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Posted by Alex Jordan

ADHD and sleep: How it affects sleep patterns and strategies for improvement

A man with ADHD laying down on his bed but unable to sleep
Medically reviewed by Dr. Shane Wolson on 29 October, 2024
6 minute read
Over 70% of people with ADHD experience ADHD sleep problems like insomnia and restless sleep [1].

ADHD has a direct impact on the brain’s ability to regulate attention, emotions, and behaviour, and these challenges extend to sleep as well. This guide will explain how ADHD and sleep are linked, common issues that arise, and offer practical tips to sleep better with ADHD.

Effective ADHD sleep solutions 

Sleep problems are common for those with ADHD. It’s not just about struggling to fall asleep; ADHD can also disrupt sleep quality throughout the night. This means individuals with ADHD often wake up feeling unrefreshed and tired, even if they’ve spent the recommended number of hours in bed. 

The link between ADHD and sleep issues isn’t fully understood yet, but researchers believe that ADHD’s effect on executive function and emotional regulation may play a key role. For instance, difficulty winding down at the end of the day, racing thoughts, and overstimulation can all make sleep harder to achieve. 

How ADHD affects sleep patterns 

Problems with sleep in ADHD are diverse and complex and may both aggravate and be aggravated by the symptoms of ADHD [7]. People with ADHD often have trouble relaxing in the evening, making it hard to fall asleep at a regular time. Their minds may race and be filled with thoughts about the day or what needs to be done tomorrow. In addition, transitioning from day to night or from one activity to another is generally more difficult for people with ADHD. This struggle to switch off can be a major contributor to ADHD sleep problems. 

In many cases, ADHD and sleep disturbances go hand-in-hand. One key issue is that ADHD can affect the body's circadian rhythm, the internal clock that regulates the sleep-wake cycle. This can make individuals feel more alert late into the evening and groggier in the morning when they need to wake up. As a result, many people with ADHD describe themselves as "night owls" who find it tough to maintain typical sleep schedules [2]. 

Even when they do fall asleep, many people with ADHD experience fragmented sleep. They may wake up frequently during the night or find that their sleep isn’t as deep and refreshing as it should be. This type of light, broken sleep means that people with ADHD can feel tired and irritable the next day, regardless of how long they were in bed [3]. 

Common sleep problems associated with ADHD 

Several sleep disorders and ADHD have been identified and can vary from person to person. 

Here are some of the most common sleep issues linked to ADHD: 

  • Insomnia: People with ADHD often find it hard to fall asleep, stay asleep, or they wake up too early in the morning. This can lead to sleep deprivation and exhaustion, which in turn can worsen ADHD symptoms [4]. 
  • Restless sleep: Even after falling asleep, many people with ADHD report that they experience ADHD and restless sleep. They toss and turn, wake up multiple times during the night, and struggle to feel rested in the morning [2]. 
  • Delayed sleep phase: This condition causes people with ADHD to have a natural sleep cycle that’s shifted later than usual, meaning they often fall asleep much later than most people. As a result, they may struggle with waking up on time in the morning [5]. 
  • Sleep apnea: Although not directly caused by ADHD, studies show that people with ADHD are more likely to experience obstructive sleep apnea, which causes breathing disruptions during sleep and can further reduce sleep quality [3]. 

In children, up to 50% of those with ADHD experience some form of sleep disorders, and many of these issues persist into adulthood [1]. As these problems continue over time, they can lead to increased fatigue, irritability, and even anxiety or depression. 

Practical strategies to improve sleep for ADHD patients 

The good news is that there are several ADHD sleep solutions that can help manage these problems and improve sleep quality. 

Here are some practical, actionable tips: 

  • Stick to a routine: Going to bed and waking up at the same time every day, even on weekends, is one of the most effective ways to regulate your body’s sleep-wake cycle. This consistency is particularly helpful for people with ADHD, as it reduces the impact of ADHD sleep problems by creating predictable patterns [3]. 
  • Limit screens before bed: The blue light from phones, tablets, and other electronic devices interferes with the production of melatonin, the hormone that helps you fall asleep. To sleep better with ADHD, try to stop using these devices at least an hour before bedtime. Instead, engage in relaxing activities like reading or listening to calming music [6]. 
  • Wind down with relaxing activities: Establishing a wind-down routine can help signal to your body and mind that it’s time to sleep. Activities like reading, taking a warm bath, or practising mindfulness can reduce stress and calm your mind before bed. This helps counteract the racing thoughts that are often part of ADHD sleep problems. 
  • Watch what you eat and drink: Avoid caffeine in the afternoon or evening, as it can make falling asleep more difficult. Heavy meals or sugar-laden snacks before bed can also cause disruptions in sleep, so stick to light snacks in the evening if you feel hungry [2].  
  • Make your bedroom comfortable: Creating the right sleep environment is key to managing ADHD and restless sleep. Keep the room cool, dark, and quiet. You can also use earplugs or a white noise machine to block out any unwanted noise. Investing in a comfortable mattress and pillow can make a big difference too [7]. 

