How ADHD Impacts Your Sleep And What You Can Do About It
If you’re a person living with ADHD, you probably won’t be shocked to hear that sleep problems are a common concern. ADHD-induced sleep issues are often overlooked, especially in adults. Learning why you have sleep problems and what you can do about it is a huge factor in creating a wellness plan for your ADHD.
Let’s explore why ADHD causes sleep issues and what you can do to boost your sleep quality and quantity.
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Sleep Disorders are common in ADHD
Studies have shown that around 40-80% of adults with ADHD experience disordered sleep. The most common complaint is insomnia, which includes significant difficulties falling asleep, staying asleep, or waking up too early. There is also evidence that circadian rhythm sleep disorder, narcolepsy, restless leg syndrome, and sleep apnea are more common among people with ADHD.
Experts don’t fully understand the exact connection between sleep issues and ADHD, but several potential contributing causes exist. Many people with ADHD find it hard to self-regulate, stick to schedules, and avoid late-night distractions like snacks or screens. These sleep disruptions get further complicated by side effects of meds and biological differences that negatively impact your sleep system.
But, don’t worry, whether you’re struggling with falling asleep, staying asleep, or you just don’t feel rested– there’s plenty you can do to improve your sleep with ADHD. First, let’s explore what we know so far about the causes of sleep problems in ADHD.
Why exactly do people with ADHD have sleep problems?
The reason for sleep issues in ADHD is multi-faceted. Most experts agree that the key problems with sleep in ADHD are due to some combination of behavioral symptoms, physiological differences and, in some cases, side effects of medications. Does this mean your sleep is doomed? Not at all! But you may have to work a little harder than the rest of the population to build a healthier sleep-wake cycle.
ADHD behavioral symptoms impacting sleep
ADHD impacts every area of your day-to-day life, and many of the core symptoms of ADHD can directly lead to sleep issues. The symptoms most commonly associated with problems snoozing include restlessness and hyperfocus with a side of time blindness.
Restlessness is a blanket term used to describe that underlying ripple of energy that seems to remain constant in many people with ADHD. This interior vibration tends to come out in the form of fidgeting, racing thoughts, or the need to constantly bounce your energy around a room. In scientific terms, relentlessness is physical arousal, sort of like a mild activation of your fight-or-flight system. Arousal and sleep aren’t exactly besties.
When it comes to sleep, restlessness arrives in the form of a busy mind, tossing and turning, and laying in bed wide awake even though you were just falling asleep on the couch downstairs 20 minutes ago. Restlessness can lead to sleep disruptions, frequent awakenings, and an annoyed partner as you sausage roll yourself in the blankets during the night. Even if you don’t wake up, increased restlessness during the night can lower the quality of your sleep, leaving you feeling tired in the AM despite “sleeping” all night.
The fix? In addition to practicing good sleep habits (see our guide to that at the bottom) and doing your best to get plenty of physical activity during the day, you can quiet a busy mind (and body) before bed with some easy-to-do scientifically-proven techniques. Choose from the options below (there are plenty of free resources available) and test to see what works best for you:
Progressive Muscle Relaxation
Journaling before bed
Breathing exercises (i.e. box breathing)
Hyperfocus and Time Blindness
Paying attention with ADHD tends to be all or nothing. When engaged in an activity that appeals to your senses (in that moment, anyway), it’s pretty common to slip into hyperfocus. Hyperfocus tends to interfere with sleep when people with ADHD stay up until obscene hours involved in an activity where they can’t pull themselves away.
Another common issue with ADHD is the concept of time blindness. Time blindness refers to the fact that your internal clock is not set when you’re living with ADHD. Time is experienced as more of an abstract concept, and it’s easy to let it slip away. In fact, it’s pretty common for people with ADHD to avoid wearing watches and mostly disregard time as a way to monitor their activities altogether.
