ADHD, or attention-deficit/hyperactivity disorder, can cause restlessness, forgetfulness, and problems with everything from concentrating on a task to following instructions. But the condition can also have huge impacts on your sleep, making it hard to get enough of it each night.
And the relationship goes two ways: your sleep can have a huge impact on your ADHD symptoms. When you don’t get enough sleep, and you don’t get it at the right times for your body clock, symptoms get worse and harder to live with.
In this blog post, we’ll explain the link between ADHD and sleep and show you how the RISE app can help you get better sleep, even with ADHD. The app can help you get enough sleep and stay in sync with your body clock by guiding you through 20+ sleep hygiene habits each day. Plus, it can help anyone who uses the “spoons theory” manage and improve their energy levels.
ADHD stands for attention-deficit/hyperactivity disorder. It’s usually diagnosed in childhood, but adults suffer from it, too. According to CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), about 10 million adults have ADHD.
Common symptoms of ADHD include:
These things may affect kids’ performance at school. In adults, it can cause problems at work and in relationships.
Researchers still aren’t sure what causes ADHD, but it’s thought genetics plays a part, as do things like exposure to lead, alcohol, and tobacco during pregnancy; low birth weight; and brain injuries. More recent research is finding out how disruptions to your sleep and circadian rhythm could be behind ADHD and ADHD-like symptoms (more on this soon).
Sleep is pivotal to health, but it doesn’t come easy to those with ADHD.
Research shows people with ADHD experience:
Those with ADHD are also more likely to have common sleep disorders like obstructive sleep apnea, restless leg syndrome, and circadian rhythm sleep disorders.
To make matters even worse, while medication used to treat ADHD can help some people sleep, it can disrupt the sleep of others.
Plus, people with ADHD often have other mental health issues — up to 87% of children with ADHD have at least one other disorder. Bipolar disorder, autism, post-traumatic stress disorder, and obsessive compulsive disorder are common in those with ADHD, and all of them are linked to sleep problems.
Depression and anxiety are also often associated with ADHD, and — you guessed it — those can cause sleep problems, too.
It’s a vicious circle, too, as sleep disturbances can then make ADHD — and all the other problems mentioned here — even worse.
Those with ADHD are also more likely to have delayed sleep phase disorder (DSPD). They struggle to fall asleep and wake up at earlier, socially acceptable times. This is most likely due to their circadian rhythm being delayed, and they could find themselves on a sleep-wake cycle two to six hours later than the rest of the world.
A 2019 study looked at adults with sleep problems. It found probable ADHD was reported by almost 50% of those with DSPD, and only about 27% of those without DSPD. It concluded: “The data suggest a high prevalence of probable ADHD in DSPD patients and increased prevalence of DSPD and other sleep disorders in patients with probable ADHD.”
ADHD negatively impacts sleep, but sleep can also have an effect on ADHD.
Sleep deprivation can make ADHD symptoms worse, an unfortunate fact considering ADHD can cause sleep deprivation in the first place.
Research shows sleep deprivation results in a significant decrease in performance on tasks that need skills like sustained attention, which are commonly used to measure ADHD symptoms in children. Further studies show that after not getting enough sleep at night, people with ADHD had increased inattention, cognitive problems, impulsivity, and hyperactivity.
We know ADHD can cause sleep problems, and sleep problems can actually make ADHD symptoms worse, causing a vicious circle. But research is also finding out that sleep problems may even cause, or at least mimic, ADHD.
Sleep disturbances in young children, including waking up often during the night or having sleep onset insomnia (struggling to fall asleep), have been associated with an increased likelihood of developing ADHD symptoms in later life. For example, sleep problems between the ages of 2 and 4 predicted attention problems at age 5, and even sleep disturbances at age 4 predicted attention and aggression problems at age 15.
But researchers don’t know for sure yet. Children’s sleep problems may be the first symptom of later ADHD, or they may be the cause of it.
The link between sleep problems and ADHD is so strong that researchers say problems with sleep may actually lead to the development of ADHD.
But it’s not just a lack of sleep, though. There’s also a theory that ADHD may be associated with a lack of regular circadian sleep, or sleep that’s well-timed with your circadian rhythm.
Your circadian rhythm is your internal biological clock. It runs on a roughly 24-hour cycle and controls things like your sleep-wake cycle, when your body produces certain hormones, and how your body temperature fluctuates throughout the day and night.
Research shows that 75% of those with ADHD have a physiological sleep phase — the phase where you show signs associated with sleep, like higher levels of the sleep hormone melatonin — that is delayed by 1.5 hours.
Core body temperature changes associated with sleep are also delayed, and those with ADHD are often more alert later in the evening.
