ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate as well as long-acting atomoxetine can actually improve sleep.
But people with ADHD can still have trouble getting to sleep soundly. They often twirl and flip, waking frequently. Even when they do go to sleep their minds are active.
Medicines
A significant proportion of adults suffering from ADHD have sleep issues. While the literature on ADHD does not typically discuss these problems however, they are believed to be widespread. Parents, patients and healthcare professionals often describe difficulties falling asleep or staying asleep, waking at night and nocturnal activities, as well as drowsiness throughout the day. Objective measures like polysomnography, actigraphy and subjective measures like diary entries or self-rated questionnaires have shown statistically greater sleep disturbances in people with ADHD than those who are not.
The most common medication prescribed for ADHD is stimulant class medicines. They can help enhance concentration and focus however, they can also interfere with sleeping in certain patients. It is essential to identify the primary sleep disorder such as narcolepsy before taking these medications (Spruyt & Gozal 2011,).
Stimulant-class medications can cause a sudden increase in wakefulness and a decrease in the efficiency of sleep. The sleep disturbances can be caused by a decrease in the production of melatonin or a direct action on the nervous system. In addition, stimulants could trigger a sedating side effect, a paradoxical agitation in some people.
In a controlled, randomized study of the drug ramelteon (an drug that stimulates the hormone melatonin, believed to entrain the circadian rhythms) insomnia was observed to be improved in patients with ADHD who were treated with this medication as when compared to placebo. This was a small preliminary study, with a limited power and few control groups, but it could stimulate future research into dosing and timing, type of insomnia, daytime blood levels and ramelteon's metabolites.
Other medications that have been used to treat insomnia in some people with ADHD include clonidine, trazodone and mirtazapine. However, they aren't as well studied and many clinicians prefer not to use them in patients with ADHD due to their potential for sedation that can last into the next day.
If a person with ADHD is having trouble with insomnia the first thing to do is to practice good sleep hygiene and take a dose of their normal ADHD medication 45 minutes before bedtime. In my practice this method is typically successful for most people with ADHD and sleep issues. If this doesn't work, the melatonin supplement may be tried.
Diet
The kind of food is consumed by a person can have an impact on their mood. A balanced and nutrient-rich diet can help improve ADHD symptoms as well as those related to sleep. Foods should be low in processed fat and sugar, and rich in nutrients like vegetables, fruits, lean proteins, whole grains and healthy fats including omega-3 acid fatty acids. Cooking at home is an excellent method to ensure that meals are filled with all the essential ingredients for a healthy lifestyle however, many people with ADHD find meal planning and cooking challenging. In these instances individuals may turn to takeout or restaurant meals, which can be high in sodium, sugar and artificial ingredients that can exacerbate ADHD symptoms for certain individuals.
People with ADHD frequently have difficulty getting down to sleep at night. In fact, sleep problems are the most common complaints that people with ADHD have reported. These sleep problems can cause lower quality of life, and also increased stress, depression, anxiety, and, in women over 40, menopausal symptoms such as hot flashes.
There are a variety of causes of sleep issues in people with ADHD that could be related to symptoms of the disorder or other causes. It is possible that certain medications used to treat ADHD like methylphenidates, can cause sleep issues in certain people. People suffering from ADHD also tend to have smaller pineal glands which can affect the body's circadian rhythm.
To help people with ADHD achieve better sleep, doctors typically recommend a combination of treatment options. This includes establishing an established routine for sleep and enhancing the sleep environment (such as creating a quiet, dark bedroom) and limiting screen time prior to bed. Adults should also be able to get enough sleep, which typically is 7 to 9 hours per night.
In addition to changes in diet exercising can also aid in sleep for adults suffering from ADHD. Before going to bed take a few minutes for gentle stretching and deep breathing exercises can help to relax the body and mind. This will lead to more restful sleep.
Exercise
Certain people who suffer from ADHD struggle to maintain a fitness routine. uk adhd medication can provide discipline as well as motivation and accountability while incorporating the individual's preferred exercise into a fitness regimen. Incorporating aerobic exercises into your daily routine can give physical and mental benefits. adhd uk medication for strength and mind-body exercises such as yoga, Tai Chi or breathing exercises can be incorporated into your daily routine to provide an all-encompassing approach to managing ADHD symptoms.
In addition to helping people shed weight and build muscle, exercise has other beneficial effects on the brain, including raising levels of norepinephrine and dopamine. Norepinephrine, a neurotransmitter that aids in self-control as well as concentration and dopamine is a neurotransmitter that boosts levels of norepinephrine. Exercise also increases the development of neurons and strengthens connections between them. This is evident particularly in the cerebellum - an area that may cause fidgeting in some ADHD individuals. Studies have shown that judo training, as an example, can elevate dopamine and norepinephrine in the cerebellum more than just running on treadmills.
The medication used to treat ADHD can have side effects that include decreased sleep. It's important that a person talk about their medication with a doctor or health professional and establish healthy sleeping habits.
Many adults suffering from ADHD have difficulty falling asleep. They may wake often, toss and turn, or sink into what is known as "the sleep of the dead." Their minds wander from one thought to the next until they finally close off their day-today activities and fall into a light sleep.
In my practice, I've discovered that at the very least, 80 percent of my patients who suffer from sleep issues have this pattern. These disturbances aren't just due to ADHD, but are an integral part of the disorder. Adults with ADHD may have difficulty maintaining an accurate internal time which could be a contributing factor in their inability to fall asleep. In addition, they have trouble judging the amount of time they've spent in the bed. In reality, a sleep study often requires several nights of sleep logs, and can be difficult for a person with ADHD to do accurately.
Sleep Environment
It is difficult to get a good night's sleep for all, but it's especially difficult for those with ADHD. It is difficult to relax or fall asleep due to the anxiety and racing mind that are associated with ADD. Many of the medicines prescribed to treat ADHD have side effects that can disrupt sleep, including insomnia. This is why it is essential for people suffering from ADHD to practice good sleep hygiene, establish an established sleep routine and create a tranquil and relaxing bedroom environment.
In addition, those with ADD often suffer from sleep disorders that may hinder their ability to enjoy adequate amounts of restful sleep. These include sleep apnea (in which breathing stops intermittently throughout the night) and depression, anxiety and in women over age 40, menopausal-related issues such as night sweats. Sleep problems in those with ADHD should be assessed by a physician to determine the reason.
Research has revealed that those with ADHD have lower quality sleep than the rest of us and are more likely to report being tired and slow throughout the day. This is partially due to their insomnia that may be caused by their inability to control their internal clock. It is possible that sleep problems could be caused by side effects of medications or concomitant conditions.
The inability to fall asleep for sleep and frequent awakenings in the night are common for people with ADD especially those who are treated with stimulants. In certain studies, the onset of sleep delay and sleep efficiency of those who took stimulants were reported to be significantly lower than those taking placebos.
Some people report that taking their ADHD medications right before bedtime helps improve sleep. However it should be done under the supervision of a doctor, as some sleep disorders can be exacerbated by certain medications. Adults suffering from ADHD may benefit from other techniques for promoting sleep like progressive muscular relaxation (in which you tighten your muscles before releasing them) and slow, deep breaths. It's recommended not to use your bed for any purpose other than sex or sleep.