Facilitating sleep initiation in children with ADHD and sleep problems: a qualitative experience-based study

Children with Attention Deficit Hyperactivity Disorder (ADHD) often experience significant sleep difficulties, which can impair daily functioning and exacerbate ADHD symptoms. Sleep-related challenges, such as difficulties with sleep initiation, not only affect the child but also disrupt family dynamics, thereby impacting general family well-being. Understanding the factors that facilitate better sleep initiation could provide valuable insights to inform the development of targeted interventions to support children with ADHD and associated sleep problems. This study aimed to explore the experiences of facilitators supporting sleep initiation among children with ADHD and sleep problems. An exploratory, inductive qualitative design was used. Individual interviews were conducted with 21 children (11 boys and 10 girls) aged 6-12, diagnosed with ADHD and sleep problems. Data were analyzed through qualitative content analysis, resulting in five subcategories and two main categories. The findings revealed that children with ADHD and sleep difficulties identified both behavioral and environmental factors that facilitate sleep initiation. Behavioral factors included engaging in physical exercise, regulating digital device use, and maintaining a balance between activity and rest. Environmental facilitators included a calming sleeping environment and the maintenance of consistent evening routines. The children highlighted the importance of individualized approaches to the integration of these strategies, to effectively support sleep initiation. This study highlights the relevance of both behavioral and environmental aspects in supporting sleep initiation among children with ADHD. These exploratory findings may inform future research and practice by emphasizing the value of integrating children's own perspectives and preferences when designing supportive strategies.