ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate or the long-acting Atomoxetine may improve sleep.
But adults with ADHD can still have trouble getting restful sleep. They frequently toss and turn and wake frequently. Even when they do go to sleep their minds are active.
Medicines
A large percentage of adults suffering from ADHD suffer from sleep problems. Although the scientific literature does not typically discuss these problems however, they are believed to be common. Patients, parents and clinicians frequently report difficulty sleeping or staying asleep, waking up at night, nocturnal activity and fatigue during the daytime. Objective measures, including actigraphy and polysomnography, as well as subjective measures (eg, self-rated questionnaires and diaries) have demonstrated statistically greater sleep problems in people with ADHD compared to controls.
The most frequently prescribed medication for ADHD is stimulant class medicines. These can enhance concentration and focus, but may interfere with sleeping for some patients. It is crucial to rule out the primary sleep disorder like narcolepsy prior to taking these drugs (Spruyt & Gozal, 2011).
Stimulant-class drugs can trigger an abrupt increase in the amount of time you are awake, and an increase in the efficiency of sleep. The sleep disturbances may result from a decrease in the production of melatonin or directly affecting the nervous system. Additionally, stimulants may trigger a sedating side effect, a paradoxical agitation in some people.
In a randomized controlled study of the drug ramelteon (an drug that stimulates the hormone melatonin, believed to regulate the circadian rhythms) insomnia was found to be improved in patients who suffer from ADHD who were treated with this medication as when compared to placebo. This was a tiny preliminary study with limited power and few controls but should inspire future research to further investigate dosing, timing, studying the sleep patterns and the levels of blood ramelteon during the daytime and its metabolites.
Other medications that have been used to treat insomnia in some people with ADHD include trazodone, clonidine and mirtazapine. However, these are less well studied and many clinicians prefer to avoid them for people with ADHD due to their potential for sedation that can last into the next day.
If someone with ADHD has insomnia, they should first try to practice good sleeping habits. They should also take their ADHD medication 45 minutes prior to the time of bed. In my experience this method is generally successful for most people with ADHD and sleep problems. If this doesn't work, a melatonin supplement can be considered.
Diet
The type of food that is consumed by a person can impact their mood. A balanced diet that is rich in nutrients can help improve ADHD symptoms as well as those associated with sleep. Foods that are low in sugar, processed fat and high in nutrients, including vegetables, fruits, and lean proteins ought to be consumed. Whole grains, as well as healthy fats like omega-3 fatty acids should be a part of the diet. It is important to cook at home in order to ensure that your meals have all the necessary ingredients to maintain good health. However many people with ADHD have difficulty making plans and cooking meals. In these circumstances it is possible that people rely heavily on take-out or restaurant meals that are loaded with sodium artificial ingredients, as well as sugar.
People suffering from ADHD are unable to fall asleep at night. In reality, sleep problems are the most common complaints that people with ADHD report. These sleep issues can result in an improvement in the quality of life, as well as an increase in stress, depression, anxiety and, in women over 40, menopausal symptoms including hot flashes.
There are a variety of reasons for sleep issues for people suffering from ADHD that may be related to symptoms of the disorder or other causes. Certain medications used to treat ADHD such as methylphenidates can cause sleep issues in some people. People suffering from ADHD also tend to have smaller pineal glands which can affect the body's circadian rhythm.
Doctors typically recommend a combination treatment options to help people with ADHD to sleep better. This includes creating a regular sleeping routine and optimizing your sleep environment (such by creating a quiet and dark bedroom) and limiting the time you spend on your computer before going to the bed. It is also crucial for adults to get enough sleep, which is usually about 7-9 hours each night.
Exercise can help adults with ADHD sleep better. Before sleeping, a few minutes of gentle stretching and deep breathing exercises can relax the mind and body. This can lead to a better night's sleep.
Exercise
Certain people with ADHD struggle to stick to a routine exercise. A personal trainer can provide discipline, motivation and accountability, while incorporating the individual's preferred exercise into a fitness routine. Incorporating aerobic exercise into your daily routine can bring physical and mental benefits. Strength training and mind-body exercise such as Tai Chi, yoga or breathing exercises could be incorporated into a daily routine for an holistic approach to managing ADHD symptoms.
Exercise has many other advantages for the brain. It can help people shed weight, build muscle and boost levels of dopamine and norepinephrine. Norepinephrine, a neurotransmitter, aids in self-control and concentration and dopamine is a neurotransmitter that increases levels of norepinephrine. Exercise also stimulates the growth of neurons and improves the connections between them. This is evident particularly in the cerebellum - an area that can cause fidgeting in some ADHD people. Research has revealed that judo can elevate dopamine and norepinephrine in the cerebellum. This is greater than running on a treadmill.
Treatments for ADHD can cause adverse side effects, including a decrease in sleep. It's important that a person talk about their medication with a health professional, and establish healthy sleep habits.
Many people with ADHD struggle to fall asleep. They might wake often, toss and turn, or slip into what some call "the sleep of the dead." Their minds restlessly wander between thoughts until they finally stop their day-to-day routines and fall into a peaceful sleep.
In my practice, at least 80 percent my adult patients suffering from sleep disorders exhibit this pattern. These disturbances are not simply a result of the ADHD, but rather are an essential component of the disorder itself. It's difficult for adults with ADHD to maintain a precise internal clock, which may be a factor in the difficulty falling asleep. In for beginners may have difficulty determining the length of time they've been in their bed. In fact, a sleep study often requires several nights of sleep logs, and can be difficult for a person with ADHD to accurately complete.
Sleep Environment
It is difficult to get a good night's sleep for everyone, but it is particularly difficult for those who suffer from ADHD. This is because the inherent restlessness and racing thoughts associated with ADD make it difficult to relax and fall asleep. In addition, many of the treatments used to treat ADHD can cause sleep-disrupting side effects like insomnia. Therefore, it is essential that those suffering from ADHD maintain a good sleeping routine and establish a regular schedule. They should also set up an energizing, peaceful bedroom.
In addition, people with ADD often suffer from co-occurring sleep disorders which can hinder their ability to get adequate amounts of restful and restful sleep. These include sleep apnea (in which breathing stops intermittently during the night), depression, anxiety and in women over age 40, menopause-related issues like night sweats. Sleep issues for those with ADHD should be evaluated by a doctor to determine the reason.
Research has shown that people with ADHD have lower quality sleep than other people and are more likely report feeling exhausted and sluggish throughout the day. This is partly due to the restless nature of their sleeping, which is exacerbated by their inability to regulate their internal circadian clock. However, it is also possible that the sleep disturbances are the result of medications that cause side effects or comorbid conditions.
The inability to fall asleep for sleep and frequent awakenings in the night are not uncommon for people with ADD especially those who are treated with stimulants. In fact, sleep onset latency and sleep quality are found to be significantly higher for those who are taking stimulants compared to those on placebos in some studies.
Some people report that taking their ADHD medications prior to bedtime improves sleep. However, this should be done under the supervision of a physician, as certain sleep disorders may be exacerbated by certain drugs. Other methods that promote sleep, like progressive muscle relaxation -- where you stretch and release your muscles -- and slow, deep breathing can be beneficial for adults suffering from ADHD. It's recommended not to make use of your bed for anything other than sex or sleeping.