Unlock Better Sleep for ADHD Kids: Discover the Power of Physical Activity

Attention Deficit Hyperactivity Disorder (ADHD), one of the most commonly diagnosed neurodevelopmental disorders in children and young adolescents, is characterized by inattentiveness, hyperactivity, and impulsivity. These core symptoms, often misunderstood as laziness, irresponsibility, or uncooperativeness, can persist into adulthood, leading to lower self-esteem, diminished quality of life, sleep disturbances, and slower learning progress.

Sleep problems are prevalent in children with ADHD, with research indicating a prevalence of sleep issues ranging from 25% to 55%. Furthermore, about 62% of children with ADHD suffer from moderate to severe sleep problems, including sleep-onset delay (SOD), bedtime resistance, and night awakenings, which can persist into adolescence and adulthood. Poor sleep in individuals with ADHD not only exacerbates ADHD symptoms but also leads to impaired daytime performance, causing problematic behavior, unstable emotions, and slower learning progress.

ADHD, PHYSICAL ACTIVITY, AND SLEEP – WHAT DOES THE RESEARCH SAY?

While pharmacological medication is a common treatment approach for sleep problems in children with ADHD, its application remains controversial due to potential side effects such as worsening hyperactivity and behavioral difficulties. Given that sleep plays a crucial role in brain development and symptom presentation, it is imperative to find effective strategies to improve sleep quality in this population. Increasingly, research over the past decade has shown the positive effects of physical activity on sleep quality across various populations. Regular physical activity has been associated with a reduced number of midnight awakenings and improved sleep quality, making it a potential alternative intervention for children with ADHD. However, there is still a need for more intervention studies to establish the impact of physical activity on sleep quality in children with ADHD. One study aimed to examine the intervention effect of physical activity on sleep quality in this population, hypothesizing a positive impact on their sleep quality.

METHODOLOGY

The study involved a total of 33 children (26 boys and 7 girls) aged 8 to 12 years, all diagnosed with ADHD. All participants could perform the required physical activities and had no prior training in jogging. The children, recruited from a local special school, didn’t have any medical conditions limiting their physical activity capacities nor any complex neurological disorders. A randomized control trial was then conducted to assess the impact of a 12-week jogging program on the participants’ sleep quality. The participants were divided into two groups: the intervention group, consisting of 17 children (14 boys and 3 girls), and the control group, consisting of 16 children (12 boys and 4 girls). The children’s sleep patterns were assessed for a week before the start of the program and immediately after its completion.

The intervention group participated in a 12-week jogging program, with each session lasting 45 minutes. The sessions were held in a gymnasium, with an instructor-to-participant ratio ranging from 1:3 to 1:2, depending on attendance. The sessions included a 10-minute warm-up, 25-minute jogging exercise, and a 5-minute cool-down. Various motor learning exercises were incorporated during the jogging portion of the session. In contrast, the control group didn’t participate in the jogging program and continued with their normal daily routines. Four parameters were evaluated to measure sleep behaviors and quality: sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset. An actigraphy accelerometer was used to measure these parameters over seven consecutive days. In addition, parents of the participants recorded the sleep log and pattern throughout the assessment period.

RESULTS OF THE STUDY ON ADHD, PHYSICAL ACTIVITY, AND SLEEP

Data analysis revealed the following:

• The study comprised the intervention group with 17 participants (14 boys, 3 girls) and the control group with 16 participants (12 boys, 4 girls). Both groups had similar demographic profiles in terms of age, weight, height, BMI, and medication use.
• Post-intervention, the intervention group showed significant improvements in sleep parameters as measured by actigraphy, including:
  • Increased Sleep Efficiency
  • Decreased Wake After Sleep Onset
  • Increased Sleep Duration
• The control group did not exhibit the same pattern of sleep improvements.
• Sleep log data confirmed these results, with the intervention group showing improved SE and a significant decrease in Sleep Onset Latency.
• Both groups, according to the sleep log, showed an increase in sleep duration.

As hypothesized, the intervention was effective in enhancing Sleep Efficiency (SE), reducing Sleep Onset Latency (SOL), and Wake After Sleep Onset (WASO).

TIPS AND SUGGESTIONS: ADHD, PHYSICAL ACTIVITY, AND SLEEP

• Implementing regular physical activity to a child’s daily routine, such as a jogging program, can be an effective strategy to enhance sleep quality in young adolescents with ADHD. Regular exercise has shown to increase Sleep Efficiency (SE), reduce Sleep Onset Latency (SOL), and decrease Wake After Sleep Onset (WASO).
• Considering physical activity’s role in improving sleep quality, educators and caregivers should encourage daily exercise routines in children with ADHD. This can align with other health-promoting activities throughout the day.
• The potential link between physical activity and melatonin, a hormone that regulates the sleep-wake cycle, may be important for managing sleep patterns in children and adolescents with ADHD. Introducing activities that may increase melatonin secretion, such as exposure to natural light during the day and creating a calming environment before bedtime, could be beneficial.
• Note that further research is needed to fully understand the complex relationship between physical activity, sleep, and melatonin secretion in children with ADHD. Meanwhile, incorporating physical activities in daily routines should be seen as an essential part of a comprehensive care plan.
• The benefits of improving sleep quality extend beyond night-time rest. Better sleep may result in improved daytime performance, cognitive functions, and behavioral regulation in children with ADHD, improving overall well-being.
• Before starting a jogging program or similar physical activity intervention, it would be helpful to assess the child’s current level of physical activity and jogging skills. This will help to tailor the program to individual needs, enhance engagement, and ensure safety.
• Consider any new physical activity program as an ongoing process, continuously reviewing and adjusting it based on the child’s progress and response. Future studies are encouraged to strengthen this evidence-based practice further.

REFERENCE

Liu, H. L. V., Sun, F., & Tse, C. Y. A. (2023). Examining the Impact of Physical Activity on Sleep Quality in Children With ADHD. Journal of Attention Disorders, 27(10), 1099–1106. https://doi-org.ezproxy.cul.columbia.edu/10.1177/10870547231171723

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