or purchase as a standard supplement online.

For some children, including some children with autism or ADHD, a doctor or specialist may consider melatonin when sleep difficulties have continued despite appropriate sleep support and are having a significant impact on the child and family.

NICE recommends that, for children with autism, a sleep plan should be tried first. If sleep problems persist and are having a negative impact, melatonin may be considered following consultation with an appropriate specialist, alongside non-medication sleep strategies.

I do not prescribe, recommend doses of, or supply melatonin.

My role is to help you understand what may be contributing to your child's sleep difficulties and work on appropriate behavioural, environmental and routine-based strategies.

If you are wondering whether melatonin could be appropriate for your child, please speak to your GP, paediatrician or other appropriate healthcare professional. They can assess your child's individual circumstances and advise whether medication is appropriate.

Please don't buy melatonin products online or use products marketed as children's sleep supplements without discussing them with a healthcare professional. The NHS specifically advises that melatonin supplements sold in some countries are not authorised for sale in the UK.

Medication should never be a substitute for understanding why your child is struggling with sleep.

Together, we can work alongside medical professionals to support the non-medication aspects of your child's sleep.