ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate and long-acting atomoxetine can actually enhance sleep.
But people with ADHD may have difficulty getting a good night's sleep. They often toss and turn and wake up often. And even when they do fall asleep their minds are alert.
Medicines
Sleep problems are reported by a large number of adults with ADHD. These problems are not usually discussed in the scientific literature, however they are quite common. Patients, parents and healthcare professionals often describe difficulties falling or staying asleep, night wakings and nocturnal activities, as well as drowsiness throughout the day. Measures that are objective like polysomnography, ACTIgraphy, and subjective measures like diaries or self-rated questionnaires have been found to show statistically greater sleep problems among those with ADHD than controls.
The most frequently prescribed medication for ADHD is stimulant-class medication that increase focus and concentration however, they can also affect sleep in certain patients. In fact it is recommended that the underlying sleep disorder, such as narcolepsy be identified prior to starting these drugs (Spruyt and Gozal 2011).
Stimulant-class medication can cause a sudden increase in wakefulness and decrease in sleep efficiency. The sleep disturbances can be caused by a decrease in the production of melatonin or an immediate effect on the nervous system. In addition, stimulants could cause a sedating side effect, a paradoxical agitation in a few people.
A randomized controlled trial of the drug ramelteon, which activates the melatonin receptor and is thought to entrain circadian rhythms, showed that insomnia was improved for those with ADHD who received this medication in comparison to placebo. This was a small preliminary study, with limited power and few control groups, but it will be a catalyst for future research that will investigate the dosage and timing, the type of insomnia, daytime blood levels, and ramelteon's metabolites.
Other drugs that have been used to treat insomnia in people with ADHD include clonidine, trazodone and mirtazapine. However, they are not as well studied and many clinicians prefer not to use them in patients with ADHD because of their potential for sedation that can last into the next day.
If someone who suffers from ADHD has insomnia, they should first attempt to improve their sleeping habits. They can also take their ADHD medication 45 minutes before the time they go to bed. In my experience, this approach is usually successful for most people with ADHD and sleep problems. If it doesn't work for you, the melatonin supplement may be tried.
Diet
The kind of food consume by a person can have an impact directly on how they feel. A balanced, nutrient-rich diet can help to improve ADHD symptoms, including those associated with sleep. Foods that are low in processed fat, sugar and rich in nutrients, such as vegetables, fruits and lean proteins ought to be consumed. Whole grains, as well as healthy fats, such as omega-3 fatty acids, should also be consumed. Cooking at home is a great way to ensure that one's meals contain all of the essential ingredients required for good health however, many people with ADHD have difficulty planning meals and cooking difficult. In these situations, people may rely on take-out or restaurant meals which can be high in sugar, sodium and artificial ingredients that may increase ADHD symptoms for certain people.
People with ADHD often have trouble settling to sleep at the end of the night. Sleep issues are among the most frequently reported complaints among those suffering from ADHD. These sleep issues can lead to a reduced quality of life as well as more depression, anxiety, and stress.
Sleep problems can be caused by many factors including signs of ADHD or other causes. It is possible that certain medications used to treat ADHD such as methylphenidates, could cause sleep issues in some people. In addition, those suffering from ADHD tend to have smaller pineal glands that can affect how the body regulates its circadian rhythm.
To help people with ADHD get better sleep doctors usually recommend a combination of treatment options. This includes establishing an ongoing sleep routine and enhancing the sleep environment (such as creating a dark, quiet bedroom) and limiting screen time before going to bed. Adults should also prioritize getting enough sleep, which typically is 7-9 hours a night.
Exercise can help adults suffering from ADHD sleep better. A short stretch or a deep breathing exercise before bed can help calm the mind and body, which will result in a more peaceful sleep at the end of the night.
Exercise
Some individuals who suffer from ADHD have difficulty to stick with a workout routine. A personal trainer can provide discipline and motivation, while incorporating an individual's preferred exercise into a fitness routine. Incorporating aerobic exercises into your daily routine could give physical and mental benefits. Training for strength and mind-body exercises like Tai Chi, yoga, or breathing exercises can also be added to the routine of your day to take an holistic approach to managing ADHD symptoms.
Exercise has many other advantages for the brain. It helps people lose weight, build muscle and increase levels of dopamine and norepinephrine. Norepinephrine, a neurotransmitter that aids in self-control as well as concentration, and dopamine is a neurotransmitter which increases levels of norepinephrine. Exercise boosts the growth of neurons, and strengthens their connections. This is especially evident in the cerebellum, an area that is a major cause of fidgeting in some individuals with ADHD. Research has shown, for instance, that judo can elevate dopamine and norepinephrine within the cerebellum. This is greater than running on a treadmill.
The medication used to treat ADHD may have negative side effects that can include a decrease in sleep. This is why it's important to discuss the person's medication with their physician or a health professional and also to establish healthy sleeping habits.
Many people suffering from ADHD struggle to fall asleep. They might wake up frequently, toss and turn, or fall into what is known as "the sleep of the dead." Their minds wander between thoughts until they finally close off their day-to-day routines and fall into a peaceful sleep.
In my practice, I've observed that at about 80 percent of my adult patients who suffer from sleep issues have this pattern. These disturbances are not simply due to ADHD however, they are an integral part of the disorder itself. Adults with ADHD may have difficulty maintaining an accurate internal time and this could be a contributing factor in their difficulty falling asleep. Additionally they may have difficulty determining the amount of time they've spent in their bed. A sleep study requires a regular journal of sleep for a number of nights, which can be difficult for people with ADHD to accurately complete.
Sleep Environment
It's difficult for everyone to get quality sleep, but it can be especially difficult for people with ADHD. This is because the inherent agitation and racing thoughts associated with ADD make it difficult to sleep and relax. A lot of the drugs prescribed to treat ADHD have adverse effects that can disrupt sleep, like insomnia. It is therefore important that those suffering from ADHD maintain a good sleeping routine and adhere to a regular routine. They should also set up a calm, relaxing bedroom.
In addition, people with ADD often suffer from sleep disorders that may interfere with their ability to enjoy adequate amounts of restful and restful sleep. adhd otc medication can include sleep apnea (in which breathing stops intermittently during the night) as well as anxiety, depression and in women over 40, menopause-related issues like night sweats. Sleep issues in those with ADHD must be examined by a doctor to determine the root cause.
Research has shown that individuals who suffer from ADHD have a lower quality of sleep than other people, and are more likely to report feeling tired and unfocused throughout the daytime. This is partly due to their sleeplessness and can be exacerbated by their inability to manage their internal clock. It is possible that sleep problems could be caused by side effects of medications or concomitant conditions.
Inability to settle to sleep and the frequent awakenings throughout the night are common for those with ADD particularly those treated with stimulants. In certain studies, the sleep onset delay and the effectiveness of sleep of those who took stimulants were significantly lower than those on placebos.
Some people report that taking their ADHD medication prior to bedtime helps improve sleep. This should only be done with the advice of a doctor since certain medications can exacerbate sleep disorders. Other sleep-promoting methods such as progressive muscle relaxation -- where you relax and tensen your muscles - and deep, slow breathing could be beneficial for people with ADHD. It's also a good idea to use your bed solely for sex or sleeping and to not use it as a space to discuss issues or to argue.