As a result of hyperfocus and getting lost in time, you might find yourself with an erratic sleep schedule. Inconsistent sleep patterns can cause major disruptions to your circadian rhythm and contribute to sleep issues, like insomnia.
The fix? Keep regular. You can’t always control what time you go to bed but being stern with yourself about keeping a consistent wake time is a powerful tool that will help better regulate your circadian rhythm. You can help yourself out by investing in a sunrise alarm clock which is especially helpful on those bleak winter mornings. If you didn’t get much sleep (because you stayed up late), it’s perfectly fine to grab a 20-30 minute nap during the day before 2 pm.
Physiological symptoms of ADHD that impact sleep
Sleep is a complicated activity regulated by two key systems in your body– your sleep drive and your circadian alerting system. Your sleep drive builds up during the day and makes you feel sleepy at night. Your circadian alerting system works on a 24-hour schedule and sends signals that tell your body when it’s time to sleep and time to be awake. It has been found that people with ADHD often have irregularities in this signaling system that negatively impact sleep quality and quantity.
ADHD and Circadian Rhythm Dysfunction
It’s common for people with ADHD to have delayed circadian rhythms– known more commonly as “being a night owl.” With a delayed circadian rhythm, your sleep signals are delayed by two hours or more beyond what is considered a normal bedtime. As a result, it’s harder to fall asleep and you have a tendency to want to sleep in. You might feel more comfortable living life as a semi-nocturnal being, but society isn’t really set up for that lifestyle.
There is also evidence that there is less stability in daily rhythms, which can negatively impact how efficiently you sleep. These daily rhythms control signals for alertness and downtime, which could leave you feeling sleepy and alert at the wrong times.
The fix? Find your rhythm. Cues like light and darkness are extremely important for maintaining a healthy circadian rhythm. People with ADHD often find they sleep better while camping outside, likely because of the natural exposure to light and darkness. If sleeping outside forever isn’t your jam, you can build a healthier rhythm by getting 20 minutes of light exposure in the morning, or use artificial light like a happy lamp. Early light exposure can help shift your circadian rhythm backwards so that it’s easier to fall asleep at a “normal” hour.
Melatonin delays in ADHD
Melatonin is a key hormone for sleep. It gets released by your circadian alerting system in the evening before your normal bedtime to help you fall asleep, and your body pumps it during the night to keep you snoozing. Research has found that people with ADHD who have trouble falling asleep often have a delay in their melatonin release.
The fix? If you have trouble falling asleep and you have ADHD, you can try a melatonin supplement. Make sure to stick with a low dose (0.5-3mg) as that better mimics your body’s natural levels. You should also cycle off melatonin regularly so that it doesn’t negatively affect your natural production.
ADHD and Sleep Drive
Your sleep drive, or sleep pressure, builds up during the day due to rising levels of a chemical called adenosine. It peaks around 16 hours after you wake up resulting in you feeling sleepy and wanting to crawl into your bed. Although people with ADHD appear to have normal sleep drives, they are more likely to engage in behaviors that disrupt sleep pressure.
The most common sleep pressure disruptors among people with ADHD are excessive caffeine use and daytime napping. Caffeine binds to adenosine which can cause a delay in sleep pressure if you drink too much or have it too late. Napping resets adenosine levels, which also delays sleep pressure since your brain has to start over with the build-up.
The fix? Drink caffeine wisely and nap strategically. Avoid caffeine within around eight hours of bedtime and try to stick to 400mg (4 cups) or less during the day. Try to keep naps to 20 minutes or less and get them in before 2 pm.
ADHD medications that impact sleep
Some people find that their sleep is greatly improved with stimulant medications. This is especially true for those who have a busy mind or high distractibility at night. It’s not uncommon for people to take their stimulant medications right before bed.
It’s also not uncommon for people taking stimulant medications to have sleep issues. The most common complaints are trouble falling asleep and poor quality sleep during the night. Many of the currently prescribed ADHD meds are extended-release, meaning that they stay active in your system for 8-16 hours.
