ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate and the long-acting atomoxetine can actually enhance sleep.
But adults with ADHD may have difficulty getting restful sleep. They move around and toss, waking up frequently. Even when they do finally go to sleep, their minds are still active.
The effects of medication
Sleep issues are reported by a large number of adults with ADHD. Although the literature in the field does not typically discuss these issues, they are reported as common. Parents, patients and even clinicians often talk about difficulties falling or staying asleep, night wakings or activities that are nocturnal, as well as general drowsiness during the day. Objective measures like polysomnography, actigraphy and subjective measures such as diaries or self-rated questionnaires have shown statistically greater sleep disturbances in people with ADHD than those who are not.
The most commonly prescribed medication for ADHD is stimulant-class medication, which can enhance focus and concentration, but can cause sleep disturbances in some patients. In fact, it is recommended that the main sleep disorder, such as Narcolepsy, be eliminated before starting these medications (Spruyt and Gozal 2011).
Stimulant-class medication can cause a sudden increase in wakefulness and a decrease in sleep efficiency. The sleep disturbances may result from a decrease in the production of melatonin, or an immediate effect on the nervous system. In addition, stimulants could induce a sedating effect, a paradoxical agitation in some people.
In a controlled, randomized study of ramelteon (an agent that activates melatonin and is believed to regulate the circadian rhythms), insomnia was observed to be reduced in those who suffer from ADHD who were treated with this medication as compared to a placebo. This was a brief preliminary study, with a limited power and a few control groups, but it will be a catalyst for future research that will investigate the timing and dosage, the kind of insomnia, nighttime blood levels and the metabolites of ramelteon.
Other agents that have been used to treat insomnia in people with ADHD include clonidine, trazodone and mirtazapine. However, they are not as researched and many doctors prefer to avoid them in people who suffer from ADHD due to their potential for sedation that can last into the next day.
If a person suffering from ADHD is experiencing problems with insomnia the first thing to do is to try practicing good sleep hygiene and take a dose of their normal ADHD medication 45 minutes before going to bed. This method has proven to be effective in my experience for a majority of people suffering from sleep disorders and ADHD. If it doesn't work for you, a melatonin supplement can be tried.
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 can aid in reducing ADHD symptoms, including sleep issues. Foods that are low in sugar, processed fat and high in nutrients, like fruits, vegetables and lean proteins ought to be consumed. Whole grains, as well as healthy fats like omega-3 fatty acids should also be consumed. Cooking at home is a great method to ensure that meals contain all of the essential ingredients required for a healthy lifestyle, but many people with ADHD find meal planning and cooking difficult. In these situations it is possible that people rely heavily on take-out or restaurant meals that are high in sodium and artificial ingredients as well as sugar.
People with ADHD often have trouble settling to sleep at the end of the night. In fact, sleep issues are the most frequent complaints that people with ADHD report. These sleep problems can lead to a reduced quality of life as well as more depression, anxiety, and stress.
Sleep problems may be caused by a variety factors which include symptoms of ADHD or other factors. Certain medications that treat ADHD like methylphenidates may cause sleep problems in certain people. People who suffer from ADHD also have smaller pineal glands, which could affect the body's circadian rhythm.
Doctors typically recommend a combination treatment options to help people with ADHD sleep better. This includes creating a regular 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 is usually 7 to 9 hours per night.
Exercise can help adults suffering from ADHD sleep better. Before bed taking a few minutes of gentle stretching and deep breathing exercises can relax the mind and body. This can lead to a better night's sleep.
Exercise
Some individuals who suffer from ADHD find it challenging to stick with a workout routine. A personal trainer can offer discipline and motivation while incorporating the individual's preferred type of exercise into a fitness program. Aerobic exercise can provide physical and mental benefits. Strength training and mind-body exercise like yoga, Tai Chi or breathing exercises could also be added to a daily routine for an all-encompassing approach to managing ADHD symptoms.
Apart from helping I Am Psychiatry lose weight and build muscle mass, exercise has other beneficial effects on the brain, including raising levels of norepinephrine and dopamine. Dopamine and norepinephrine are neurotransmitters that improve self-control and concentration. Exercise increases the number of neurons that are growing, and strengthens their connections. This is particularly evident in the cerebellum - an area that can cause a fidgeting pattern in ADHD individuals. Research has proven that judo training, as an instance, can increase dopamine and norepinephrine levels in the cerebellum more than just running on a treadmill.
The medication used to treat ADHD can have negative side effects that can include a decrease in sleep. It is essential that patients consult with a doctor or health professional and establish healthy sleeping habits.
Many people suffering from ADHD struggle to fall asleep. Many ADHD sufferers struggle to fall asleep.
In my practice, I've observed that at about 80 percent of my patients who report sleep problems have this pattern. These issues aren't due to ADHD they are an integral part of the disorder. It is difficult for people with ADHD to maintain an accurate internal clock, which may be the reason for the difficulty falling asleep. Additionally they are unable to determine the length of time they've been in their bed. In actual fact the process of completing a sleep study typically requires many nights of nightly sleep logs and is difficult for someone suffering from ADHD to complete accurately.
Sleep Environment
Sleeping well is a challenge for all, but it's especially difficult for those who suffer from ADHD. It is difficult to fall asleep or relax due to the restlessness and racing mind that are associated with ADD. A lot of the drugs prescribed to treat ADHD have adverse effects that can disrupt sleep, such as insomnia. Therefore, it is essential that those suffering from ADHD practice good sleep hygiene and set a regular schedule. They should also set up an energizing, peaceful bedroom.
Additionally, people with ADD often have sleep disorders that may hinder their ability to get sufficient amounts of restful sleep. These include sleep apnea (in which breathing stops intermittently during the night) and anxiety, depression and in women over age 40, menopause-related issues like night sweats. Individuals with ADHD must always have their sleep problems evaluated by a medical professional to determine the underlying causes.
Research has proven that those with ADHD have a lower quality of sleep than other people, and are more likely to be tired and sluggish during the daytime. This is due in part to the erratic nature of their sleep which can be made worse by their inability to regulate their internal circadian clock. It is possible that sleep problems can be caused by medication side effects or comorbid conditions.
People with ADD particularly those who are treated with stimulants frequently have trouble sleeping and getting up frequently in the night. In certain studies, the sleep onset delay and sleep efficiency of those taking stimulants were reported to be significantly lower than those on placebos.
Despite this, some discover that taking their ADHD medication prior to bedtime helps to improve sleep. This should only be done on the advice of a doctor since certain medications can trigger sleep disorders. Other sleep-promoting methods such as progressive muscle relaxation -- in which you tensen and then release your muscles - and slow, deep breathing can be beneficial for people with ADHD. It's also a good idea to use your bed only for sex or sleeping, and to avoid using it as a place to discuss problems or debate.