Many individuals with ADHD experience difficulty sleeping. This may be explained by stimulant-class medications used to treat their condition interfering with sleep patterns while nonstimulant ADHD medicines may cause side effects which make falling asleep more challenging.
Practice good sleep hygiene and avoid activities close to bedtime that disrupt sleep pressure can help those living with ADHD sleep more soundly, but this is only part of the solution.
Lack of Circadian Rhythm
ADHD patients often struggle to fall asleep at their regular times and may find waking up difficult; this could be caused by poor sleep hygiene and should be addressed through targeted diagnostic assessments, which might include asking them about their sleeping patterns on work days versus free days and using objective measures like wrist actigraphy to determine the daily light-momentary onset (DLMO) of saliva to confirm a delayed circadian rhythm.
The circadian clock is controlled by a brain circuit known as the Melatonin Enkephalin System, or SCN, which is activated by low levels of the hormone melatonin produced in the pineal gland and when exposed to light; when stimulated it sends signals that encourage production of more melatonin; those with delayed SCN rhythms often struggle to fall asleep on time at conventional times due to reduced production. Blue spectrum light therapy can help remedy this, for instance when treating seasonal affective disorder [133].
Adults with ADHD are estimated to suffer from Delayed Sleep Phase Syndrome, a sleep disorder characterized by difficulty falling asleep at normal times and misdiagnosed as chronic sleep onset insomnia. Studies have revealed that bright light therapy may help improve circadian rhythm in delayed sleep phase cases.
Studies have consistently demonstrated the correlation between chronic circadian sleep disorders and poor quality of life, such as decreased daytime functioning and impairments to cognitive, behavioral, emotional, and physical outcomes; but more difficultly to ascertain whether they are the causes or effects of psychological conditions such as ADHD.
Empirical findings have been inconsistent, and longitudinal studies that track both sleep and ADHD symptoms over time are necessary. Furthermore, studies that track primary sleep disorders among ADHD patients such as narcolepsy, snoring, RLS and insomnia should also be conducted to ascertain their cause and nature of association(s).
Disrupted Sleep-Wake Patterns
People living with ADHD often struggle to sleep through the night, suffering from racing thoughts or bursts of energy that prevent them from falling asleep quickly enough. Furthermore, they might awaken numerous times throughout the night without feeling rested when waking up in the morning – leading them down a path toward fatigue that lessens concentration and ultimately increasing risk and poor performance at work or school.
An altered sleep-wake rhythm can also have serious ramifications for memory and emotions. It may cause one to become more irritable or moody, making it difficult to form and sustain healthy relationships – this could have serious long-term repercussions for both their life and health.
People living with ADHD frequently suffer from sleep-wake disorders like insomnia or restless legs syndrome, which often go untreated, interfering with a person’s ability to get enough restful rest at night and worsening ADHD symptoms over time. Without effective treatment for such disorders, they can worsen over time and further interfere with getting sufficient rest at night resulting in further disruption to daily functioning.
ADHD sufferers may have a late chronotype that makes them naturally night owls; others’ circadian rhythm may shift later due to Daylight Saving Time; both can contribute to poor sleep hygiene by leading people to go to bed late and rise too early.
People living with ADHD often suffer from other forms of sleep disorder. These can include narcolepsy, obstructive sleep apnea, restless leg syndrome and delayed sleep phase syndrome – when people fall asleep later and wake too early.
Taken at bedtime to help induce restful slumber can be extremely helpful. My ADHD patients find that taking their medication at the appropriate time of night helps them relax their minds and bodies enough for restful restful slumber. For adult patients taking ADHD medication, 45 minutes prior to bedtime usually works best; alternatively they could try Melatonin or SMR neurofeedback to see if that helps more.
Daytime Sleepiness
Most of us have witnessed children with ADHD sleeping through alarms or falling asleep midway through a long drive, often misdiagnosed as “narcolepsy”. According to Marian Sigurdson, Ph.D, a specialist in ADHD and EEG research, people with ADHD share similar sleeping disorders as people without it due to the intrusion of lower brain wave activity known as theta waves into alpha/beta rhythms of alertness; at this point symptoms of narcolepsy often manifest themselves.
Sigurdson points out that those with ADHD tend to display extreme concentration when driving or engaging in potentially risky activities after school, such as working at their computers or phones – something psychiatrists refer to as executive dysfunction and is a hallmark of ADHD.
Sleep deprivation combined with executive function deficits often leads to lifestyle choices that exacerbate insomnia and other sleeping difficulties, including unhealthy eating patterns and excessive alcohol or drug usage – both of which have detrimental impacts on restful slumber. Chronically engaging in these behaviors may further erode a good night’s rest.
Impulsivity and hyperactivity can make developing a consistent routine difficult, which can make sleeping challenging for adults who struggle. My adult patients who struggle to sleep often complain of going to bed each night with racing thoughts and their bodies moving uncontrollably; my job is to show them in a non-risk setting how their medication will soothe away any restlessness so they can relax enough to sleep peacefully.
My best advice to my patients is to begin a mindfulness or meditation practice that can promote focus and concentration, while simultaneously strengthening resistance against distractions. This form of exercise may also make it easier to establish and adhere to a consistent routine and avoid stimulants before bedtime as well as block out distractions with white noise or dark curtains; if that fails, a doctor may suggest medication or other forms of sleep support such as CPAP machines, cognitive behavior therapy (CBT) or bright light therapy as solutions.
Insomnia
ADHD doesn’t only interfere with your sleep-wake cycle; it can also contribute to insomnia. Insomnia refers to difficulty falling or staying asleep or waking too early; this condition is more prevalent among people diagnosed with ADHD, negatively impacting both their work life and social lives.
Though many adults with ADHD may struggle to relax before bedtime, this difficulty often stems from an inner vibrating that manifests itself through fidgeting and racing thoughts. While not hyperactivity per se, such an interior vibration does activate our fight-or-flight response and makes it hard for us to turn off our minds at night.
Additionally, some stimulant medications used to treat ADHD may interfere with sleep. While they can provide focus during the daytime hours, their staying power in the brain often makes it hard to fall asleep at night. Luckily, non-stimulant options like Clonidine have proven more successful at improving quality restful slumber.
Motivation can also play a part in ADHD-related insomnia; people may feel as if they’re wasting their time or don’t deserve adequate rest. Therefore, it is essential that effective sleep hygiene be observed – including engaging in sufficient physical activity daily, going to bed at the same time each night, and turning off screens like TV and computer before sleeping.
Making sleep quality one of your top priorities is one of the best ways you can manage ADHD. If you are still having difficulty sleeping, consult with your physician. They may suggest lifestyle habits and suggest other treatments which could enhance it further.
Sleep is essential to good health. If you experience symptoms of ADHD and insomnia, speak to your physician about them; they might suggest lifestyle adjustments or alternative treatment options that could enhance your quality of life; they might even refer you to a sleep specialist for further assessment and evaluation. Frida provides free screening tools, online diagnostic evaluation and personalized treatment plans – making taking control easier from within your own home!
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