25 to 50% of people with ADHD have sleep problems that intensify with age.
Looking back at childhood, adults with ADHD can often recognize that they had challenges with falling asleep, waking up, daytime sleepiness, and frequent nightmares that seemingly had no clear cause. Hyperactive thoughts often interfere with going to sleep. Sometimes, the night is the only period of the day without distractions, which disrupts the sleep-wake cycle.
Some studies link the predominantly inattentive type of ADHD with later bedtimes, while the predominantly hyperactive type is associated with insomnia.
People with sleep deprivation due to ADHD often develop frequent mood swings such as grumpiness, irritability, and restlessness, and these symptoms can be mistaken for a mood disorder.
This makes it difficult to determine what came first – sleep disorders that exacerbate ADHD symptoms or unregulated ADHD that leads to the development of sleep disorders.
What is the connection between ADHD and sleep?
Sleep problems in ADHD can stem from disruptions in the brain’s circuits that control arousal, alertness, and regulation.
Other researchers believe that sleep problems in ADHD are linked to a disrupted circadian rhythm.
Additionally, brain studies have shown a smaller size of the pineal gland (epiphysis), which secretes the hormone melatonin that regulates wakefulness and sleep. As a result, there is a delayed onset of melatonin synthesis.
Comorbidities such as anxiety, depression, and poor sleep hygiene worsen sleep difficulties. In the long term, chronic sleep deprivation makes individuals vulnerable to developing associated physical health problems, such as eating disorders due to energy dips throughout the day, mood disorders, weight gain, and a weakened immune system.
What are the most common sleep disorders in people with ADHD?
- Sleep-disordered breathing: Snoring and sleep apnea affect up to one-third of patients with ADHD
- Restless legs syndrome: Affects nearly 50% of people with ADHD. Some studies link this syndrome to a deficiency in iron and dopamine
- Narcolepsy: It is twice as common in people with ADHD. Individuals with narcolepsy tend to fall asleep suddenly during the day and may have difficulty maintaining deep sleep at night. It is treated with medication
- Nightmares and vivid dreams: A reflection of internal hyperactivity and excessive thinking
- Teeth grinding
- Short and light sleep
- Difficulty falling asleep
- Difficulty waking up
- Insomnia
What worsens these sleep problems?
- Hyperactive mind
- Overthinking
- Sensory factors (too hot or too cold in the room, too light a blanket, noise, lighting)
- Excessive stimulation before sleep
- Scrolling
- Screens in the bedroom
- Late-night eating
- Too much stimulation at the end of the day
Tips for good sleep hygiene
- The bedroom is reserved for sleep and sex
- Sufficient exercise in the first part of the day
- Go to bed and wake up at the same time every day, choosing a time that is realistic and sustainable in the long term
- Tell yourself “Stay awake!” instead of “Go to sleep!” The ADHD brain tends to do the OPPOSITE of what it’s told
- Light stimulation before sleep (calming music, a “brain break” book, a comedy series, time with pets, a bath, …)
- A darkened room and/or wearing a sleep mask
- Cool the room before sleep
- Wear silicone earplugs
- Heavy blanket
- Place your phone in a box out of reach at least 30 minutes before bedtime
- Exposure to sunlight early in the morning (vitamin D helps with better dopamine synthesis).
- Releasing hyperactive thoughts through journaling or writing to-do lists before bed
- Melatonin supplements
- Light therapy
- Medications prescribed by a psychiatrist familiar with ADHD, as some ADHD medications can counteract the effects of sleep medications and vice versa.
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