Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that can make it difficult to sleep well. By some estimates, about 33% of people with ADHD get the eight hours of restorative sleep they need each night to feel alert and content in the daytime. People with ADHD who sleep badly often feel tired, drained and distracted during the day, which can lead them to stay up longer as they try to live their lives. These disruptive experiences can create a cycle of disordered sleep that seems never-ending.
Though the relationship between ADHD and poor sleep remains unknown, the conditions may be linked. Here’s how ADHD and poor sleep may overlap and what you can do to deal with these conditions. Even small changes, like investing in adjustable mattresses, could make a meaningful difference in your sleep quality.
Find the Perfect MattressHow Are ADHD and Poor Sleep Related?
If you have ADHD, you’re more likely to sleep for short periods of time and have trouble falling asleep, staying asleep or waking up. Lack of sleep can make it harder to concentrate and remember things during the day. Learning what you can do to sleep longer and better, like improving your sleep hygiene and investing in the best mattresses, can improve your quality of life.
Which Sleep Disorders Are Linked to ADHD?
Researchers believe up to 80% of adults with ADHD have trouble sleeping. These people frequently experience sleep disorders like insomnia, sleep-disordered breathing, narcolepsy, restless legs syndrome (RLS) and circadian rhythm sleep disorders. Scientists think these issues could be related to chemical imbalances or functional irregularities in the brain, but the exact relationship between poor sleep and ADHD remains unknown.
Nevertheless, people with ADHD who sleep badly may notice that their ADHD symptoms, like hyperactivity, poor working memory and trouble processing information, worsen with time. They may also be more vulnerable to long-term physical and mental health problems that make it difficult to enjoy life. Here’s a look at some sleep disorders people with ADHD may experience:
Insomnia
Insomnia is a condition that makes it difficult to fall or stay asleep. People who experience insomnia frequently have bursts of energy at night, racing thoughts and wakefulness in the wee hours of the morning. They may also feel stress when they go to bed, which further contributes to sleeplessness.
Sleep-Disordered Breathing (SDB)
Sleep-disordered breathing (SDB), which includes snoring and sleep apnea, affects up to 33% of people who have ADHD. People who develop irregular breathing patterns while they sleep may inhale less oxygen and get less rest, which can cause fatigue and diminish the body’s ability to regulate and repair itself.
Narcolepsy
Narcolepsy is a condition that includes difficulty waking up, daytime sleepiness and falling asleep in the daytime. People with narcolepsy rarely sleep soundly at night. Some researchers believe that genetics or neurotransmitter imbalances cause this disorder, which can make it difficult to get through the day.
Restlessness and Restless Legs Syndrome (RLS)
Restlessness describes a heightened state of arousal that can cause fidgeting and racing thoughts. It’s associated with non-refreshing sleep and being a “light sleeper" who wakes up easily and frequently. Some people with restlessness twitch in their sleep and experience restless legs syndrome, which causes their legs to tingle and move involuntarily. These movements, which may be caused by dopamine and iron deficiencies, can disrupt sleep.
Circadian Rhythm Sleep Disorders
The circadian rhythm aligned with day and night defines the human sleep-wake cycle, and people who experience disorders like delayed sleep phase syndrome (DSPS) find themselves out of sync. Normally, the body produces the hormone melatonin at night to help people sleep and then slows production in the morning. People with circadian rhythm sleep disorders may feel more alert in the evening and be known as “night owls.” Bright lights, especially artificial blue lights, can disrupt your body’s melatonin production cycle and “inner clock,” leading to tiredness and distractibility during the day.
What Causes Poor Sleep Patterns in People With ADHD?
Because ADHD and sleep disorders are likely to co-occur, researchers believe the factors below may contribute to both conditions.
Neurotransmitter Imbalances
Chemicals like serotonin, norepinephrine, noradrenaline and dopamine are neurotransmitters that also help regulate sleep. People with ADHD often experience imbalances of norepinephrine and dopamine that can affect their attention and arousal and lead to sleep disturbances. They may also experience a dysregulation of dopamine and noradrenaline that affects their REM sleep and leads to narcolepsy.
Sleep Drive Dysregulation
Your sleep drive is a key physical system that regulates sleep by building up levels of a chemical called adenosine during the day. Adenosine levels typically peak after 16 hours of being awake and signal the body to sleep again. People with ADHD often have disrupted sleep drives if they engage in adenosine-altering activities like consuming large amounts of caffeine or taking daytime naps.
Delays in Melatonin Production
Melatonin is a sleep hormone that helps people fall and stay asleep at night. Many people with ADHD experience delays in their melatonin release that make them feel alert at night.
