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Sleep Problems and ADHD

Inattention, hyperactivity, and impulsivity are not the only problems experienced by children and adults with ADHD. Just as the symptoms of ADHD do not go away during adulthood, they do not go away at night, either.  Many ADHD sufferers have to contend with difficulty sleeping, staying asleep, or waking up. Sleep problems are an easily overlooked symptom of ADHD because they tend to appear later in life; some experience them as teenagers, while others experience sleep disturbances as young as ten.  Those who take ADHD medication have it just as bad – insomnia is a common side effect of stimulant drugs.

Although researchers have yet to find a causal relationship between ADHD and sleep problems, the problems are real and need immediate attention. Below are the three most common sleep problems experienced by individuals with ADHD.

Insomnia

At least 75% of adults with ADHD have difficulty sleeping because they cannot shut off their thoughts.  They either get a burst of energy during the evening, or feel tired during the day but unable to sleep as soon as their head hits the pillow. Their mind starts to jump from one thought to another, maintaining the cycle of sleeplessness.  Up to 15% of children with ADHD also experience insomnia before reaching puberty.  The number increases as they grow older – 50% of children 12 years old and older have difficulty falling asleep.

Restless sleep

When people with ADHD eventually fall asleep, they find their sleep to be fitful and light. They wake up at the slightest noise or they spend a lot of time tossing and turning. When the alarm rings in the morning, they feel just as tired as they did when they went to bed at night.

Difficulty waking up

Over 80% of adults with ADHD have extreme difficulty waking up in the morning. They sleep through their alarm clocks and the attempts of their family members to wake them, and are very irritable in the morning. Many report that they are never entirely awake until noon.

There are a number of theories that explain these sleep problems.  The simplest explanation is that sleep disturbances are a symptom of ADHD itself.  Hyperactivity eventually disappears with age, but it can manifest itself through mental restlessness. Up to 75% of adults with ADHD report that their mind tends to wander from one thought to the other for hours until sleep finally comes.  Another explanation has to do with problematic circadian rhythm, the body's internal clock that measures the changes in light from the sun. After studying the sleep patterns of adults with ADHD, psychiatrist Myron Brenner believes that individuals with ADHD have weak circadian clocks that are never "set" at the right time. This is why sleep only comes to them at 3 am or never comes at all.

Finding the source of the problem is only half the battle. The other half involves remedying sleep disturbances with "sleep hygiene" – the highly individualized set of conditions conducive to sleep. Some need soft music or white noise, while others need total silence. Some kids might want a bedtime snack; others don't want to eat before going to bed.  However, there are some universal rules of sleep hygiene:

  • Avoid afternoon naps
  • Stick to your bedtime and bedtime routine
  • Avoid caffeine during dinner and at night