Is There a Link Between ADHD and Sleep?
People with ADHD are more likely to have shorter sleep times, trouble falling asleep and staying asleep, and a higher chance of developing a sleep disorder starting around puberty. Nightmares5 are common in children with ADHD, particularly those who also suffer from sleeplessness. Although sleep issues in early childhood6 are a risk factor for future emergence of ADHD symptoms, they tend to increase with age in those with ADHD.
Even people who aren't hyperactive during the day can have racing thoughts and a rush of activity at night, which can make it difficult to sleep. Because there are less distractions at night, some people find it easier to "hyperfocus" on a project. Unfortunately, this makes it harder to fall asleep and can lead to a sleep-wake cycle that is interrupted. Insomnia may worsen over time when people develop stress-related sensations around bedtime.
As a result of insufficient sleep, many persons with ADHD feel daily tiredness and difficulties waking up. Others have restless, non-refreshing sleep, as well as frequent nightly awakenings.
Sleep issues in people with ADHD appear to vary depending on the type of ADHD they have7. Individuals with primarily inattentive symptoms are more likely to sleep later, while those with primarily hyperactive-impulsive symptoms are more likely to have insomnia. Those with ADHD who have both hyperactive-impulsive and inattentive symptoms have poor sleep quality and go to bed later.
Many of the symptoms of ADHD resemble those of sleep deprivation. Adult ADHD sleep issues include, among other things, forgetfulness and difficulty concentrating. Fatigue in children might manifest as hyperactivity and impulsivity8. It's sometimes difficult to distinguish whether these problems are caused by ADHD or a lack of sleep. This could lead to misdiagnoses or sleep disorders going unnoticed. As a result, experts advise screening patients for sleep issues before providing ADHD medication.
What's the Science Behind the ADHD-Sleep Link?
Impaired arousal, alertness, and regulatory pathways in the brain may be a secondary effect of ADHD sleep issues. Other researchers believe that ADHD sleep issues are caused by a delayed circadian rhythm and melatonin synthesis that starts later9. Despite the fact that many sleep disorders and ADHD symptoms are comparable, research has failed to identify consistent sleep abnormalities in ADHD patients.
The soothing effects of stimulant drugs, which are widely recommended for ADHD, help some people sleep better. Stimulant medicines, on the other hand, can create a variety of sleep issues in their own right for many people. Sleep problems are likely to be exacerbated by coexisting conditions such as anxiety, depression, or substance addiction, as well as poor sleep hygiene.
What Are the Consequences of ADHD Sleep Issues in Day-to-Day Life?
Despite the lack of research on ADHD and sleep problems, children and adults with ADHD and a sleep issue frequently report more severe ADHD symptoms and a lower quality of life. They may also have a higher BMI and be more prone to depression, anxiety, hyperactivity, inattention, and difficulties processing information. Chronic sleep deprivation makes people vulnerable to physical health concerns in the long run.
Sleepiness during the day might have a negative impact on education and job. People may judge a person with ADHD for sleeping at odd hours, not recognizing that this is a common symptom of the disorder and impossible to avoid. Sudden drowsiness can be problematic when driving or doing other activities that require concentration.
Daytime weariness can be caused by a lack of sleep at night. People with ADHD may be grouchy, impatient, restless, or weary, and they may have problems paying attention at school or at work. These signs and symptoms can be confused for those of a mood disorder. An increased incidence of sleep disorders has been linked to anxiety and behavioral difficulties in children with ADHD.
Families and caregivers of people with ADHD are also affected by these issues. According to preliminary study, primary caregivers of children with ADHD and sleep issues are more likely to be unhappy, anxious, stressed, and tardy to work.
What Sleep Disorders Are Commonly Found in ADHD Patients?
People with ADHD have higher-than-normal incidence of specific sleep problems, in addition to generalized insomnia. Because the symptoms of ADHD are frequently confused with those of several sleep disorders, underlying sleep disorders may go undetected. Children, in particular, may have trouble expressing their emotions, leading to a misdiagnosis of ADHD when their issues are actually caused by a sleep disturbance. They could also have ADHD and a sleep issue.
Circadian Rhythm Sleep Disorder (CRSD): Most people with ADHD, especially teenagers, are more alert in the evening. It may be challenging to keep work or school commitments due to this unusual schedule. Circadian rhythm sleep difficulties in people with ADHD may be caused by a smaller pineal gland, clock gene anomalies, and delayed melatonin release. It may be possible to modify your schedule by taking melatonin pills at specific times or employing bright light treatment.
Sleep-Disordered Breathing: Up to one-third of ADHD patients suffer from sleep-disordered breathing (SDB), which includes snoring and sleep apnea. SDB produces sleep disturbances and daytime drowsiness, as well as ADHD-like symptoms. Treatment for SDB may minimize the requirement for stimulants in children with ADHD, which is good news. Tonsillectomy10 has been shown to benefit children with ADHD and sleep apnea symptoms, while CPAP equipment are a better option for adults.
Restless Legs Syndrome (RLS) is a condition in which people experience tingling feelings in their legs that make it difficult to fall asleep. Nearly half of patients with ADHD have RLS or other types of periodic limb movement disorders. Both ADHD and RLS children appear to spend more time in stage one light sleep11, which is less restorative. RLS is thought to be caused by iron and dopamine deficits, both of which have been linked to ADHD. Iron supplements or dopaminergic medications may be used to treat RLS.
Narcolepsy is a condition in which people fall asleep unexpectedly during the day and have trouble sleeping peacefully at night. Adults with narcolepsy are twice as likely to have experienced attention deficit hyperactivity disorder (ADHD) as children. While the link between the two isn't apparent, experts suspect that narcolepsy-induced sleepiness may exacerbate ADHD symptoms. It's also possible that both problems are caused by the same thing, such as a faulty gene or a neurotransmitter problem. Medication is usually used to treat narcolepsy.
Treating underlying sleep disturbances is a crucial step in helping people with ADHD sleep better. Request a sleep study from your doctor to rule out any secondary sleep disorders that may require treatment in addition to your ADHD. Potential sleep disorders should be monitored on a regular basis by a skilled doctor, as they tend to grow over time.