Alaska Sleep Education Center

Sleep Problems Are Common Among Adults With ADHD

Posted by Maleeha B on Oct 27, 2021 1:16:00 AM

Woman suffering from poor sleep last night.


Diagnosed in childhood, ADHD is likely to progress into adult life despite treatment. Besides struggling with impairments in major functional domains, adults with ADHD experience multiple sleep problems ranging from insomnia to secondary sleep disorders.

An estimated 25-50 percent of individuals with ADHD have difficulties falling asleep, sleeping soundly at night, or waking up fresh. But studies also show a reverse relationship in which adults who do not receive adequate sleep develop ADHD symptoms.

Either way, sleep disturbances associated with ADHD can cause significant daytime fatigue and changes in mood or behavior. The resulting exhaustion will hurt your quality of life with potential overall health deterioration unless you receive adequate care.

If you think it probable you have ADHD symptoms, seeking professional help early is essential in averting the associated consequences of sleep disorders later in life. With online ADHD treatment that includes diagnosis and medication prescription in some instances, you can now receive standard ADHD care from the comfort of your home.

ADHD and Sleep Disorders

For years, the link between ADHD and sleep disorders has been unclear. As a result, comorbid sleep conditions in ADHD populations remain largely untreated.

Previously, the diagnosis of ADHD syndrome included sleep symptoms. But the recent American Psychiatric Association DSM-5 diagnostic criteria leaves out sleep problems as part of the syndrome due to their late-onset. 

Current research makes the relationship clearer with pointers to the potential causes of sleep issues among ADHD patients.

Possible Causes of Sleep Problems in Adults With ADHD

  1. Disruption of the circadian rhythm

Researchers attribute the increased prevalence of sleep disorders among ADHD patients to interferences with the normal sleep-wake cycle—medically known as circadian rhythm. For instance, most adults with ADHD exhibit delayed circadian rhythm phases marked by melatonin secretion changes and core body temperature.

Delay in early morning cortisol secretion is another marker of circadian rhythm disturbances in ADHD patients. A combination of these changes makes it difficult for adults with the disorder to fall asleep or have a restful night. Thus, most patients with ADHD display "night owl" signs characterized by increased alertness in the evening and circadian rhythm delays.

The consequence of these circadian cycle disruptions is short sleep time, which leads to daytime sleepiness and fatigue.

  1. ADHD medications

Doctors often prescribe either stimulant or non-stimulant medications to manage ADHD that is non-responsive to behavioral therapies. Studies show that these stimulant drugs, including methylphenidate and amphetamine, can alter your sleeping pattern with increased wakefulness. On the contrary, some non-stimulant ADHD drugs induce daytime sleepiness.

Other substances such as caffeine are likely to worsen sleep problems in individuals with ADHD. Coffee, tea, chocolate, and soda are common sources of caffeine. Therefore, taking such beverages before bedtime increases your night owl episodes.

Individuals with ADHD usually have other co-existing mental conditions such as anxiety, mood disorders, and depression. Without effective treatment, these can also cause a chronic problem of difficulty falling asleep.

Regardless of the cause, ADHD-related sleep disorders lead to a vicious cycle of symptom exacerbation.

Common Sleep Disorders Among Adult ADHD Patients

Any condition that interferes with your ability to have a good night's sleep regularly constitutes a sleep disorder. The National Sleep Foundation recommends that adults have between 7-9 hours of sleep, but most ADHD patients do not achieve this sleep time.

Adults with attention-deficit/hyperactivity disorder usually experience one or more of the following sleep problems:

  1. Insomnia

Insomnia manifests with challenges falling asleep, staying asleep, or both despite a conducive environment. Nearly 66 percent of adults with ADHD exhibit features of insomnia as they have prolonged sleep onset and repeated night awakenings.

Consequently, the patients wake up tired and remain fatigued throughout the day. Insomnia will affect your mood, energy levels, and overall quality of life.

