Individuals with ADHD frequently experience sleep problems, with estimates suggesting that 50-75% of adults with ADHD report sleep issues. These problems can include insomnia (difficulty falling asleep or staying asleep), restless legs syndrome, and disruptions to the body’s natural sleep-wake cycle (circadian rhythm). The relationship is complex, with ADHD symptoms, medication side effects, and other sleep-related disorders potentially contributing to sleep difficulties.
Common Sleep Problems in ADHD
Insomnia: Many individuals with ADHD struggle with both initiating and maintaining sleep, leading to insufficient sleep duration and poor sleep quality.
Delayed Sleep Phase Syndrome (DSPS): This involves a shift in the body’s natural sleep-wake cycle, causing people to fall asleep and wake up later than desired.
Restless Legs Syndrome (RLS): An urge to move the legs, often accompanied by uncomfortable sensations, can disrupt sleep.
Sleep-Disordered Breathing (SDB): Conditions like snoring and sleep apnoea, which interrupt sleep and can lead to daytime sleepiness, are also more common in people with ADHD.
Difficulty Waking Up: Many individuals with ADHD experience significant difficulty waking up in the morning, even after a full night’s sleep.
WHY ARE SLEEP PROBLEMS COMMON IN ADHD?
ADHD Symptoms: Hyperactivity, restlessness, and impulsivity can make it challenging to settle down for sleep.
Medication Side Effects: Some ADHD medications, particularly stimulants, can interfere with sleep if taken too close to bedtime.
Neurotransmitters: Imbalances in neurotransmitters like dopamine, norepinephrine, and serotonin, which are involved in both ADHD and sleep regulation, may play a role.
Melatonin: People with ADHD may have a delayed release of melatonin (the sleep promoting hormone, not a sleeping pill, sedative or any other ‘drug’), a hormone that regulates sleep-wake cycles, making it harder to fall asleep.
Sleep Reactivity: Some individuals with ADHD may be more prone to experiencing sleep disturbances in response to stress or minor life events, potentially leading to insomnia according to the NIH.
THE IMPACT OF SLEEP PROBLEMS ON ADHD
Worsened ADHD Symptoms: Sleep deprivation can exacerbate ADHD symptoms like inattention, hyperactivity, and impulsivity, creating a cycle of poor sleep and increased symptom severity.
Increased Daytime Sleepiness: Insufficient sleep can lead to excessive daytime sleepiness, which can further impair cognitive function and daily functioning.
Difficulty Managing ADHD: Sleep problems can make it more challenging to implement coping strategies and manage ADHD symptoms effectively.
ADDRESSING SLEEP PROBLEMS IN ADHD
Consult with a Healthcare Professional: It’s important to discuss sleep concerns with a doctor or sleep specialist to rule out any underlying sleep disorders and determine the best course of action.
Prioritise Sleep Hygiene: Establishing a consistent sleep schedule, creating a relaxing bedtime routine, optimising the sleep environment, and limiting screen time before bed can improve sleep quality.
Consider Medication Adjustments: If ADHD medications are contributing to sleep problems, discuss potential adjustments with a doctor.
Cognitive Behavioural Therapy for Insomnia (CBT-I): This type of therapy can help individuals with ADHD develop strategies to manage insomnia and improve sleep habits.
Melatonin: In some cases, melatonin (the sleep promoting hormone, not a sleeping pill, sedative or any other ‘drug’) supplementation may be helpful.
As a clinic psychologist, Deb can help you understand the issues underlying any sleep/wake issues. Deb can assist you come up with a plan to change any unhelpful behaviours that are disrupting your sleep/wake cycle. We can work together in clinic or via telehealth (secure video platform).
Deb hasn’t been trained in CBT for sleep/wake disorders. If you think that you would benefit from CBTi for sleep/wake issues, I’d suggest that you contact your GP for a referral.
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