ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate as well as long-acting atomoxetine are both known to improve sleep.
But adults with ADHD aren't always successful in getting a good night's sleep. They frequently toss and turn and wake up frequently. Even when they do get to sleep, their minds are still active.
Medicines
Sleep problems are reported by a significant number of adults with ADHD. These problems are not usually discussed in the scientific literature, but they are common. Clinicians, patients and parents frequently report difficulty falling asleep or staying asleep, waking up at night, nocturnal activity and fatigue during the day. Objective measures such as polysomnography, actigraphy and self-rated questionnaires or diaries have demonstrated statistically higher sleep impairments among people with ADHD as compared to controls.
The most commonly prescribed drug for ADHD is stimulant-class drugs, which can improve concentration and focus but can cause sleep disturbances in certain patients. In fact it is recommended that the main sleep disorder, like narcolepsy, be ruled out prior to introducing these medication (Spruyt and Gozal 2011).
Stimulant-class medication can cause an abrupt increase in wakefulness and a decrease in sleep efficiency. Sleep disturbances can be caused by a decline in the production of melatonin or a direct effect on the nervous system. In addition, stimulants could cause a sedating side effect, which can cause paradoxical agitation in a few people.
In a randomized controlled study of Ramelteon (an agent that triggers the hormone melatonin, believed to entrain the circadian rhythms), insomnia was found to be improved in patients who suffer from ADHD who were treated with this drug opposed to a placebo. This was a small, preliminary study with only a small amount of power and very only a few controls, but it could inspire future research to further investigate the timing, dosage, and recording of insomnia and the levels of blood ramelteon during the daytime and its metabolites.
Other medications that have been used to treat insomnia in some people with ADHD include trazodone, clonidine and mirtazapine. However, they are not as well studied and many clinicians prefer to avoid them for people who suffer from ADHD due to their potential for sedation into the next day.
If I Am Psychiatry with ADHD has insomnia, they should first try to practice good sleep hygiene. They can also take their ADHD medication at least 45 minutes prior to bedtime. In my practice this method is typically successful for a majority of people with ADHD and sleep issues. If it doesn't work, a melatonin supplement can be considered.
Diet
The kind of food people consume can impact their mood. A diet that is rich in nutrients and balanced can aid in reducing ADHD symptoms, including sleep issues. Foods should be low in processed fats and sugars and high in nutrients like fruits, vegetables lean proteins, whole grains and healthy fats including omega-3 fats. Cooking at home is an excellent method to ensure that meals contain all of the essential ingredients to be healthy, but many people with ADHD have difficulty planning meals and cooking challenging. In these situations it is possible that people rely heavily on restaurant and take-out meals that are loaded with sodium and artificial ingredients as well as sugar.
People suffering from ADHD are unable to fall asleep at the end of the night. Sleep issues are among the most common complaints among people suffering from ADHD. Sleep issues can lead to a reduction in quality of life, as well as increased stress, depression, anxiety, and, in women over age 40, menopausal symptoms like hot flashes.
Sleep issues may be caused by a variety factors, including symptoms of ADHD or other factors. Certain medications that treat ADHD like methylphenidates may cause sleep problems in certain people. In addition, people with ADHD tend to have smaller pineal glands, which could affect the way in which the body regulates its circadian rhythm.
In order to help individuals with ADHD get better sleep Doctors typically suggest a combination of treatment options. This includes creating regular sleep routines and enhancing your sleeping environment (such by creating an unlit and peaceful bedroom) and limiting the time you spend on your computer before going to bed. It is also important for adults to ensure they get enough sleep, which is typically 7 to 9 hours per night.
Alongside dietary changes exercising can also improve sleep for adults with ADHD. Before bed taking a few minutes of gentle stretching and deep breathing exercises can calm the mind and body. This will result in an improved night's sleep.
Exercise
Some individuals who suffer from ADHD find it challenging to keep up with a workout routine. A personal trainer can offer the structure and motivation while incorporating the individual's preferred exercise routine into a fitness plan. Incorporating aerobic exercises into a daily routine can give physical and mental benefits. Training for strength and mind-body exercises like yoga, Tai Chi or breathing exercises could be incorporated into your daily routine to provide an all-encompassing approach to managing ADHD symptoms.
Aside from helping people lose weight and build muscle, exercise can also have other positive effects on the brain, like raising levels of norepinephrine and dopamine. Dopamine and norepinephrine are neurotransmitters that enhance concentration and self-control. Exercise also boosts the growth of neurons and improves the connections between them. This is evident particularly in the cerebellum, an area that contributes to fidgeting in some individuals with ADHD. Studies have shown that judo-training, for example, can elevate norepinephrine and dopamine in the cerebellum, more so than running on a treadmill.
Treatments for ADHD can have adverse side effects, including a decrease in sleep. It is essential that patients discuss their medication with a physician or health professional, and establish healthy sleep habits.
Many adults with ADHD struggle to fall asleep. They might wake up often, toss and turn, or fall into what some refer to as "the sleep of the dead." Their minds wander from one thought to another until they can finally put aside their day-to-day routines and fall to sleep.
In my practice, I've found that at the very least, 80 percent of my adult patients who suffer from sleep issues have this pattern. These problems aren't simply caused by ADHD however, they are an integral part of the disorder itself. It's difficult for adults with ADHD to maintain a precise internal clock, which may be partly responsible for the difficulty in falling asleep. They also have trouble assessing the duration of time they've spent in their bed. A sleep study requires a daily sleep diary for several nights, which is difficult for people with ADHD to accurately complete.
Sleep Environment
It's difficult for everyone to get a good night's sleep, but it can be especially difficult for people with ADHD. It is difficult to fall asleep or relax due to the anxiety and racing mind that are associated with ADD. In addition, many of the treatments used to treat ADHD can have sleep-disrupting effects such as insomnia. It is crucial that those suffering from ADHD adhere to a healthy sleep routine and establish a regular schedule. They should also create an energizing, peaceful bedroom environment.
Sleep disorders can also affect the ability of people with ADD to get enough restful sleep. This can include sleep apnea (in which breathing stops intermittently during the night) as well as anxiety, depression and in women over 40, menopausal issues like night sweats. Sleep issues in people suffering from ADHD should be evaluated by a doctor to determine the reason.
Research has revealed that people with ADHD have a lower quality of sleep than the general population, and are more likely to feel exhausted and slow throughout the daytime. This may be due to their insomnia that may be caused by their inability to manage their internal clock. However, it is possible that the sleep problems are due to medication side effects or comorbid disorders.
People with ADD, especially those who are treated with stimulants frequently have trouble falling asleep and awakening frequently in the night. In fact, sleep onset latency and sleep efficiency are reported to be significantly worse in those taking stimulants in comparison to those who are on placebos in certain studies.
Despite this, some people discover that taking their ADHD medication right before bedtime can help improve sleep. However it should be done under the guidance of a doctor, as some sleep disorders can be exacerbated by certain medications. Adults with ADHD may benefit from other sleep-promoting techniques like progressive muscular relaxation (in which you tensen your muscles and then release them) and deep, slow breaths. It's also a good idea not to use your bed for any purpose other than sleeping or sex.