The fix? You can decrease these side effects by making sure to take your medication at the same time every day (aim for early morning if you find it negatively impacts your sleep). You can also always talk to your doctor about switching medications or trying out four-hour doses instead of extended-release for meds like Adderall or Ritalin. There are several non-stimulant options like clonidine which may actually improve sleep.
Other Sleep Concerns with ADHD
The brain chemicals that are affected in ADHD also help regulate sleep. Serotonin tells our bodies when it’s time to fall asleep, norepinephrine helps us wake up, and dopamine regulates your circadian rhythm. These brain chemicals also get dysregulated with other disorders such as anxiety or depression, which commonly co-occur with ADHD. Getting treatment for these mental health conditions from a professional clinician is the best way to help better regulate these brain chemicals and improve your sleep.
Is good sleep even possible? It is! Your body has a very sophisticated sleep system, and it does its best to help you catch up on missed hours by sleeping more efficiently and getting you through your days when you haven’t slept well. You can improve your sleep through some key habit changes that help you optimize your body’s natural processes for sleep. You may have more challenges than others when it comes to sleep, but it’s absolutely possible to get the sleep you need.
How to Sleep Better When you Have ADHD
Improving your sleep with ADHD doesn’t have to be a painful process. You don’t have to change everything at once– start with a few key changes and gradually improve your sleep habits (also known as sleep hygiene) over time. Here are some key changes you can focus on to improve your sleep as a person with ADHD:
Boost your sleep environment: In addition to an inviting bed, some decluttering, and a cool room (between 60 to 67° F or 16 to 19° C)– you can absolutely transform your sleep by adding in a sound machine and sleep mask or blackout curtains. Sounds like pink noise (think ocean waves and rain) have been shown to boost sleep stability. A sleep mask or black-out curtains helps keep things dark, which boosts melatonin production.
Stimulus control: Stimulus control is the clinical word for “stop doing stuff in your bed that isn’t sleep.” When you do activities in your bed like watching TV, working, or rage texting your ex, your brain begins to associate these activities with the bed. Your body runs on programs like this, and strengthening the program of bed= sleep (and sex) means having an easier time falling asleep.
Keep regular: Ok, we get it! This one is hard. Do your best to focus on one consistent thing, such as waking up at the same time every morning. Try scheduling something fun in the morning to give yourself an incentive. Buy special coffee, do some yoga, walk your dog, get a bullet journal and have fun with creativity– whatever works to get you looking forward to mornings!
See the light: Getting 20 minutes of natural light in the morning is an ideal way to help regulate your circadian rhythm. If that’s not feasible, grab yourself a happy lamp and set it up at your desk for some morning light sessions. Light is one of the most important cues for keeping a healthy circadian rhythm, which is often dysregulated in ADHD.
Log off: Putting away electronics an hour or so before your desired bedtime can have a massive effect on sleep. Scrolling your phone is emotionally activating and also emits blue light. Blue light suppresses melatonin two times longer than other types of light. It will also help you prevent traveling down rabbit holes of weird content in the wee hours of the morning. You can also help your body produce a bit more melatonin by turning off overhead lights and using a red light bulb before bedtime.
As we continue to better understand the importance of quality sleep, more focus has shifted to sleep problems in ADHD. Although there are physiological reasons for some of the sleep issues, when it comes to sleep– habit changes are very powerful. If you find that even with positive changes your sleep issues are negatively impacting your life, you should aim to get a consultation with a sleep specialist. Programs such as cognitive behavioral therapy for insomnia (CBT-I) are a great way to build awesome sleep habits under professional guidance.
Taking control of your ADHD is a vital first step for improving the way you sleep. Frida offers a free screening tool to help you determine if you’re eligible for a diagnostic assessment. You will also get access to a treatment plan and ongoing support from the comfort of your own home. Click here to get started today and take back control of your life and your sleep!