ADHD and Sleep: Understanding the Relationship Between ADHD and Sleep Problems

One of the lesser-explored and often underappreciated realms of ADHD is its intricate relationship with sleep. Feeling tired, experiencing sleep disturbances, and difficulty falling asleep are all traits that often run alongside this neurodevelopmental condition.  

If ADHD can make such an impact on an individual's day-to-day life, why would these symptoms disappear at night? In this article, we’re going to delve into how and why ADHD affects sleep, and some tips on how to manage it.

Do People with ADHD Have Problems with Sleep?

It is common for people with ADHD to feel exhaustion, more so than a neurotypical individual. The daily battle with hyperactivity, impulsivity or sustaining attention can be exhausting, however, on top of this, the difficulty switching off and falling asleep at night or sleeping soundly through the night, can create a cycle of ADHD and sleep problems that are difficult to break.

Thomas Brown, PhD, a long-time researcher in ADHD and developer of the Brown Scales sees sleep disturbances as indicative of problems of arousal and alertness in ADHD itself. There are 5 symptom clusters that emerge from the Brown Scales and 2 of these involve activation and arousal:

• Organisation and activation to begin work activities.

• Sustaining energy, effort, and alertness throughout.

It is these 2 symptom clusters which Brown views as associated with sleep problems. He states that sleep disturbances are direct manifestations of ADHD itself, whilst also being a developmentally based impairment of management functions of the brain. Whilst hyperactivity is more common in men, most women feel the mental and physical restlessness of ADHD when trying to slow down the arousal state of the daily functioning of the brain, by trying to fall asleep.

The ADHD/ Sleep Cycle

The relationship between ADHD and sleep is bidirectional, meaning each influences the other continuously. On one hand, individuals with ADHD commonly experience difficulties falling asleep and maintaining a regular sleep schedule. On the other, insufficient, or disrupted sleep can exacerbate ADHD symptoms, creating a cycle that can be challenging to break. 

Impulsivity and Hyperactivity.

Sleep deprivation can heighten impulsivity and hyperactivity, which can create a challenging cycle where poor sleep intensifies ADHD, and heightened ADHD symptoms, in turn, disrupt sleep.

Cognitive Impairment.

Sleep deprivation can impair cognitive functions, which can further hinder attention and focus and in turn can cause a cognitive fog, making it even more challenging for individuals with ADHD to navigate daily responsibilities. 

Emotional Dysregulation.

A lack of sleep can contribute to emotional dysregulation, amplifying mood swings and making it difficult for those with ADHD to manage stress and frustration. 

Top 4 Sleep Problems Facing Those with ADHD.

1.     Falling Asleep.

Racing thoughts, restlessness, and a heightened state of alertness can contribute to delayed sleep onset, leaving those with ADHD tossing and turning whilst trying to fall asleep. Many people with ADHD describe themselves as night owls, getting a burst of energy as soon as the sun goes down. Prior to puberty, 10-15% of children with ADHD report having trouble getting to sleep, this number increases to 50% by age 12 ½ and 70% by age 30.

2.     Restless Sleep.

Individuals with ADHD often experience more frequent awakenings during the night, leading to fragmented sleep and a lack of restorative benefits the body and mind need from restful sleep. Added to this the struggle to maintain a consistent sleep schedule for those with ADHD can disrupt the body’s natural circadian rhythm, leading to irregular sleep patterns.

3.     Difficulty Waking.

It is very common for adults with ADHD to report experiencing multiple awakenings through the night, until around 4 am, after which they achieve a “sleep of the dead” "-like state, which they are then extremely difficult to rouse. 

4.     Intrusive Sleep.

If a person with ADHD has an interest in something, they can achieve what is commonly known as “hyper-focus” However, if the individual loses interest in the activity, their nervous system disengages, sometimes so abruptly, that it can induce sudden extreme drowsiness, even to the point of falling asleep.

How to Break the ADHD/ Sleep Cycle and Improve Your Sleep

Understanding your own sleep hygiene or figuring out what triggers the initiation and maintenance of sleep for you, is the first step into breaking the ADHD/ Sleep cycle. There are many factors that can contribute to an individual's sleep onset initiation including: 

• Consistent Sleep Routine - creating a regular sleep routine involving a consistent bedtime and wake-up time to help regulate the circadian rhythm, promoting better sleep quality.

• Mindfulness and Relaxation - meditation and deep-breathing exercises, can help to manage the racing thoughts that may interfere with sleep onset.

• Limiting Stimulants Before Bed - reducing caffeine intake and time on electronic devices, in the hours leading up to bedtime can contribute to a calmer state conducive to sleep.

• Creating a Sleep-Friendly Environment - comfortable bedding, minimal light, and a quiet atmosphere can enhance the chances of restful sleep. 

How can we Help? A Private ADHD Clinic in Manchester.

It is only now becoming more prevalent just how interlinked ADHD and sleep really are. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) originally stated that all ADHD symptoms are present by the age of 7. However, more recently, it has been found that typically, from around the age of 12, sleep disturbances tend to present in those with ADHD. 

ADHD does not disappear regardless of age or time of day and even though the research is heading in the right direction, it can still be difficult to understand why you’re struggling with sleep or what to do to improve it.

Thankfully, there is a way. Beyond is a private ADHD clinic in Manchester, specialising in ADHD assessment, diagnosis, and treatment in all aspects of your ADHD journey. Just as every person is unique, every person’s ADHD is unique too and we pride ourselves in a genuine and personalised approach to your care.

Contact us today and see how Beyond can help you.