Screen Use after Bedtime and ADHD
By Dr. Mary Rooney, Ph.D.With phones, tablets, and video game consoles accessible to kids just about any time and anywhere, setting limits around screen time is more challenging than ever. When ADHD is added into the mix, setting screen time limits becomes even harder. Kids and teens with ADHD are more likely to use screens excessively, become argumentative when limits are put into place, and have a harder time sticking to the limits and resisting the impulse to use their devices when they’re supposed to be doing other things. While research shows that screen time and video games don’t cause ADHD, under certain circumstances, too much screen time does make ADHD symptoms worse. The biggest culprit for many kids and teens with ADHD is sacrificing sleep to get more screen time!
Sleep is essential for regulating emotions, staying focused, and making good decisions. So, when a child or teen has ADHD, their ADHD symptoms are much worse when they aren’t sleeping enough. Unfortunately, having ADHD can make getting a good night’s sleep a struggle. In fact, studies show that up to 70% of kids and teens with ADHD have ongoing sleep problems. One of the biggest culprits influencing sleep problems among kids with ADHD is screen time.
There’s a great deal of research showing that using screens right before bed leads to poorer sleep in kids and teens with and without ADHD. But even more problematic for many kids with ADHD is the time they spend on screens after bedtime, when they should be sleeping instead. In a recent study of nighttime media use, researchers surveyed 81 teens with ADHD about their sleep habits and media use after 9pm.1 Study results showed that almost all participants had a cell phone in their room, and 50% also had other devices (e.g. tablet, TV). 80% of the participants reported spending more than two hours using their devices after 9pm. Screen time after 9pm was associated with more sleep problems and more symptoms of anxiety and depression in teens with ADHD. And the majority of the teens in the study were getting far less than the recommended number of hours of sleep each night.
What can parents do to help limit screen use after bedtime? Well, prevention is really the only effective strategy. After all, parents cannot physically monitor their child or teen’s screen time when they are asleep themselves. In practice, the most effective strategies that I’ve seen work are keeping all digital devices out of the child or teen’s room (including a television), using cell phone monitoring and control tools to restrict use after the bedtime hour, turning off household (or teen) internet access after bedtime, and using a device monitoring app to check the child’s usage and ensure that they are in fact sticking to the screen limits.
The biggest challenge to using these strategies at home comes from the kids and teens. Most will complain (convincingly!) that they cannot fall asleep if they are not using their device in some way – they will say that they need to watch TV or videos to fall asleep, need to listen to music on their device, or need to use a white noise app on their phone or tablet. Parents need to resist giving in and look for alternative solutions to help their child or teen fall asleep. For example, a white noise machine can be purchased to replace a white noise app. A simple screen-free Mp3 player can be used to replace music on a phone or tablet. Books can be used in place of videos if they need something to quiet their mind before bed. Your child or teen isn’t going to be enthusiastic about any of these alternatives, because what they really want is to have their device back! But the bedtime limits really are in the best interest of the child or teen, and their disappointment is a small price to pay for better sleep, better ADHD symptom management, and potentially fewer symptoms of anxiety and depression. If parents are able to stick to the limits, after a while, their child or teen will adjust to their new routine, the complaints will die down, and they should be sleeping better. If sleep problems persist, consider talking to your child’s pediatrician. There are many ways to treat sleep problems, and the pediatrician will help you find the right solution.
1Becker, S.P. & Lienesch, J.A. (2018). Nighttime media use in adolescents with ADHD: links to sleep problems and internalizing symptoms. Sleep Medicine, 51, 171-178.
ABOUT DR. MARY ROONEY
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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