ADHD & Sleep

Not until very recently have we began understanding the very underestimated significance of a good night’s rest. In short, sleep influences EVERYTHING from our critical thinking, decision making, physical health, and even our ability to interpret the world around us accurately. According to Dr. Matthew Walker, “Sleep is not a disposable luxury – it’s a non-negotiable biological necessity1.”

When we don’t get enough good quality sleep, our functioning suffers. This is true for all people, especially children, teenagers, and young adults with ADHD, as their developing brains are incredibly sensitive to the effects of sleep deprivation.

Despite sleep problems being so common, it’s difficult to pinpoint what is disturbing our sleep and even harder, what to do about it! Let’s explore some of the most consistent complaints among those of us with ADHD.

Bedtime procrastination and time blindness are not good sleeping partners

Picture this: you finish eating dinner and sit on your couch to relax and watch some TV. You know you must get up early to prepare for a work presentation in the morning, but that’s literally the last thing that you want to think about. You decide to zone out and watch just one episode of the show you’re currently binging. Before you know it, you’re four episodes in and nearly three hours have passed. You quickly brush your teeth, wash your face, and jump into bed. But then…the late-night-snuggled-up-in-bed doom scrolling sneaks in. Next thing you notice it’s late into the morning and now you’re stressing about the hours left before your alarm goes off.

We know this all too well, even those of us that have lived through the next day repercussions of procrastinating on sleep. But if the effects of not sleeping are really that terrible, why in the world do we do this to ourselves?

It’s funny – our brilliant, yet stubborn, ADHD brains sometimes trick us into sacrificing the sleep we physiologically crave to squeeze out a tiny bit of dopamine from our phones before powering down for the night.

Psst – Katie: I know you’re still awake. I need to tell you something before you go to bed super quickly! Sleep is SO BORING anyways, so let’s just see what’s going on in the world instead. You won’t regret it, I promise….

We could just blame it all on technology, but that’s not the whole story. Put the tech away and I’m sure you’ll still find something else to distract yourself with instead of going to bed.

Restlessness due to hyperactivity, heightened arousal, or medication interference

On top of delaying the time we actually get into bed, our can ADHD play a significant role in disrupting our sleep. For those with combined or primarily hyperactive ADHD, physical restlessness at night can be a very real challenge. This can be mimicked or exemplified if you are taking stimulant medication that is interfering with your body’s ability to naturally wind down. Think of this like drinking 3 shots of espresso and then trying to fall asleep – you’re probably not going to have a restful sleep.

When you think about the combined effects of bedtime procrastination, time blindness, and restlessness that stem from ADHD, it’s incredible that we sleep at all. But contrary to the popular belief that we can “sleep when we’re dead” or catch up on sleep over the weekend, this isn’t the case. When we practice bad sleep habits, this translates into poor sleep hygiene, which are the practices and environments that contribute to our sleep quality – i.e. overall how good or bad your sleep is. Just like oral hygiene impacts a lot more than just the quality of our breath, sleep quality encompasses more than the duration of our sleep (stay tuned for a blog on sleep quality later!)

So…What now?!

First off, you’re not alone. ADHD is incredibly complex, with no two people being the same. Reports suggest that 25-50% of people with ADHD experience sleep problems, including insomnia, sleep-disordered breathing, and restless leg syndrome2. But just because we know we struggle with bad sleep, this doesn’t have to be our destiny. If you struggle with sleep, try out these strategies to improve your next sleep:

Observe your habits and track them

That’s right – write these down (or use data from a smart device if accessible)! Take note of things like when you wake up, times you eat meals and snacks, exercise times and intensity, when you start to get tired and the time you get into bed. All of these influence and are influenced by your circadian rhythm – your body’s natural 24-hour cycle. If we can live a life with activities that coincide with our circadian rhythm, you will become much more productive when you are awake and be able to get restful sleep.

Track your habits and sleep for a few days and see what you notice. Are your behaviors consistent or do they shift a lot? The more consistent you can make your habits, the better. I will talk more about the importance of consistency and circadian rhythms in a later blog.

Make a nighttime plan

Think of this like your planner or calendar for the day – it tells you what you need to do and deadlines for when these need to be completed. If you can come up with a plan that is relaxing and winds you down for bed by the time you plan on falling asleep, that is ideal! Since I have ADHD and struggle from time blindness, I like to plan backwards to ensure all my activities are accounted for. For example, I like to go to bed around 10 pm, which means I must brush my teeth, wash my face, and put on my pajamas around 9:30 pm. That way, I can read a book for 15 minutes before I get sleepy. The only thing left is to make sure I am done working or doing any high-energy expending activities before 9 pm so that I am not still wound up before I try to get in bed.

Sometimes we don’t realize how much sleep affects our daily lives until we become aware of common struggles. If you have ADHD and are interested in optimizing your sleep to enhance your daytime hours, join me in exploring more in this ADHD & Sleep blog series.

References

1. Walker, M. (2018). Why we sleep. Penguin Books. 

1. Wajszilber, D., Santiseban, J. A., & Gruber, R. (2018). Sleep disorders in patients with ADHD: impact and management challenges. Nature and science of sleep, 10, 453–480.