ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate as well as long-acting atomoxetine may actually enhance sleep.
But adults with ADHD may have difficulty getting restful sleep. They often toss and turn and wake up often. Even when they do sleep their minds are always active.
Medicines
A significant number of adults with ADHD suffer from sleep problems. adhd otc medication aren't often discussed in the scientific literature, however they are common. Clinicians, patients and parents often report difficulties sleeping or staying asleep, waking up at night or nocturnal activity as well as drowsiness during the daytime. Objective measures such as polysomnography, actigraphy, and subjective measures like diary entries or self-rated questionnaires have been found to show statistically greater sleep problems among those with ADHD than those who are not.
The most commonly prescribed medication for ADHD is stimulant-class medication that can help enhance focus and concentration, however, they can also affect sleep in certain patients. In fact it is recommended that the primary sleep disorder, such as narcolepsy, be ruled out prior to introducing these medication (Spruyt and Gozal 2011).
Stimulant-class medicine can trigger an abrupt increase in wakefulness and a decrease in the efficiency of sleep. The sleep disturbances could result from a decrease in the production of melatonin or directly affecting the nervous system. In addition, stimulants can induce a sedating effect, a paradoxical agitation in some people.
In a controlled, randomized study of the drug ramelteon (an agent that triggers melatonin and is believed to influence the circadian rhythms) insomnia was observed to be improved in people with ADHD who were treated with this medication as compared to a placebo. This was a small preliminary study, with limited power and few control groups, but it could inspire future research to explore the dosage and timing, the kind of insomnia, nighttime blood levels, and the metabolites of ramelteon.
Other medications that have been used to treat insomnia in patients with ADHD include clonidine, trazodone and mirtazapine. However, they aren't as well-studied and many physicians prefer to avoid them for those who suffer from ADHD because of their potential for sedation into the next day.
If someone with ADHD is experiencing insomnia, they should make an effort to maintain good sleep hygiene. They should also take their ADHD medication 45 minutes prior to the time they go to bed. In my practice this method is generally effective for the majority of people suffering from ADHD and sleep problems. If this doesn't work you can try a melatonin supplement.
Diet
The type of food a person eats can have a direct impact on their mood. A diet that is rich in nutrients and balanced may aid in reducing ADHD symptoms including sleep problems. Foods should be low in processed fats and sugars and rich in nutrients like vegetables, fruits and lean proteins, whole grains, and healthy fats, including omega-3 fats. 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 suffering from ADHD have trouble planning and cooking their meals. In these circumstances it is possible that people rely heavily on takeout and restaurant meals that are high in sodium, artificial ingredients, and sugar.
People suffering from ADHD often have trouble settling to sleep at the end of the night. Sleep issues are among the most frequently reported complaints among people suffering from ADHD. Sleep issues can lead to an improvement in the quality of life, as well as an increase in anxiety, depression, stress and, for women over age 40, menopausal symptoms like hot flashes.
There are many different reasons for sleep issues for those suffering from ADHD that may be related to symptoms of the disorder, or to other factors. Certain medications that treat ADHD like methylphenidates may 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 achieve better sleep doctors usually recommend an array of treatment options. This includes creating a regular sleep routine as well as optimizing the environment for sleep (such as creating a quiet, dark bedroom) and limiting screen time prior to bed. It is also crucial for adults to prioritize sufficient sleep, which typically is about 7-9 hours each night.
Exercise can help people with ADHD sleep better. A few minutes of gentle stretching or a deep breathing exercise prior to bedtime can relax the body and mind, which will ensure a more peaceful sleep at night.
Exercise
Certain people with ADHD have difficulty sticking to a routine of exercise. A personal trainer can provide the structure and motivation while incorporating the person's preferred exercise routine into a fitness routine. Incorporating aerobic exercises into a daily routine can provide mental and physical benefits. Mind-body exercise and strength training such as yoga, Tai Chi or breathing exercises can also be added to your daily routine to provide a holistic approach in managing ADHD symptoms.
Exercise also has other advantages for the brain. It can help people lose weight, build muscle mass and increase levels of norepinephrine and dopamine. Norepinephrine is a neurotransmitter that aids in self-control as well as concentration, and dopamine is a neurotransmitter that boosts levels of norepinephrine. Exercise also stimulates the growth of neurons as well as strengthens connections between them. This is evident particularly in the cerebellum - an area that can cause fidgeting in some ADHD people. Studies have shown that judo training, as an example, can elevate dopamine and norepinephrine levels in the cerebellum, more so than running on a treadmill.
Treatments for ADHD can have adverse side effects, including a decrease in sleep. This is why it's vital to discuss the medication a person is taking with their physician or a health professional and also to establish healthy sleeping habits.
Many people suffering from ADHD struggle to fall asleep. They may wake frequently, twirl and turn, or fall into what is known as "the sleep of the dead." Their minds restlessly wander from one thought to the next until they finally stop their day-to-day routines and fall into a light sleep.
In my practice, I've found that at least 80 percent of my patients who suffer from sleep issues have this pattern. These issues aren't a result of ADHD they are a major component of the disorder. It's difficult for adults with ADHD to maintain an accurate internal clock, which could be the reason for the difficulty of falling asleep. Additionally, they have trouble judging the length of time they've been in bed. A sleep study requires a daily sleep diary for several nights, which is difficult for those with ADHD to complete accurately.
Sleep Environment
It's not easy for everyone to get adequate sleep, but it can be especially difficult for people with ADHD. It can be difficult to fall asleep or relax due to the restlessness and racing mind associated with ADD. A lot of the drugs prescribed to treat ADHD have negative side effects that can disturb sleep, such as insomnia. For these reasons, it is essential for people who suffer from ADHD to practice good sleep hygiene, establish a regular sleep schedule, and create a calm and relaxing bedroom environment.
Additionally, people with ADD frequently have co-occurring sleep disorders which can hinder their ability to get adequate amounts of restful and restful sleep. Sleep apnea, a condition in which breathing stops intermittently during the night as well as depression, anxiety and menopausal-related problems such as night sweats are all included. Sleep issues for those with ADHD must be examined by a doctor to determine the cause.
Research has proven that those with ADHD experience poorer quality sleep than their peers, and are more likely to feel tired and sluggish throughout the daytime. This is largely due to the unpredictable nature of their sleep, which can be aggravated by their difficulty regulating their internal circadian clock. It is possible that sleep disturbances may be triggered by the effects of medication or concomitant conditions.
People suffering from ADD, especially those who are treated with stimulants, often have difficulty falling asleep and waking up frequently in the night. In fact, sleep onset latency and sleep efficiency have been reported to be significantly higher in those taking stimulants compared to those on placebos in a few studies.
However, some discover that taking their ADHD medication right before the bedtime can improve sleep. This should be done on the advice of a doctor since certain medications can cause sleep disorders. Other methods that promote sleep, like progressive muscle relaxation -- where you stretch and release your muscles -- and slow, deep breathing can be helpful for adults with ADHD. It is also an excellent idea to make your bed only for sleeping or sex and to not use it for a place to talk about issues or to argue.