Plus, restoring proper sleep patterns in kids has been shown to improve their ADHD symptoms.
All this, and more, leads researchers to think that ADHD could be caused by sleeplessness or disruptions to your circadian rhythm, or at least, these things play an important part in it.
It wouldn’t be too surprising if it was true. Circadian rhythm disruption has been associated with most mental health disorders, including anxiety, schizophrenia, and autism. Researchers are therefore debating whether circadian rhythm disruption could cause mental health disorders or whether it’s a symptom of them. Researchers also believe new treatments for mental health disorders could be found by studying circadian rhythm disruption.
The symptoms of sleep deprivation — think difficulty concentrating, forgetfulness, and mental health problems — are so similar to those of ADHD that sleep disorders and deprivation are often misdiagnosed as ADHD, especially in children.
Children’s ADHD symptoms are often noticed when their circumstances change, like when they start school. And starting school can often lead to sleep deprivation and misaligned circadian rhythms from being forced to wake up early.
But this may lead to people getting the wrong treatment and sleep problems getting worse. For example, Adderall and Ritalin are often prescribed for ADHD, but they can also cause insomnia, which will then make all of those ADHD-like symptoms even worse.
This is especially dangerous in children whose brains are developing. Their sleep disorder or disruption is misdiagnosed as ADHD, and they subsequently get treated for it, which makes the sleep disorder or disruption even worse, making their ADHD-like symptoms worse, too.
More research needs to be done to find the best treatment options for ADHD and the sleep-related problems that often come along with it or before it.
But there are a few things you can do to improve your sleep, and therefore your energy levels, and potentially your ADHD symptoms, too.
Sleep hygiene interventions are often recommended as a first-line option for those with ADHD, both for people on medication and not.
Sleep hygiene is the name for the set of behaviors you can do each day to help you fall asleep faster, stay asleep all night, and fall asleep at your desired bedtime. They will help you get enough sleep each night and stay in circadian alignment, two things that have been shown to improve ADHD symptoms.
Here’s what you can do:
This may look like a lot to remember, but the RISE app can guide you through 20+ sleep hygiene habits, helping you not only do each one, but do them at the right time for your own circadian rhythm, which makes them more effective. You don’t need to worry about forgetting habits or getting distracted from doing them, RISE can coach you through them all every day.
RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.
A small sleep study on children with ADHD and insomnia found sleep hygiene interventions reduced sleep latency to below 60 minutes in about 20% of patients.
Sleep hygiene is recommended as a first-line option for ADHD because, as we’ve covered, sleep disorders can present as ADHD, and because ADHD medication can cause sleep problems. ADHD medications can also wear off by bedtime, meaning symptoms reappear and keep you up.
Traditional ADHD medications also often don’t address the symptoms of circadian rhythm delay, whereas sleep hygiene can help to keep your circadian rhythm in check and stop it from drifting later and later in the day.
Sleep hygiene is also a good option to try as there are no harmful side effects, unlike other treatments for sleep issues like prescription and over-the-counter sleep aids.
Sleep debt is the running total of how much sleep you owe your body compared against your sleep need, which is the genetically determined amount of sleep you need each night. When you don’t get enough sleep for you, you’ll build up sleep debt, which can make ADHD symptoms worse.
Sleep hygiene helps keep your sleep debt low as it helps you fall asleep faster and wake up less often during the night, increasing how much sleep you get overall.
RISE can calculate your individual sleep need and how much sleep debt you’re carrying.
RISE users on iOS 1.202 and above can click here to view their sleep need.
RISE users on iOS 1.202 and above can click here to view their sleep debt.
As the link between circadian rhythm disruptions and ADHD is getting clearer, you want to think about your circadian rhythm more in your daily life.
You can live in sync with your circadian rhythm by:
RISE users on iOS 1.202 and above can click here to set up a reminder to check their Melatonin Window.
Light is the most powerful zeitgeber, or something that can change the timing of your circadian rhythm. Getting light in the morning can shift it forward, whereas getting it in the evening can push it back. So, getting the timing of your light exposure right is a key part of sleep hygiene and can help you fall asleep at an earlier time. It’s also been shown to be powerful when treating ADHD.
Research has found longer duration of light exposure throughout the day is strongly associated with lower levels of hyperactivity symptoms in kids.
One study looked at whether bright light therapy can reduce ADHD symptoms by bringing the circadian rhythm forward. Over the course of two weeks, participants got 30 minutes of 10,000 lux of light in the morning and minimized overhead light after 4 p.m. The results showed that bright light therapy advanced their circadian rhythms, and this resulted in an improvement of their ADHD symptoms.