These small adjustments can go a long way in reducing ADHD sleep problems and promoting better, deeper sleep. 

Medical treatment options for ADHD-related sleep issues 

If behavioural adjustments aren’t enough, there are medical options that can be explored to help manage ADHD sleep problems. 

Here are a few potential treatments: 

  • Melatonin: This natural hormone helps regulate the sleep-wake cycle. Many people with ADHD find that taking melatonin supplements can help them fall asleep more easily and get the rest they need. However, melatonin should be taken under the guidance of a healthcare professional to ensure proper dosing [7]. 
  • Sleep medications: In some cases, doctors may prescribe short-term sleep aids. These can be useful for addressing temporary sleep disruptions, but they should be used cautiously due to the potential for dependency. Speak with your doctor to discuss the pros and cons of sleep medication [8]. 
  • Cognitive behavioural therapy for insomnia (CBT-I): This is a non-drug treatment that addresses the thoughts and behaviours that interfere with sleep. CBT-I helps people with ADHD and insomnia develop healthy sleep habits, reduce anxiety about sleep, and address the root causes of ADHD sleep problems [6]. 

Before starting any medical treatment, it’s important to consult a healthcare provider to find the best solution for your needs. 

The role of ADHD medication in sleep problems 

In addition to sleep-specific medications, ADHD treatments themselves can play a role in ADHD sleep problems. Stimulants like Ritalin and Adderall are commonly prescribed to manage daytime ADHD symptoms, but they can make it harder to sleep, particularly if taken later in the day [4]. 

For some, switching to non-stimulant medications like Strattera may help, as these drugs are less likely to interfere with sleep. Adjusting the timing or dosage of stimulant medications can also minimise their impact on sleep. If you suspect your medication is contributing to ADHD and insomnia, it’s important to have an open discussion with your doctor to explore other options [5]. 

ADHD and sleep challenges are common, but they don’t have to be a permanent struggle. By establishing a consistent bedtime routine, limiting screen time, and creating a comfortable sleeping environment, people with ADHD can take steps to sleep better with ADHD. For those who continue to struggle with sleep despite making these adjustments, there are medical treatments and therapies that can help. 

Improving sleep can lead to better control of ADHD symptoms during the day, as well as an overall improvement in mood, attention, and quality of life. If sleep issues are persistent, seeking professional advice is key to finding the right ADHD sleep solutions. 


How HealthHero can help?

We offer specialist support for those dealing with ADHD sleep problems. Our team of healthcare professionals can provide advice, treatments, and tailored solutions to improve your sleep and well-being. Contact us today to learn how we can help you sleep better and feel more in control of your ADHD symptoms. 


Sources

  1. ADHD Ireland. https://adhdireland.ie/general-information/adhd-faq/ [Date accessed October 14, 2024]
  2. HSE. The good sleep guide. https://www.hse.ie/eng/about/who/cspd/medicines-management/bzra-for-anxiety-insomnia/the-good-sleep-guide.pdf [Date accessed October 14, 2024]
  3. Sleep Foundation. ADHD and sleep. https://www.sleepfoundation.org/mental-health/adhd-and-sleep [Date accessed October 14, 2024]
  4. HSE. Occupational therapy and ADHD. https://www.hse.ie/eng/about/who/cspd/ncps/mental-health/adhd/resources/occupational-therapy-and-adhd.pdf [Date accessed October 14, 2024]
  5. HSE. ADHD in Adults. National Clinical Programme. https://www.hse.ie/eng/about/who/cspd/ncps/mental-health/adhd/ [Date accessed October 14, 2024]
  6. Medical News Today. ADHD and sleep. https://www.medicalnewstoday.com/articles/adhd-and-sleep [Date accessed October 14, 2024]
  7. Hvolby, A. (2014, August 17). Associations of sleep disturbance with ADHD: Implications for treatment. ADHD Attention Deficit and Hyperactivity Disorders, 7, 1-18. https://link.springer.com/article/10.1007/s12402-014-0151-0 [Date accessed October 14, 2024]