ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate and long-acting atomoxetine can actually help you sleep better.
But people with ADHD can still have trouble getting restful sleep. They twirl and change positions and are often awake. And even when they do sleep their minds are active.
Medicines
Sleep issues are reported by a large number of people with ADHD. Although the scientific literature doesn't usually discuss these problems however, they are believed as common. Parents, patients and clinicians often describe difficulty falling asleep or staying asleep, waking up at night as well as nocturnal activity, and fatigue during the day. Objective measures, like polysomnography and actigraphy, as well as subjective measures (eg self-rated questionnaires, self-rated questionnaires, and diaries) have been shown to show statistically higher impairments in sleep in people with ADHD compared to controls.
The most commonly prescribed medication for ADHD is stimulant class medications. These medications can improve focus and concentration however, they can also interfere with sleeping for some patients. It is crucial to rule out the primary sleep disorder like narcolepsy prior to taking these drugs (Spruyt and Gozal, 2011).
Stimulant-class medicine can trigger an abrupt increase in the amount of time you are awake and decrease in sleep efficiency. The sleep disturbances may result from a decrease in the production of melatonin, or an immediate effect on the nervous system. Additionally, adhd sleep medication may cause a sedating side effect, which can cause paradoxical agitation in some individuals.
A controlled study that was randomized to the drug ramelteon, which activates the melatonin receptor and is believed to regulate circadian rhythms, showed that insomnia was reduced in those suffering from ADHD who received this medication in comparison to placebo. This was a small preliminary study, with a limited power and few control groups, but it could be a catalyst for future research that will investigate the timing and dosage, the types of insomnia, daytime blood levels, and ramelteon's metabolites.
Other medications that have been used to treat insomnia in some people with ADHD include trazodone, clonidine and mirtazapine. However, they aren't as well studied and many clinicians prefer to avoid them in patients with ADHD due to their potential for sedation to the next day.
If someone who suffers from ADHD is experiencing insomnia, they should try to practice good sleep hygiene. They should also take their ADHD medication 45 minutes prior to the time of bed. In my practice, this approach is usually effective for the majority of people suffering from ADHD and sleep problems. If it doesn't work for you, a melatonin supplement can be considered.
Diet
The kind of food people eat can have a an immediate impact on their mood. A balanced, nutrient-rich diet can help improve ADHD symptoms that are associated with sleep. Foods that are low in sugar, processed fat and rich in nutrients, including vegetables, fruits, and lean proteins should be consumed. Whole grains and healthy fats like omega-3 fatty acids should be a part of the diet. Cooking at home is an excellent method to ensure that meals contain all of the essential ingredients required to be healthy however, many people with ADHD have difficulty planning meals and cooking difficult. In these situations individuals may turn to takeout or restaurant meals, which are high in sugar, sodium and artificial ingredients that can increase ADHD symptoms for certain people.
People with ADHD frequently have difficulty getting down to sleep at the end of the night. Sleep issues are among the most frequently reported complaints among those suffering from ADHD. These sleep issues can result in lower quality of life as well as an increase in anxiety, depression, stress and, in women over 40, menopausal symptoms like hot flashes.
Sleep issues can be caused by many factors which include symptoms of ADHD or other factors. Certain medications that treat ADHD such as methylphenidates can cause sleep issues in some people. In addition, those suffering from ADHD tend to have smaller pineal glands, which can affect how the body regulates its circadian rhythm.
To help those with ADHD to sleep better Doctors typically suggest a combination of treatment options. This means establishing a regular sleeping routine and optimizing your sleep environment (such by creating an unlit and peaceful bedroom) and limiting time spent on screens prior to going to going to bed. Adults should also make sure they get enough sleep, which typically is 7 to 9 hours per night.
Exercise can help adults with ADHD sleep better. A short stretch or a deep breathing exercise prior to bedtime can relax the body and mind and ensure a more peaceful sleep at the end of the night.
Exercise
Some people suffering from ADHD have difficulty sticking to a routine exercise. A personal trainer can provide discipline as well as motivation and accountability while incorporating the person's preferred exercise routine into a fitness plan. Incorporating aerobic exercises into your daily routine can give physical and mental benefits. Training for strength and mind-body exercises like Tai Chi, yoga or breathing exercises can be incorporated into the routine of your day to take an holistic approach to managing ADHD symptoms.
Aside from helping people lose weight and build muscle, exercising has other beneficial effects on the brain, such as raising levels of norepinephrine and dopamine. Dopamine and norepinephrine are neurotransmitters that enhance concentration and self-control. Exercise increases the number of neurons that are growing, and improves their connections. This is particularly evident in the cerebellum, an area that is known to cause fidgeting in some ADHD people. Studies have shown that judo training, as an instance, can raise dopamine and norepinephrine levels in the cerebellum more than just running on treadmills.
Treatments for ADHD can have adverse side effects, including decreased sleep. It's important that a person discuss their medication with a health professional and establish healthy sleep habits.
Many adults suffering from ADHD have difficulty falling asleep. They might wake up often, toss and turn, or sink into what some call "the sleep of the dead." Their minds restlessly wander from one thought to the next until they can finally put aside their day-to-day activities and drift to sleep.
In my practice, I've discovered that at about 80 percent of my adult patients who suffer from sleep issues have this pattern. These disturbances aren't just due to ADHD, but are a major component of the disorder. It is difficult for people with ADHD to maintain a precise internal clock, which may be a factor in the difficulty of falling asleep. In addition, they have trouble judging the length of time they've been in bed. A sleep study requires a regular sleep diary for several nights, which can be difficult for those with ADHD to accurately complete.
Sleep Environment
It is difficult to get a good night's sleep for all, but it's especially difficult for those who suffer from ADHD. It can be difficult to relax or fall asleep because of the agitation and racing mind that are associated with ADD. Many of the medicines prescribed to treat ADHD have side effects that can disrupt sleep, including insomnia. For these reasons, it is crucial for those suffering from ADHD to maintain good sleep hygiene, establish a regular sleep schedule and create a tranquil and comfortable bedroom.
In addition, people with ADD often suffer from co-occurring sleep disorders which can hinder their ability to get adequate amounts of restful sleep. Sleep apnea is a condition where breathing stops frequently during the night, depression, anxiety, and menopausal-related issues like night sweats could all be included. Sleep issues in people suffering from ADHD must be examined by a doctor to determine the reason.
Research has proven that those who suffer from ADHD have lower quality sleep than the rest of us and are more likely to report feeling exhausted and sluggish throughout the day. This is largely due to the erratic nature of their sleep, which is exacerbated by their inability to regulate their internal circadian clock. It is possible that sleep disturbances could be caused by medication side effects or concomitant conditions.
The inability to fall asleep to sleep and the frequent awakenings during the night are common for those suffering from ADD especially those treated with stimulants. In fact, sleep onset latency and sleep efficiency are reported to be significantly higher when taking stimulants as compared to those on placebos in a few studies.
Despite this, some find that taking their ADHD medication before bedtime helps to improve sleep. This should only be done on the advice of a doctor as certain medications can cause sleep disorders. Other methods to promote sleep, such as progressive muscle relaxation -- where you relax and tensen your muscles -- and slow, deep breathing can be helpful for adults with ADHD. It's also an excellent idea to make your bed solely to sleep or for sex and to avoid using it as a place to discuss problems or argue.