Southampton researchers launch new study to help children with ADHD sleep better

Children with ADHD will be offered digital help for sleep problems in new national research led by Southampton.

Almost 75 per cent of children with ADHD have sleep problems. Poor sleep can make daytime behaviour and schoolwork worse and affect the quality of life of the whole family. Knowledge about how to effectively treat these problems is limited.

Researchers at University Hospital Southampton NHS Foundation Trust, the University of Southampton and Southampton Clinical Trials Unit have been awarded £2.28 million to help children with ADHD and their families.

The study is funded by the National Institute for Health and Care Research (NIHR), the research partner of the NHS, public health and social care.

Over the next five years the study will provide resources and training for healthcare professionals to help them correctly identify sleep problems. It will also offer new online support to help children and their families.

Attention deficit hyperactivity disorder (ADHD) is a condition that affects people’s behaviour. It can cause them to be restless and impulsive and they may find it hard to concentrate. Around 3-6 per cent of school-age children are estimated to have it in the UK.

Children with ADHD often have trouble sleeping – almost three quarters find it hard to get to sleep at bedtime, wake in the night or wake up early in the morning.

Losing sleep can make their ADHD symptoms worse. This study, by helping them to sleep better, could therefore improve their behaviour and ability to concentrate.

It is led by Prof Cathy Hill, Professor of Paediatric Sleep Medicine, and Prof Samuele Cortese, Professor of Child and Adolescent Psychiatry.

They will work closely with researchers in the University of Southampton Primary Care Research Centre with expertise in digital health interventions, colleagues in King’s College London, University of Surrey, Newcastle University, Nottingham Trent University, and the University of Nottingham.

The study is supported by Hampshire County Council, the ADHD Foundation Neurodiversity Charity and the National Attention Deficit Disorder Information and Support Service (ADDISS).

There is currently no national guidance for health professionals on treating sleep problems in children with ADHD. Many are therefore unsure of the best way to treat it.

This often means they prescribe melatonin, a hormone which controls sleep patterns, as a ‘one size fits all’ treatment. However, melatonin does not always work, can have side effects and might not be the most effective treatment in the long term.

Prof Cortese explains: “This medication works quite well to induce sleep, but ultimately is not the most comprehensive way to address this problem. We also need to actively involve parents in the management of the sleep problems of their children.”

The Digital Sleep Support for Children with ADHD study, known as DISCA, aims to develop an app or website that provides tools to improve children’s sleep.

The team want to work in partnership with parents and carers. People can find out more and register their interest here.

The researchers will test how well the new digital sleep intervention works in a large trial, co-designed and run with the team at the Southampton Clinical Trials Unit. The study, due to open in March 2025, aims to recruit around 350 children aged 6-12 years with ADHD from across the UK. This will include hard-to-reach children, such as those living with foster carers.

Parents and carers of children taking part will have the chance to access digital support to improve sleep.

Researchers will follow up at six months to see if there are lasting improvements to the child’s sleep, behaviour and ability to concentrate. They will also investigate the wider effects of better sleep on families, for example by allowing a parent to come off antidepressants or return to work.

Prof Cathy Hill said: “This study has the potential to greatly improve the lives of children with ADHD and their families.

“We hope that by educating parents, carers and health professionals on the best techniques to improve sleep, we can ensure these children get the help they need to sleep better.”

ADHD case study – Jonah's story

Jonah was first diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) when he was seven years old. Like many other children with the condition, ADHD affects his ability to sleep.

“When it comes to bedtime, feeling tired doesn’t come naturally to Jonah and he can lie in bed awake until midnight – his mind is racing,” explains his mum, Natasha. “It is incredibly frustrating for him that he can’t sleep – especially as it’s so valuable to an active child plus there is a knock-on effect in the morning when preparing for school.

“In other families, children may have an easier bedtime routine. They might play up and get over excited a bit however eventually they will fall asleep. It is hard for those families to comprehend that we’ve got a ten-year-old who is just not going to sleep as he is physically not able to. I’ll put our other two children to bed, but then Jonah’s still awake or still has needs, then it encroaches on my husband and I’s time.”

Jonah lives in London with his parents and his two younger brothers. Natasha says that other families with neurotypical children often struggle to understand the difficulties they face at bedtime. Bedtimes can be a challenge that can last for hours. This not only means that Jonah loses out on sleep, but that Natasha and her husband have little to no time together in the evenings.

If Jonah has a difficult night, this can make the mornings even more stressful, Natasha explains, as a lack of sleep can make his ADHD heighten. He can become more emotional and could be more impulsive in the morning because he’s not as rested from a good night’s sleep.

Jonah’s ADHD has an impact on the whole family. While it can be easier at weekends, a typical school day can be fraught with stressful situations, particularly at breakfast time, leaving for school and at the end of the school day.

His brothers are often downstairs first sitting in a calm way, and then Jonah wakes up, comes down and says good morning to everybody. This could then be followed by touching a sibling, not to hurt them, but just unintentionally getting too much in their space. It becomes quite a stressful household as parents try to bridge the peace between the siblings.

When it comes to eating breakfast, it is a race against the clock and the smallest of distractions can cause unbalance that results in a greater distance of achieving the goal. Distractions can be anything from fidgeting to reading a comic – paired with being up and down out of his chair – there is a lot of energy.

They’ve tried following all the usual advice, including a bedtime routine, bath time and stories, but it doesn’t help.

Now Jonah has joined a new £2.2m research study, led by Prof Cathy Hill at University Hospital Southampton NHS Foundation Trust (UHS), that aims to improve the sleep of children with ADHD. Natasha hopes it will not only help him, but other children with ADHD who struggle with sleep.

“I think if anything could help these children suffering from not being able to sleep then it could be life-changing, because it will affect their whole wellbeing if they get a good night’s sleep.”