ADHD & Sleep: Finding Solutions for Better Rest

Introduction:- ADHD(Attention-deficit/hyperactivity disorder) is a neurodevelopmental disorder that impacts millions of people around the world. Essentially, it diminishes their ability to hold onto attention, to be overactive, and to have a tendency toward impulsive behavior. The relationship between ADHD & Sleep is a crucial aspect that frequently gets overlooked.

Current research indicates that very often, people with ADHD experience a spectrum of sleep problems, which creates a vicious cycle that worsens the ADHD and also the sleep problems. The toxic interaction between ADHD & Sleep has even more significant implications on daily functioning, health, and quality of life.

ADHD and Sleep: An Intimate Alliance

People with ADHD may suffer from sleeplessness; yet, the trouble is not the same for the identical group. The majority of patients with ADHD report that they either cannot fall asleep at night, wake several times while resting, or feel somnolent during the day despite having slept enough hours. Commonly, these events are consequences of sleep pattern changes caused by the characteristics of ADHD symptoms, such as being overactive, inattentive, or failure in planning a routine.

This calls for discipline more than for anyone else to patients suffering from ADHD as inattentiveness, racing thoughts, or restless energy can easily prevent patients with ADHD from unwinding before sleep. Moreover, most ADHD medications are stimulants that may trigger insomnia and create a vicious cycle where the problems of sleep aggravate the symptoms of ADHD, and poor regulation of ADHD leads to larger problems with sleep.

Common Sleep Disorders among ADHD Patients

Some other sleep disorders to which those suffering from ADHD are very prone include insomnia: Inability to sleep or stay asleep is common in people who have ADHD. Racing thoughts, hyperactivity, and the inability of the mind to “turn off” make it extremely difficult for these people to drift off into restful sleep.

• Delayed Sleep Phase Syndrome (DSPS): Many with ADHD are considered “night owls.” People find themselves sleepiest in the morning and most awake in the evening. This is simply a result of an individual’s natural circadian rhythm getting out of sync with the external demands on sleep.
• Restless Leg Syndrome (RLS): Some individuals with ADHD have RLS. RLS is a clinical disorder featuring an irresistible urge to move the legs: usually associated with unpleasant sensations in the legs. This alone creates sleep difficulty, falling asleep, and staying asleep.
• Sleep Apnea: Many studies show that people with ADHD also tend to have sleep apnea: recurrent episodes of breathing cessation during sleep. Poor quality sleep due to these disruptions affects attention further.

The vicious cycle of ADHD & Sleep

The bi-directional relationship between sleep and ADHD is such that the symptoms of ADHD can directly affect sleep, but sleep deprivation or poor-quality sleep exacerbates the symptoms of ADHD.

• Hyperactivity and Sleep Problems: Hyperactivity linked to ADHD contributes to the inability of children and adults alike to relax at night. Even an adult can get the feeling of the body being stuck in a state of “go mode.” Many children with ADHD have difficulty winding down at bedtime. This leads to being unable to sleep and thus having fewer hours for rest.
• Impulsivity and Poor Sleep Hygiene: The central symptom of ADHD is impulsivity; this actually prevents an individual from following the routine bedtime. He might be surfing on his television and playing video games or doing something else that stimulates him or gratifies him, knowing that he should sleep.
• Nighttime:  The inability to focus during the day can be transferred to the night as one keeps battling with intruding thoughts, anxieties, or worries that cannot be silenced. This may eventually result in insomnia, where the mind remains operational when the body wants to rest.
• The Role of Medication: ADHD medications can also cause problems with sleep, especially if someone takes a stimulant medication like methylphenidate or amphetamines. These are very effective in the daytime but interfere with the onset of sleep if taken too late in the day or early in the evening. Conversely, unmedicated, the symptoms of ADHD can intensify in a way that makes it difficult to establish any kind of regular sleep schedule.

Impact of Deprivation on ADHD & Sleep Symptoms

Poor sleep has profound effects on the ADHD symptoms. Sleep loss somewhat degrades other cognitive functions such as attention, memory, and executive functioning, all of which are already degraded in individuals with ADHD. Thus, sleep-deprived people are much more likely to exhibit irritability, mood swings, or other maladaptive behaviors that express heightened ADHD symptoms.

Working memory and learning impairments are already problems that come with ADHD. However, when it interacts with poor sleep, it becomes even more complicated. Experts have verified that sleep is critical in the consolidation of memory and processing information as part of supporting learning. Sleep loss significantly impairs this process, putting a child suffering from ADHD at an even greater disadvantage.

• Emotional Dysregulation: This is yet another proven impact of sleep deprivation: it negatively impacts emotional regulation by providing higher scores for irritability, frustration, and mood swings. For those who already tend to be emotionally uncontrolled in ADHD, a night without sleep will push the act still further.
• Diminished Impulse Control: Sound sleep is important for the executive brain functioning that performs control of impulses. Poor sleep affects the brain’s ability to resist temptation and plan; on top of this, the individual begins to make less rational decisions. This can be worse for individuals suffering from ADHD as their initial problem is a lack of impulse control.

Improvement Strategies in People with ADHD & Sleep Disorder:

The toxic relationship between ADHD & Sleep should be addressed from a holistic approach that considers the symptoms of ADHD along with the sleep disorder.

• Establish a Routine: A bedtime routine regularizes your body’s internal clock. Try going to bed and waking up at the same time every day, even on weekends. This will help your body adjust and learn how to sleep more easily.
• Reduce Stimulants: Try to minimize your intake of caffeine, sugar, or other stimulating activities in the evening. This can interfere with your capacity for winding down.
• Medication Timing: If on ADHD medication, discuss this with your doctor to either adjust the timing or medication dosage. Taking medication early in the day will help minimize this disruption as much as possible.
• CBT: CBT-I for insomnia has been successful in the treatment of sleep problems in the ADHD population. This therapy helps a patient change unsleep-promoting behaviors and work through the thoughts that impede sleep.
• Sleep Environment: The sleep environment needs to be made inviting. This includes the right mattress, removal of distractions such as a TV or mobile phone, and a light- and quiet-free room.

Conclusion of ADHD & Sleep

The snarled and vicious relationship between ADHD & Sleep is complex and deeply destructive, especially because sleep problems can trigger ADHS symptoms, and ADHS symptoms can trigger sleep problems.  Breaking this cycle should, therefore, be understood in terms of specific sleep challenges that go along with ADHD and its implementation in strategies to improve sleep hygiene. This would make it possible to reduce the negative impact of sleep issues on both the ADHD symptoms and the quality of life as a whole.