ADHD and Sleep
Despite popular belief, most ADHD medications do not cause sleep problems. In fact, methylphenidate and long-acting Atomoxetine could improve sleep.
Adults with ADHD have trouble getting to sleep. They toss and change positions and wake up often. Even when they do get to sleep, their minds are still active.
The effects of medication
A large percentage of adults with ADHD have sleep issues. Although the literature in the field does not typically discuss these issues however, they are believed to be common. Patients, parents and clinicians often describe difficulty sleeping or staying asleep, night awakenings as well as nocturnal activity, and drowsiness during the daytime. Objective measures such as polysomnography, ACTIgraphy, and subjective measures like self-rated questionnaires or diaries have been found to show statistically greater sleep problems among those with ADHD as compared to controls.
The most commonly prescribed drug for ADHD is stimulant-class medications, which can increase focus and concentration however, they can also affect sleep in certain patients. In fact, it is recommended that the primary sleep disorder, such as narcolepsy, be ruled out prior to starting these medication (Spruyt and Gozal 2011).
Stimulant-class drugs can trigger an abrupt rise in wakefulness and an increase in the efficiency of sleep. The sleep disturbances may be caused by a reduction in the production of melatonin, or an immediate effect on the nervous system. Additionally, stimulants may induce a sedating effect, paradoxical agitation, in some people.
In a controlled, randomized study of the drug ramelteon (an agent that triggers the hormone melatonin, believed to influence the circadian rhythms) insomnia was found to be improved in patients who suffer from ADHD who were treated with this medication as when compared to placebo. This was a brief preliminary study with limited power and a few control groups, but it should inspire future research to explore the dosage and timing, the types of insomnia, daytime blood levels, and the metabolites of ramelteon.
Other agents that have been used to treat insomnia in some patients with ADHD include clonidine, trazodone and mirtazapine. These medications are not as well-studied and a lot of doctors do not recommend them for treating patients with ADHD due to their potential for sedation next day.
If someone who suffers from ADHD has insomnia, they should first make an effort to maintain good sleep hygiene. They can also take their ADHD medication 45 minutes prior to the time of bed. In my experience this method is generally effective for the majority of people suffering from ADHD and sleep issues. If this doesn't work, a melatonin supplement can be tried.
Diet
The kind of food people eat can have a a direct impact on how they feel. A diet rich in nutrients and balanced can help improve ADHD symptoms including sleep problems. Foods that are low in sugar, processed fat and high in nutrients, such as vegetables, fruits and lean proteins should be consumed. Whole grains, as well as healthy fats such as omega-3 fatty acids, should be a part of the diet. It is essential to cook at home in order to ensure that your meals are stocked with all the necessary ingredients for good health. However best adhd medication for adults with anxiety suffering from ADHD have trouble planning and cooking their meals. In these cases, people may rely on take-out or restaurant meals which are high in sodium, sugar and artificial ingredients that may increase ADHD symptoms for certain individuals.
People suffering from ADHD frequently have difficulty getting to sleep at the end of the night. In fact, sleep issues are the most frequent complaints that people with ADHD report. These sleep issues can lead to a reduced quality of life and an increase in depression, anxiety and stress.
There are many different reasons for sleep issues for people suffering from ADHD, which can be related to symptoms of the disorder, or to other factors. Certain medications that treat ADHD such as methylphenidates can cause sleep issues in some people. In addition, people with ADHD tend to have a smaller pineal gland, which could affect the way in which the body regulates its circadian rhythm.
Doctors typically recommend a combination treatment options to help people with ADHD get better sleep. This includes creating an established routine for sleeping, optimizing your sleeping environment (such a creating a quiet and dark bedroom) and limiting screen-time before the bed. It is also essential for adults to ensure they get enough sleep, which typically is 7-9 hours per night.
In addition to dietary changes, exercise can aid in sleep for adults suffering from ADHD. Before bed taking a few minutes of 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 find it challenging to stick with a workout routine. A personal trainer can provide structure, motivation, and accountability while incorporating the individual's preferred exercise routine into a fitness program. Aerobic exercise can have both physical and mental advantages. In addition adding exercise for strength and mind-body such as yoga, tai-chi, or breathing exercises is an all-encompassing approach to managing ADHD symptoms, while also improving the cognitive functioning, emotional well-being and self-regulation.
Aside from helping people lose weight and build muscle, exercising can also have other positive effects on the brain, such as raising levels of norepinephrine and dopamine. Norepinephrine is a neurotransmitter that aids in self-control and concentration and dopamine is a neurotransmitter that increases levels of norepinephrine. Exercise stimulates the growth of neurons, and strengthens their connections. This is particularly evident in the cerebellum, which is an area which is responsible for the fidgeting of some individuals with ADHD. Research has proven that judo training, as an instance, can increase dopamine and norepinephrine in the cerebellum, more so than running on a treadmill.
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 health professional, and establish healthy sleep habits.
Many adults suffering from ADHD have difficulty falling asleep. They might wake up frequently, 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 stop their day-to-day activities and drift to sleep.
In my practice, at least 80 percent my adult patients with sleep problems show this pattern. These disturbances aren't just a result of ADHD, but are a major component of the disorder. Adults suffering from ADHD might have trouble keeping an accurate internal time which could be a contributing factor to their inability to fall asleep. They also have trouble assessing the length of time they've been in their bed. In fact, a sleep study often requires several nights of sleep logs and is difficult for someone suffering from ADHD to do accurately.
Sleep Environment
It is difficult for everyone to get adequate sleep, but it can be particularly difficult for those with ADHD. It can be difficult to relax or fall asleep because of the agitation and racing thoughts associated with ADD. A lot of the drugs prescribed to treat ADHD have adverse effects that can disrupt sleep, including insomnia. It is crucial that those suffering from ADHD maintain a good sleeping routine and establish a regular schedule. They should also establish an energizing, peaceful bedroom.
Sleep disorders can also affect the ability of those with ADD to get enough restful sleep. Sleep apnea, in which breathing stops frequently throughout the night, depression, anxiety, and menopausal-related issues like night sweats could all be included. Individuals with ADHD should be evaluated for sleep issues by a medical professional to determine the root cause.
Research has revealed that people who suffer from ADHD experience poorer quality sleep than the general population, and are more likely to be tired and unfocused during the daytime. This is partially due to their sleeplessness and can be exacerbated by their inability to manage their internal clock. However, it is also possible that the sleep disturbances are a result of medication side effects or comorbid disorders.
Inability to settle to sleep and the frequent awakenings throughout the night are not uncommon for those suffering from ADD particularly those who are treated with stimulants. In fact, the latency of sleep onset and sleep quality are found to be significantly higher when taking stimulants as compared to those on placebos in certain studies.
Some people find that taking their ADHD medications right before bedtime can improve sleep. However, this should be done under the supervision of a medical professional, since certain sleep disorders can be exacerbated by certain medications. Adults suffering from ADHD can benefit from other methods to promote sleep like progressive muscular relaxation (in which you tighten your muscles and then release them) and deep, slow breaths. It's important not to make use of your bed for anything other than sex or sleep.