ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate and the long-acting atomoxetine can actually enhance sleep.
But people with ADHD can still have trouble getting restful sleep. They often toss and turn and wake frequently. Even when they do get to sleep their minds are active.
Medicines
A significant proportion of adults with ADHD have sleep issues. Although the literature in the field does not usually address these problems, they are reported to be common. Parents, patients and clinicians often report difficulties falling asleep or staying asleep, waking up at night or nocturnal activity as well as drowsiness during the daytime. Objective measures like polysomnography, actigraphy and subjective measures such as diary entries or self-rated questionnaires have been found to show statistically greater sleep impairments among people with ADHD than controls.
The most commonly prescribed drug for ADHD is stimulant-class medication, which can enhance focus and concentration, but may interfere with sleep in certain patients. In fact it is recommended that the main sleep disorder, like narcolepsy, be ruled out prior to introducing these medications (Spruyt and Gozal 2011).
Stimulant-class medications can cause an abrupt increase in the amount of time you are awake and a decrease in sleep efficiency. Sleep disturbances could result from a decrease in the production of melatonin or an effect directly on the nervous system. Additionally, stimulants may trigger a sedating side effect, a paradoxical agitation in a few people.
A controlled study that was randomized to the drug ramelteon which stimulates the melatonin receptor, and is thought to entrain circadian rhythms, found that insomnia improved in people with ADHD treated with this drug as compared to placebo. This was a brief, preliminary study with little power and a limited controls, but it should be a catalyst for future research that will further explore the timing, dosage, and recording of insomnia and the levels of blood ramelteon during the daytime and its counterparts.
Clonidine, mirtazapine and trazodone are other medications which have been used to treat insomnia in people suffering from ADHD. However, these are less well studied and many clinicians prefer not to use them in people with ADHD because of their potential for sedation into the next day.
If someone who suffers from ADHD has insomnia, they should first make an effort to maintain good sleep hygiene. They can also take their ADHD medication 45 minutes before the time of bed. This strategy has proven successful in my practice for the majority of people who have sleep problems and ADHD. If it doesn't work for you, an melatonin supplement could be considered.
Diet
The type of food that is consumed by a person can impact their mood. A diet rich in nutrients and balanced may help to reduce ADHD symptoms including sleep problems. Foods should be low in processed fat and sugar, and rich in nutrients, such as fruits, vegetables, whole grains, lean proteins and healthy fats including omega-3 fats. Cooking at home is a great way to ensure that one's meals contain all of the essential ingredients required for a healthy lifestyle however, many people with ADHD find meal planning and cooking difficult. In these situations individuals may turn to takeout or restaurant meals, which can be high in sugar, sodium and artificial ingredients that can increase ADHD symptoms for some individuals.
People suffering from ADHD have difficulty falling asleep at late at night. In reality, sleep problems are the most common complaints that people with ADHD complain about. These sleep problems can lead to a reduced quality of life as well as more depression, anxiety, and stress.
Sleep issues can be caused by many factors, including symptoms of ADHD or other causes. Certain medications that treat ADHD such as methylphenidates can cause sleep issues in some people. Additionally, those with ADHD tend to have a smaller pineal gland, which could affect the way in which the body regulates its circadian rhythm.
To help adhd anxiety medication with ADHD to sleep better, doctors typically recommend a combination of treatment options. This means establishing a regular sleeping routine and optimizing your sleep environment (such the creation of an unlit and peaceful bedroom) and limiting screen-time before going to bed. It is also important for adults to ensure they get enough sleep, which is usually 7 to 9 hours per night.
Exercise can help people with ADHD sleep better. Before bed, a few minutes of gentle stretching and deep breathing exercises can help calm the mind and body. This will lead to an improved night's sleep.
Exercise
Certain people with ADHD have difficulty to maintain a fitness routine. A personal trainer will provide the structure, motivation and accountability, while incorporating the individual's preferred exercise into a fitness regimen. Aerobic exercise can provide physical and mental benefits. Furthermore including strength training and mind-body exercises like yoga, tai-chi, or breathing exercises provides an all-encompassing method of managing ADHD symptoms, and improves the cognitive function, emotional well-being, and self-regulation.
Aside from helping people lose weight and build muscle mass, exercise can also have other positive effects on the brain, including raising levels of norepinephrine and dopamine. Dopamine and norepinephrine are neurotransmitters that help improve control and concentration. Exercise also increases the growth of neurons as well as strengthens connections between them. This is particularly evident in the cerebellum, a region that contributes to fidgeting in some individuals with ADHD. Research has revealed that the sport of judo can increase dopamine and norepinephrine levels in the cerebellum. This is higher than running on a treadmill.
The medicines used to treat ADHD could cause negative side effects that can include a decrease in sleep. This is why it's important to discuss the medication a person is taking with their physician or health care professional and to establish healthy sleeping habits.
Many people with ADHD struggle to fall asleep. They may wake frequently, twirl and turn, or fall into what is known as "the sleep of the dead." Their minds restlessly wander from one thought to another until they finally close off their day-to-day routines and fall into a peaceful sleep.
In my practice I have seen at least 80 percent of my adult patients suffering from sleep disorders exhibit this pattern. These issues aren't just due to ADHD and are actually an integral part of the disorder itself. It's hard for adults with ADHD to maintain a precise internal clock, which could be partly responsible for the difficulty of falling asleep. Additionally, they have trouble judging the length of time they've been in the bed. In reality the process of completing a sleep study typically requires several nights of nightly sleep logs, which is challenging for someone suffering from ADHD to complete accurately.
Sleep Environment
Sleeping well is a challenge for all, but it's especially difficult for those who suffer from ADHD. It is difficult to fall asleep or relax due to the anxiety and racing mind that are associated with ADD. Many of the medications prescribed to treat ADHD have side effects that can disrupt sleep, like insomnia. Therefore, it is essential that those suffering from ADHD maintain a good sleeping routine and adhere to a regular routine. They should also set up a calm, relaxing bedroom.
Sleep disorders can also hinder the ability of those with ADD to get enough restful sleep. Sleep apnea is a condition where breathing stops intermittently throughout the night as well as depression, anxiety and menopausal-related issues like night sweats could all be included. Individuals with ADHD should always have their sleep problems evaluated by a medical professional to determine the underlying causes.
Research has revealed that those with ADHD have lower quality sleep than their peers and are more likely to report being tired and slow throughout the day. This is due in part to the erratic nature of their sleeping, which can be made worse by their inability to regulate their internal circadian clock. However, it is also possible that the sleep problems are the result of the effects of medication or comorbid disorders.
People suffering from ADD, especially those who are treated with stimulants, often have difficulty falling asleep and awakening frequently at night. In fact, sleep onset latency and sleep quality are found to be significantly lower for those who are taking stimulants in comparison to those who are on placebos in certain studies.
Some people find that taking their ADHD medications right before bedtime improves sleep. This should be done with the advice of a doctor since certain medications can cause sleep disorders. Other methods to promote sleep, such as progressive muscle relaxation -- where you tensen and then release your muscles - and slow, deep breathing can be beneficial for people with ADHD. It's recommended not to make use of your bed for anything other than sex or sleep.