Hyperfocus and Time Blindness
Since people with ADHD may experience fewer external distractions at night, they may be more likely to use this time to hyperfocus on work or activities like gaming. If they’re also feeling alert, it can be hard to wind down, which can lead to time blindness and a dysregulated sleep schedule. Time blindness makes it hard for people to monitor how time is passing or notice the transition between day and night. Over time, nighttime hyperfocus and time blindness can create long-term disruptions in circadian rhythm that make it more difficult to sleep well.
Stimulant Consumption
It’s common for people with ADHD to take stimulant medications like Adderall or Ritalin, consume caffeine from beverages like coffee, tea and soda or inhale nicotine when they smoke or vape. Although stimulants can sometimes have calming effects that make sleeping easier, they usually heighten arousal and make people feel more alert, which can dysregulate sleep. Extended-release ADHD medications are especially likely to contribute to poor sleep quality because they stay active in your system for several hours.
What Can People With ADHD Do to Sleep Better?
If you have ADHD and you struggle to sleep well, making changes to your lifestyle can help you rest more easily. With a bit of know-how, effort and self-care, you can improve sleep quality and optimize your moods, attention span and working memory during the day.
Improving your sleep with ADHD doesn’t have to feel like a punishment. Taking a few steps to improve your sleep hygiene over time and treating yourself well can vastly improve your quality of life.
Make Your Bedroom a Sanctuary
One of the best ways to get good sleep is to make your bedroom inviting and comfortable. Investing in adjustable beds with high-quality natural fiber sheets and blankets and soft pillows can make it much easier to rest. You should also declutter your space, cover or move the mirror in your bedroom and cool your room to between 60° and 67° F to promote a sense of calm. To boost melatonin production, block out light by wearing a sleep mask or installing blackout curtains. Listening to pink noise may also help you sleep through the night.
Shop All PillowsCreate a Bedtime Routine
Set an evening bedtime between 10 and 11 p.m. and stick to it. Reading a favorite book, journaling, taking a warm bath and drinking chamomile tea are great ways to relax before you turn in. If racing thoughts keep you up, you can meditate, listen to soothing music or practice progressive muscle relaxation to help you fall asleep. Try different solutions to create a routine that suits you best.
Shut Off Your Screens
At night, you should use your bed for sleeping or sex only and avoid working or screen time in bed. Scrolling on your phone can distract you from keeping your bedtime and expose you to blue light that suppresses melatonin, so shut off your electronics an hour before bedtime. If possible, keep your phone, computer and TV out of the bedroom.
Wake Up on Schedule
Maintaining a consistent sleep schedule can help you regulate your circadian rhythm. Try to get up at the same time every morning, and work on an incentive, like having a nice breakfast, that helps you look forward to getting up. Exposing yourself to sunlight for 20 minutes in the morning can help you regulate your circadian rhythm. You can also use artificial light, like a sunrise alarm clock or a happy lamp, to make it easier to wake up.
Get Regular Exercise
People with ADHD frequently have plenty of energy to burn. Exercising at least every other day for 30 to 40 minutes per session may help decrease restlessness and make it easier to fall and stay asleep.
Save Focused Activities for Daytime
If you have ADHD, try to engage in your most interesting and stimulating activities during the day so you’ll have time to wind down before bedtime. Avoid working on projects that require intense focus in the evening.
Other Tips for Improving Sleep
Take stimulant medications early in the morning at the same time every day. Consider switching from extended-release doses to short-acting doses.
Try to nap before 2 p.m. for 20 minutes or less.
Stop consuming heavy foods, sugar, caffeine, nicotine and alcohol at least four hours before bedtime. Limit your caffeine intake to 400mg during the day.
To help get your circadian rhythm back on track, try taking a low-dose (0.5-3mg) melatonin supplement two or three times a week. Ask your doctor how to cycle off melatonin so that your body will continue to produce this hormone naturally.
Are There Medical Treatments for ADHD Sleep Issues?
If you still find it hard to sleep well after you change your habits, ask your doctor if you should consult with a sleep specialist. You might need to undergo a sleep study to discover the underlying cause of your issues. Medical treatments for sleep disorders include using a continuous positive airway pressure (CPAP) machine to treat sleep apnea, changing your medication, engaging in bright light therapy and using cognitive behavioral therapy (CBT) to improve your sleep hygiene.
When You Have ADHD, Better Sleep Means a Better Life
Living with ADHD and sleep issues can be difficult, but suffering isn’t inevitable. Knowing you can take steps to end the cycle of poor sleep and fatigue can help you live a healthier, happier life.
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