Improve Your Sleep: Tips for Better Sleep for Adults With ADHD

Dr. Serenity

Mind Health

April 12, 2023

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Better Sleep for Adults with ADHD: Understanding the Challenge

Sleeping well can be a major challenge for adults with attention deficit hyperactivity disorder (ADHD). The condition, which is characterized by issues such as trouble sitting still and difficulty paying attention, can make it harder to calm the body and mind at night. Most adults with ADHD report problems falling and staying asleep, and feeling fatigued during the day, according to the National Resource Center on ADHD. This disorder typically starts before age 7 or 8 and carries symptoms into adulthood. At least 4.4% of adults in the U.S. have aspects of the condition, according to surveys by the National Institute of Mental Health.

Insomnia can strike even if you control your ADHD symptoms during the day. “About three-fourths of adults with ADHD will say their minds are too ‘full’ to sleep,” says Dr. William Dodson, a Denver-based psychiatrist and expert on adults with ADHD. “They toss and turn.” And when they do drift off, adults with ADHD often fall “dead asleep” and will complain they can’t wake up even with multiple alarm clocks.

“ADHD adults are chronically sleep-deprived,” says Dr. Dodson. “The typical person will be wide awake at 3 or 4 a.m. and have to get up at 7 to go to work.” ADHD adults need seven or eight hours of sleep a night to promote health and prevent fatigue during the day, says Dr. Clete Kushida, medical director of the Stanford Sleep Medicine Center in Redwood City, Calif.

Sleep deprivation can be as impairing as other adult symptoms of ADHD combined, according to Dr. Dodson. It can also make other symptoms worse, adds Dr. Michael Coates, an adult ADHD expert and past chair of family medicine at Wake Forest Baptist Medical Center in Winston-Salem, N.C. “Sleep is critical for adults with ADHD,” he says. In this article, we share 9 tips from top experts to help you get the sleep you need.

Top Experts Share 9 Tips to Help Adults with ADHD Get Better Sleep

Method #1: Determine the Root of Your Sleep Problems

• Clinical psychologist Thomas Brown, Ph.D. advises identifying the exact cause of your sleep problems before attempting to resolve them.
• A medical check-up can rule out medical conditions like sleep apnea, depression, anxiety, and hormonal issues.

Method #2: Incorporate Exercise into Your Routine

• Regular exercise has clear benefits for ADHD, including improved sleep quality.
• Adults with ADHD should aim for 45-50 minutes of cardio per day to stimulate neurotransmitters that promote a sense of well-being.
• Exercising after 7 p.m. can interfere with sleep.

Method #3: Consider Taking Melatonin

• Melatonin, a natural hormone that helps regulate the sleep-wake cycle, can aid in getting to sleep.
• ADHD adults may experience sleep disturbances due to having no internal clock, says Dr. Dodson.
• Dr. Dodson recommends taking 1mg or less of melatonin and being consistent with taking it every night.
• However, melatonin may not help with staying asleep.

Method #4: Use natural light.

• Bright lights at night can interrupt the body’s natural production of melatonin and alter your circadian rhythm, making sleep more difficult.
• Dim lights within a few hours of bedtime.
• Use a light just strong enough to see the words if reading before bed.
• Bright light in the morning can help adults with ADHD wake up.
• Get at least a few minutes of sunshine early in the day.

Method #5: Follow the rules.

• Set a consistent bedtime and wake-up time that you stick to, even on weekends.
• Stop nighttime stimulation.
  • • Turn off the computer and TV at least an hour before bedtime.
    • Let your brain slow down.
• Stop drinking caffeinated beverages or eating foods with caffeine within hours of bedtime.
• Keep your bedroom dark, cool, and comfortable.
• Re-associate your bedroom environment as a place for sleep.
• Get up for a while if you still can’t get to sleep to avoid associating bed as a place where you can’t “shut off your brain and stop thinking of stuff.”

Method #6: Take your meds.

• Some stimulant medications commonly prescribed for symptoms of ADHD during the day can also help with sleep problems.
• Research has shown that most children with ADHD who had preexisting sleep problems did not have those same sleep problems on a high dose of methylphenidate.
• Consider trying ADHD medications to help with sleep problems.
• Dr. Coates has had success prescribing Ritalin to be taken later in the day to promote sleep.
• Stimulants don’t work for everyone, and taking them too late in the day can have the same effect as drinking too many cups of coffee, warns Dr. Brown.

Method #7: Relaxation Techniques

• Use progressive muscle relaxation and slow, deep breathing to relax and help your mind drift
• Avoid bringing worries to bed

Method #8: Avoid Alcohol

• Drinking alcohol can make sleep issues in adults with ADHD worse
• Alcohol acts as both a depressant and a stimulant

Method #9: Beware of Sleeping Pills

• Sleep medications are considered a last resort for those with adult ADHD and generally aren’t recommended
• Adding a sleep-inducing drug at night can set up a “vicious cycle” of stimulation and sedation
• Sleep medications only suppress the problem and don’t treat it

For patients with ADHD that includes hyperactivity, alpha-2 adrenergic agonist medications like clonidine may be recommended by doctors like Dr. Dodson. These medications work by slowing the heart rate and inhibiting stimulating brain chemicals, which can help with some ADHD symptoms and make it easier to fall asleep.

However, Dr. Dodson advises against using sleeping pills if possible, as they can set up a cycle of stimulation and sedation and only suppress the problem rather than treating it.

How Much Do You Know About ADHD?

Do you struggle with inattention and restlessness? You may have attention deficit hyperactivity disorder (ADHD), which affects around 8-9 million adults. Some adults may be unaware of their condition if it was never diagnosed in childhood. Test your knowledge about this common disorder.