Unhealthy sleep practices such as lack of bedtime routine are likely to increase the severity of insomnia.

  1. Restless Leg Syndrome (RLS)

RLS is a sensorimotor disorder that presents with an irresistible desire to move the legs. Mainly, this results from uncomfortable sensations in different body parts, especially the legs. The weird feelings –itch, ache, and vibrations- tend to increase at night and become bothersome since the patient must move the legs to relieve the symptoms temporarily.

Individuals with ADHD often experience symptoms of restless leg syndrome, such as leg discomfort that begins shortly after lying or sitting down. When you experience RLS at night, you are likely to wake up fatigued and struggle with episodes of daytime sleepiness. Noteworthy, the severity of the syndrome increases with age, particularly in ADHD cases.

  1. Sleep Disordered Breathing (SDB) and Apnea

Patients with SDB have abnormal breathing patterns when asleep, including a stoppage in breathing known as sleep apnea.

Some adults with ADHD often experience sleep apnea, which is severe and potentially fatal. Snoring loudly, waking up gasping for air at night, daytime irritability, and waking up tired despite sleeping for the recommended hours are indicators of sleep apnea.

Remedies for ADHD-Related Sleep Disorders

Sleep disorders among ADHD patients vary in type and intensity. As a result, the treatment plan is usually individualized to some extent. For instance, some patients will receive behavioral therapy or medical treatment while others receive both.

Sleep hygiene is one of the remedies doctors recommend for managing ADHD sleep disorders. The approach entails optimizing sleep initiation and maintenance factors, including sounds, bedtime routine, daytime sleeping habits, and beverages before bedtime.

At EZCare, we understand the relationship between ADHD and sleep disorders is multidirectional and reciprocal, which directs our multi-modal approach. Our highly experienced psychologists use modern tests such as polysomnography to diagnose your sleep disorder before recommending the appropriate therapy.

For comprehensive ADHD care, reach us today at (415)966-0848 or walk into our clinic in San Francisco.

Attention problems may be sleep-related

Millions of children and adults struggle with difficulty concentrating, trouble completing tasks, organization problems, and memory lapses. Dealing with an attention deficit, although common, can be frustrating and difficult to deal with.

The most common diagnosis for attention problems is ADD (attention deficit disorder) and ADHD (attention deficit hyperactivity disorder). But did you know that the symptoms of attention deficits are also the symptoms of poor quality or insufficient sleep?

Prolonged sleep deprivation and sleep disorders can lead to issues with memory, learning, and focus.


Overlapping Symptoms

A lot of the symptoms of attention deficiencies, such as lack of focus and impulsive behavior, are the same as many sleep disorders.

In adults, the symptoms of sleep disorders resemble the symptoms of adult ADD. A lot of the overlapping are difficulty focusing, forgetfulness, lack of concentration, problem paying attention, short attention span, irritability, lack of impulse control, mood swings, depression, learning difficulties, and risky behavior.

In children, the symptoms of sleep deprivation resemble the symptoms of ADHD. Children who struggle with sleep disorders often have trouble focusing, sitting still, getting along with peers, and are often hyper, moody, or obstinate.

It is important to know how sleep can affect behavior and attention so that the right diagnosis can be made. Take the following quiz to see if your attention problems might be linked with sleep issues:

  1. Do you have difficulty staying awake when sitting still, watching television or reading?
  2. Do you have difficulty concentrating?
  3. Do you have trouble controlling your impulses or emotions?
  4. Are you struggling to remember important information?
  5. Do you struggle to learn to the information?
  6. Are you struggling to stay organized?
  7. Do you have difficulty completing everyday tasks?
  8. Do you feel so tired during the day that all you can think about is sleep?

 If you answered yes to any of these questions, you may be suffering from sleep-related attention problems. Call your sleep physician today to make an appointment to discuss your symptoms. 

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Topics: adhd, sleep apnea problems

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