ADHD and Sleep

Persons living with adhd often struggle to achieve uninterrupted restful sleep, due to difficulty sticking to a routine and being easily distracted by last-minute plans or activities they become hyperfocused on.

Sleep issues can lead to depression, yet they frequently go undetected. Stimulant medications may interfere with restful slumber in certain individuals and worsen ADHD symptoms as a result.

Medications

Stimulant medications used to treat ADHD can sometimes cause sleep difficulties for some individuals, depending on the medication, dose and dosing schedule. Some stimulant medicines have greater impact than others on sleep quality – it is therefore crucial that clinicians have an understanding of this effect and discuss this with patients prior to initiating therapy.

Assessing for ADHD requires asking a range of questions about sleep environments and routines, any disturbances in patterns or duration, comorbid conditions that could contribute to problems sleeping such as sleep disordered breathing (such as obstructive sleep apnea or snoring), anxiety or depression or, for women over 40, menopausal symptoms like night sweats.

Medication that impacts circadian rhythms and sleep cycles may help improve it, such as those taken prior to bedtime or just before or after waking up, such as melatonin, antidepressants or certain anticonvulsants. An experienced physician should prescribe such medicines properly according to label instructions for maximum effectiveness.

Many individuals with ADHD find taking their medication difficult, which is why it is critical that any new drug, including over-the-counter or natural supplements, be discussed with your physician prior to beginning.

ADHD medicines also work to aid sleep. A study on over-the-counter sleep aids concluded that they could significantly enhance both quality and duration of restful slumber in children diagnosed with ADHD.

People living with ADHD and impulsivity tend to engage in behaviors that disrupt sleep quality, such as staying up late or partying too frequently. Such habits can contribute to insomnia, compounding the effects of ADHD even further.

Studies into the efficacy of ADHD treatments on sleep have demonstrated that combining stimulant and non-stimulant drugs can produce optimal results, with medications which reduce hyperactivity/impulsivity having the greatest positive impact. While medicines that increase wakefulness tend to disrupt restful rest more than those which reduce hyperactivity/impulsivity.

Circadian Rhythms

People’s circadian rhythm, or 24-hour cycle that regulates various biological functions including brain wave activity, hormone production and cell regeneration, is affected by environmental cues such as light and darkness. If this system goes out of sync it may result in problems related to sleepiness and alertness such as jet lag, shift work disorder and delayed sleep phase syndrome.

Circadian rhythms also interfere with the brain’s ability to suppress and control arousal states, and may explain why those with ADHD tend towards impulsivity and difficulty shutting off activities when bored or frustrated. Furthermore, this theory may help explain some “paradoxical” improvements when stimulants are taken at bedtime: the drugs help calm the nervous system so it becomes easier to fall asleep more easily.

Studies suggest that circadian rhythm disorders and insomnia are closely tied to inattentiveness, impulsivity, apathy and sensation-seeking in ADHD; sleep deficits exacerbate their intensity (Kooij, 2017). Adults living with ADHD also often display delayed evening preferences which have been linked to more severe ADHD symptoms (Kooij 2017).

People living with ADHD frequently report difficulty sleeping at night, frequently awakening throughout the night and finding it hard to return. They also may have trouble staying awake during the day and may need frequent naps as well as experiencing intermittent wakefulness. Polysomnography tests have revealed that their sleep quality is poorer compared to adults without ADHD.

My experience has taught me that many adult patients with ADHD require their medication at bedtime to fall asleep, with full doses often needed in order to remain asleep throughout the night. If they are unable to stay asleep for long enough, their sleep becomes restless and unproductive and they often wake up feeling just as fatigued as when they went to sleep.

For optimal sleep quality, setting and adhering to a consistent schedule and restricting caffeine consumption to earlier in the day are keys. Also consider getting at least 20 minutes of natural or artificial lighting exposure such as taking a walk outside or using an “happy lamp”.

Bedtime Routines

Bedtime rituals help set up the body for restful restful sleep. Unfortunately, those living with ADHD often struggle to maintain a regular bedtime schedule due to symptoms related to their condition – including impulsivity and distractions that prevent them from going to sleep or rising at a set time in the morning. Furthermore, stimulant medications used for treatment of ADHD may interfere with restful slumber if taken with other drugs or caffeine sources.

ADHD children frequently also suffer from anxiety or depression, which can affect their sleep patterns. Symptoms may include restlessness, difficulty falling asleep and nightmares; moreover they might awaken frequently throughout the night leaving them exhausted when it’s finally time to wake up in the morning.

Poor sleep can have significant repercussions for children and adults with ADHD, including school performance, ability to regulate emotions, and overall sense of well-being. Therefore, it is crucial that individuals with ADHD understand what causes their sleep issues before taking steps to overcome them.

Establishing a regular sleep routine is one of the best ways to enhance restful slumber. Aiming for bed and wakeup times that match helps set an internal biological clock that regulates sleeping and waking cycles. People with ADHD should also avoid noise or light in their bedrooms that might disturb the cycle.

Exercise before bed can also help enhance sleep quality, especially for people with ADHD. Exercise promotes healthy sleeping patterns by burning extra energy and helping the body relax; people should avoid engaging in stimulating activities, like video games and social media in the hour leading up to bedtime.

Sleep can help you remain focused, productive and less stressed. If you are having difficulty sleeping or other concerns about your rest, seek medical advice immediately from a healthcare provider; they will assess the issue and suggest solutions to ensure you can get more restful nights’ rest.

Exercise

People living with ADHD frequently struggle to sleep due to overstimulated minds. Even when they do sleep, their restful cycles are interrupted multiple times each night by restless legs syndrome – a neurological disorder causing tingling sensations in lower extremities with an irresistible urge to move them – leading them down an exhausting path during the day and making staying focused challenging. Sleep problems also may leave them without energy reserves for sustained focus during their days off work.

Regular exercise can be one of the best ways to enhance sleeping patterns. Exercising can trigger the release of chemicals that help induce restful slumber, helping keep your mind calm before bedtime, as well as shortening the time between falling asleep and awakening – helping avoid insomnia and poor quality restful slumber.

Physical activity has been proven to improve cognitive functions associated with ADHD, including processing speed, attention span, impulse control and working memory. Cardio exercises appear to offer more of these advantages than non-cardio exercises; and researchers believe their effects are cumulative.

Studies have established a strong and statistically significant link between MVPA (Most Vital Physical Activity) and sleep. Different theories have been proposed as to its cause; one theory suggests that sleep improves cognition by providing an environment conducive to learning and memory enhancement.

Studies have demonstrated that diet and sleep changes can have an even larger impact in relieving symptoms of ADHD than medications alone, providing hope to parents that making small adjustments can make a major difference for your symptoms.

Staying physically active every day will help improve both sleep and concentration, but sticking with an exercise plan may be challenging. To make exercise fun and rewarding, use Fitbit’s gamification feature to set goals and reward yourself when they’re reached; or try exercising first thing in the morning prior to taking medication as this will give your brain double doses of mood-enhancing chemicals!