Around 1 in 20 people have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and it often begins in childhood, and more common in boys.
Symptoms experienced include feeling restless, having difficulty concentrating, acting impulsively and struggling with sleep issues all which can have an impact on school, work or in social settings.
While sleep and ADHD have a complex relationship, steps can be taken to improve sleep which can help with some of the symptoms of ADHD. Sleep plays a crucial role in supporting good mental health, helping us to regulate emotions which in turn supports better decision making.
Sleep Issues and ADHD
There can be a number of reasons that those diagnosed with ADHD have difficulty with sleep.
Unable to Switch Off
Mental alertness is one key factor. An ADHD mind can be a busy mind and it can be incredibly difficult to switch it off even at sleep time. Frequently reported is being unable to fall asleep at the start of the night due to having an overactive mind. Children and adults can both benefit from having some relaxation strategies to help them to calm their minds at night time. Repeating a meaningless words such as ‘the’ over and over again may help or using an app such as Headspace.
ADHD and Restless Sleep
When individuals with ADHD have finally managed to nod off many experience restless sleep. Sleep may not be refreshing with them moving frequently during the night. This restlessness can be caused by a number of factors including underlying sleep disorders. It is important to try to work out what may be causing this and then to take appropriate action. Having a cool bedroom around 16-18 degrees is helpful, avoiding caffeine from after lunchtime and speak to a healthcare practitioner if you suspect a sleep disorder may be to blame.
ADHD and Sleep Disorders
Sleep disorders tend to be more common in those with a diagnosis of ADHD. For example, research suggests around 3% of the population have sleep apnoea yet 25% of those with ADHD have sleep apnoea or some other sleep disordered breathing difficulty.
Restless legs syndrome involves a strong urge to move your legs in the run up to bedtime, the sensation is often unpleasant and makes it difficult to sleep. Around 2% of the population will experience this yet 44% of those with a diagnosis of ADHD have restless leg syndrome.
Always share concerns about your sleep with professionals involved, a healthcare practitioner will be able to refer you to the appropriate service for an assessment.
Getting Distracted
People with ADHD can often get distracted easily. This can mean it is challenging to stick to a routine. Even when a good routine is planned, it can soon go amiss without lots of cues and support to keep it on track. Children with ADHD may also resist bedtime making it even more difficult to put good sleep hygiene in place. The best advice is to stick to good sleep hygiene and to set reminders to keep you on track like for example an alarm on your phone to signal the end of screen time an hour before bed.
Medication
There can be issues around medication as well that may impact on sleep. Stimulants are often prescribed to manage the symptoms of ADHD. If taken too late in the day these can have a knock-on effect making it harder to fall asleep. Hunger can also be an issue as stimulants may supress the appetite, adding supper time into the routine can help to keep the hunger pangs at bay in the middle of the night.
Starting The Day
Getting up to start the day can also be an enormous challenge! Many people who have ADHD say that they often don’t manage to fall asleep until late and then when the alarm goes off in the morning find it really hard to wake up.
Having a regular wake and sleep time, seven days a week can be helpful. It is also important to expose yourself to natural daylight when you wake to supress the sleep hormone, melatonin. Open the curtains or if need be invest in a light box, these can really help in the winter months.
Tips to Try
- Stick to regular sleep times and wake times seven days a week – use visual or tangible cues to help keep on track such as a timetable
- Have a routine in place starting an hour before bedtime that includes non-stimulating activities and keep the routine quiet and calm
- Remove screens in the hour before you go to sleep. They can be mentally stimulating and the light emitted from them may wake you up
- Add a supper time snack to your routine so you don’t wake hungry in the early hours
- Keep a sleep diary and share it with practitioners involved in your care to see if they can offer any suggestions or support
- Make your bedroom a relaxing place and one that you associate with sleep
- Encourage exercise during the day
- Use light therapy to help them wake up in a morning
- If you have a child with ADHD, do try to put a routine in place. A recent research study carried out by the team at The Sleep Charity, in partnership with Sheffield Children’s Hospital and Sheffield Local Authority, found behavioural intervention resulted in on average an additional 2.4 hours sleep per night.
Charities That Can Offer Support
ADHD Foundation https://www.adhdfoundation.org.uk/
ADHD UK https://adhduk.co.uk/
Attention Deficit Disorder Association https://add.org/