Got insomnia? It’s not just you: sleep disorders are very common with ADHD.
If you have ADHD, you already know how it can disrupt your focus during the day, but what about at night? You might find yourself doing more daydreaming than actually dreaming—or even showing telltale signs of sleep disorders like sleep apnea or restless leg syndrome.
It’s not you: Sleep issues in adults with ADHD are incredibly common, says psychiatrist Susan Samuels, MD, of New York Presbyterian and Weill Cornell Medicine.
Research shows that people with ADHD experience sleep differently than those without it. For example, they spend less time in REM sleep, the time when people are at their deepest sleep and typically dream. They also don’t enter stage four sleep, which is a restorative phase of the night, and they tend to have more arousals in the night that cause them to wake up.
One theory is that adults with ADHD have a different circadian rhythm, which is your “body clock” responsible for many different body functions, including how you mentally and physically respond to daylight and darkness. Those with ADHD may have a delayed sleep-phase disorder, which means they often need to go to sleep later than usual and wake up later too. That could make functioning in a 9-to-5 work world particularly challenging.
If you have ADHD and getting quality sleep is hard for you, here’s some advice from Dr. Samuels.
Plan for 7-8 hours. Getting the right amount of sleep at night may actually reduce ADHD symptoms and improve your quality of life, according to the National Sleep Foundation, by giving you sharper focus for the day. Simply prioritizing sleep and aiming to give yourself a regular bedtime could have an impact.
Avoid stimulating activities before bed. As a general rule, give yourself a two-hour window before you need to sleep to make sure your brain has time to wind down. Say “no” to Netflix, big meals, or cat videos on YouTube during that window; instead, use that time to knock out boring, routine tasks like folding laundry or emptying the dishwasher.
Save your bed for sleeping. Once you get into bed, avoid the temptation to browse your phone or watch TV, or else your brain may start to associate your bed with these stimulating activities. (Here are more sleep hygiene tips to improve your quality of sleep.)
Avoid caffeine after lunch. This one’s obvious: That 4 pm cup of coffee may sharpen your mind for the rest of the workday, but it may keep you alert into the night when you’re trying to sleep. Instead, try chamomile tea in the evening, which is naturally decaf and has a soothing, mildly sedative effect.
Reset your internal clock. Expose yourself to sunlight first thing in the morning and dim the lights in the evening to help adjust your circadian rhythm and train your mind into an earlier bedtime.
Ask your doctor about medications or supplements. For example, restless leg syndrome affects around 44 percent of people with ADHD and can have a negative impact on sleep quality. Medicating for restless leg syndrome may improve your ability to doze off and get a full seven hours. Supplements of melatonin, a brain chemical involved in the sleep cycle, may help too. .
Consider a sedating, non-habit-forming antihistamine. Many people with ADHD find this OTC antihistamine helpful in falling asleep, but for others, it may cause extreme drowsiness in the morning and may not be best for everyone. As always, consult a doctor to find the right medication or supplement for you.
Dr. Samuels is an assistant professor of clinical psychiatry and clinical pediatrics at Weill Cornell Medicine and an assistant attending psychiatrist at NewYork-Presbyterian Hospital.
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Sleep issues in adults with
ADHD are incredibly common.
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My patients often have a hard time falling
asleep, difficulty staying asleep during
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the middle of the night, and even trouble
waking up feeling refreshed and not tired.
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Research on people's brainwaves
show that people with
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ADHD experience sleep differently
than people without it.
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They have less REM sleep,
they don't enter stage four sleep,
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which is very restorative, and
they often have more arousals.
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While experts used to think that
sleep issues in ADHD were mainly
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a result of taking stimulant
drugs to treat the ADHD,
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we now know it's more
complicated than that.
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Sleep issues are a direct
result of ADHD itself.
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One explanation is that the Circadian
clock of people with ADHD is different.
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They tend to need to go to sleep later and
wake up later.
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If you have ADHD and struggle to get
the sleep you need, here's some advice.
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First, recognize how important sleep
is in helping you manage your ADHD.
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You might think it's
okay to get by on 5 or
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6 hours of sleep, especially you
don't feel tired at 10 or 11 PM.
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But know that a good night's sleep can
go a long way towards helping you have
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a sharper focus and
attention during the day.
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Don't engage in activities that cause
you to hyperfocus too close to bedtime.
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That could mean playing games
on your phone, or reading, or
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watching something very stimulating.
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Try to give yourself a two-hour window
before bed to let your brain wind down.
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Try to do boring, routine,
tasks like folding laundry, or
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emptying the dishwasher
right before bed instead.
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Get in your bed to go to sleep.
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This is rule number one for sleep hygiene.
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You don't want your brain to associate
your bed with things that keep it up,
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like online shopping or
checking your social media feeds.
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Avoid caffeine after lunch and
especially within a few hours of bedtime.
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Caffeine can make your ADHD brain more
alert, and because caffeine is also
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a mild diuretic, it can make you need to
use the bathroom and disrupt your sleep.
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If you think your body clock
is out of sync, this might
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be the case if you stay up very, very
late and prefer to sleep very, very late.
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You can try resetting it by
letting yourself get sunlight
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first thing in the morning and by dimming
the lights in your house in the evening.
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If you struggle with feeling
like a zombie in the morning,
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you could consider this tweak
to your medication routine.
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Set two alarms an hour apart.
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Let's say you want to wake up at 8 AM.
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Set your alarm first for
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7 AM, and take your first dose
of your ADHD medication then.
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Then, go back to sleep
until your 8 AM alarm.
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When the second alarm rings, your
medication will have had a chance to kick
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in, so you'll wake up feeling more alert.
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ADHD and sleep. Washington, DC: National Sleep Foundation. (Accessed on September 21, 2017 at https://sleepfoundation.org/sleep-disorders-problems/adhd-and-sleep.)
ADHD, sleep and sleep disorders. Lanham, MD: Children and Adults with Attention-Deficit/Hyperactivity Disorder. (Accessed on September 21, 2017 at http://www.chadd.org/Understanding-ADHD/About-ADHD/Coexisting-Conditions/ADHD-Sleep-and-Sleep-Disorders.aspx.)