Speak to a healthcare professional to get a proper bright light therapy treatment plan. But at home, you can make sure you’re getting natural light first thing and avoiding artificial light close to bedtime to replicate this study. And as per the research above, make sure to get out in natural light throughout the day.
The RISE app can help by telling you the exact times you should be getting and avoiding bright light each day.
Melatonin supplements have also been shown to be effective at shifting your circadian rhythm to an earlier time — helpful for ADHD sufferers with delayed sleep phase syndrome.
In a study with children who suffered from ADHD and insomnia, melatonin reduced sleep latency and increased total sleep time, but it didn’t help to improve ADHD symptoms.
Another small study, however, found combined sleep hygiene and melatonin improved insomnia in kids who were taking stimulant medication for their ADHD.
However, melatonin isn’t usually recommended for children. You can learn more about melatonin supplements here.
If you do turn to melatonin supplements, RISE can tell you the ideal time to take them each day.
Heads-up: There are mixed results when it comes to how effective sleep aids are for ADHD and its related sleep problems as they come with a lot of unpleasant side effects. Speak to a healthcare professional to find the best treatment plan for you or your child. You can also learn more about the safety and side effects of sleep aids here.
Many people with ADHD, and indeed many chronic or mental illnesses, use the spoons theory. The theory states that you have a limited amount of spoons, or energy, to spend each day, and everything you do — from getting dressed in the morning to completing a work task — requires a set number of spoons.
Once all your spoons are gone, you’re forced to rest until you build up spoons again. This method helps people manage their energy levels and prioritize their tasks.
The RISE app can help you do this by giving you a better understanding of what gives you more “spoons” each day. You may find when your sleep debt is low and you’re living in sync with your circadian rhythm, you have more spoons to spend each day, or your spoons are replenished quicker.
Plus, RISE helps you build healthy morning and evening routines. These will not only help you keep sleep debt low and stay in sync with your circadian rhythm, they’ll automate the tasks, so they take up mental energy and preserve your spoons. The app also coaches you through the best things to do when your energy is at its highest and lowest each day, taking another thing off your plate.
RISE users on iOS 1.202 and above can click here to set up reminders for their personalized morning and evening routines.
It may be your kid who has ADHD, but that doesn’t mean you’re sleeping soundly. You may stay up late with them as they resist going to bed, get up early to get them up for school, or wake up often in the night with them as they suffer from problems like night sweats, nightmares, and fear of sleeping alone or in the dark. And that’s not to mention how the stress of the situation impacts your own sleep.
Even without ADHD yourself, you may have built up a lot of sleep debt and be living out of sync with your circadian rhythm, causing low energy, productivity, and mood — all of which you want to be the best parent you can be.
But, you can use some of the methods we’ve outlined here to help.
Use the RISE app to find out your individual sleep need and how much sleep debt you have. If you can’t get enough sleep at night to meet your sleep need, try taking naps during your afternoon dip in energy (check RISE to when this will be each day) to keep your sleep debt as low as possible. You can learn about the best nap length for you here.
Even if your sleep is disrupted, be sure to stay on top of your sleep hygiene. This will make the sleep you do get the best it can be, and ensure you get a good night’s sleep when the opportunity arises.
Get bright light in the morning and avoid it too close to bedtime, and avoid caffeine, exercise, alcohol, and large meals too close to bedtime. Check RISE for the exact time you should do each of these things, depending on your own circadian rhythm.
RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.
This one is obviously easier said than done if your kid is up at odd hours of the night and you are with them, but, as much as possible, aim to live in sync with your circadian rhythm.
The link between sleep and ADHD is yet to be fully understood. But we do know ADHD makes sleep hard to come by, and poor sleep makes ADHD worse. Disruptions to your circadian rhythm can also make ADHD harder to live with.
Use the RISE app to keep your sleep debt as low as you can and stay as in sync as possible with your circadian rhythm. Maintaining excellent sleep hygiene will help you do both, and RISE can guide you through 20+ sleep hygiene habits at the ideal timing for your own biology.
There is a strong connection between ADHD and sleep problems. People with ADHD can experience shorter sleep time, trouble falling asleep, nighttime awakenings, night sweats, night terrors, and insomnia.
Adults with ADHD often experience sleep problems. This could include trouble falling asleep and staying asleep during the night, daytime sleepiness, night sweats, insomnia, and sleep apnea. Sleep loss can also make ADHD symptoms worse.
Sleep hygiene can work as a natural sleep aid for ADHD adults by helping them fall asleep faster and stay asleep all night. Melatonin supplements can also help shift their sleep-wake cycle earlier, and therefore fall asleep at a better time.
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