ADHD And Insomnia: Understanding The Connection

Although many people claim they "must have ADHD" when they feel distracted and unable to focus properly, it is a real condition that can impact many aspects of everyday life. One lesser-known impact of ADHD is that it can present difficulties for the person suffering from it to get quality sleep at night.

Over time, not getting enough quality sleep can take a major toll on a person's work and personal life, but there are some treatment options available that can improve symptoms of both ADHD and insomnia.

What is ADHD?

ADHD, or attention-deficit hyperactivity disorder, is a neurodevelopmental disorder that is often characterized by a person's inability to control compulsive behaviors and pay attention at work or school. As a result, many people with ADHD have difficulty focusing on tasks for extended periods of time, and it can be hard for them to keep their schedules and tasks organized.

It's a relatively common condition, affecting approximately 9.4%¹ of children in the United States between the ages of 2 and 17 and impacting about 4.4%² of U.S. adults.

Some common symptoms of ADHD in children include:

• Talking excessively

• Taking unnecessary risks

• Making careless mistakes

• Having difficulty sitting still

• Daydreaming excessively

• Fidgeting excessively

• Having difficulty getting along well with others

Many of the above symptoms are present in children without ADHD occasionally, but those with ADHD tend to present them regularly.

In adults, ADHD can display the following symptoms:

• Managing time poorly

• Having a low frustration tolerance

• Experiencing frequent restlessness

• Having difficulty planning and following through

• Having difficulty coping with stress

• Experiencing frequent mood swings

If you think you might have ADHD, it can be helpful to speak with a doctor about your concerns. They may be able to refer you to a specialist that can further investigate your symptoms and give you a confirmed ADHD diagnosis or help you figure out if you are dealing with something else. Getting an official diagnosis is important as it allows your doctor or healthcare provider to give you viable treatment options to help you manage your symptoms.

Types of ADHD

The term ADHD describes a generic set of symptoms and behaviors, but there are actually three different types of ADHD:

• ADHD, inattentive and distractible type: usually appears as a tendency to get distracted or not pay attention, but without the hyperactivity

• ADHD, impulsive/hyperactive type: is characterized by hyperactivity and impulsive behaviors

• ADHD, combined type: is the most common type of ADHD, and often shows inattention, distractibility, hyperactivity, and impulsive behaviors

If you receive a diagnosis of ADHD, your healthcare practitioner may diagnose you with one of the specific types of ADHD listed above. Your treatment options may vary with the type of ADHD you have, and it may take trial-and-error and time to figure out the best treatment for you.

What does it mean to have insomnia?

Insomnia is a sleep disorder that makes it difficult for you to fall asleep or stay asleep, and it often leaves you feeling tired throughout the day. It can severely impact your mood, health, and lifestyle. Most people have experienced short-term insomnia when they have had difficulty sleeping for a few days due to travel or stressful events, but insomnia that lasts at least a month may require further investigation.

Adults typically require 7-8 hours of sleep per night to function well, but that can vary from person to person. There are several potential causes of insomnia, such as:

• Consuming caffeine, alcohol, and nicotine

• Medications

• Mental health disorders

• Medical conditions

• Sleep disorders

• Aging

Chronic insomnia can also create some complications, such as mental health disorders, increased risk of accidents due to slower reaction time, increased risk of developing chronic diseases like high blood pressure and diabetes, and worse performance in work and school.

If a person suffers from both ADHD and insomnia, it can make it difficult for them to complete normal activities of daily living and maintain adequate performance for work and school.

How ADHD and insomnia are related

A recent study found that approximately 45%³ of adults with ADHD also have insomnia disorder and that people with more severe ADHD seem to have a higher prevalence of insomnia.

Interestingly, people who have ADHD and also experience mood disorders, anxiety disorders, personality disorders, or substance use disorders also have a higher likelihood of having insomnia.

Some people with ADHD may not experience the typical hyperactivity the condition is known for during the day, but they may experience bursts of energy at night or racing thoughts that can make sleep difficult. Some people with ADHD also tend to have periods of "hyperfocus" late at night when others are asleep, and there is less chance for distractions.

Periods of hyperfocus can often last hours, which can make it hard for a person in the throes of their preferred activity to know what time it is and start a wind-down routine before bed.

Coping with insomnia and ADHD

It can be incredibly difficult to try to cope with both insomnia and ADHD simultaneously. It's helpful to see your doctor if you experience symptoms consistent with ADHD and insomnia, as that can provide you with a diagnosis that can lead to more specific treatment options.

There are also some lifestyle changes you can make to improve your sleep with ADHD, including:

Reducing screen time

Screens are everywhere these days, which gives us access to plenty of entertainment and knowledge but can also make it hard for us to fall asleep. This might be because of the blue light emitted from your phone, which acts similarly to daylight on the eyes and brain.

It might also be because looking at your phone before bed can make it hard to relax, as social media and digital games can make your mind feel engaged instead of rested, or because you may have trouble not thinking about disturbing news or emotional social media posts that you have seen.

Many people find it helpful to stay away from screens, including television and computer screens, at least 1-2 hours before bed.

Getting enough exercise

Exercise has numerous health benefits, one of which is enhancing sleep at the end of the day. Although it isn't necessarily recommended to exercise within 90 minutes of bedtime, exercise in the form of walking, biking, gardening, or anything else that gets your body moving, can help you sleep better at night.

Emerging research⁴ has also begun to show that exercise can help other symptoms of ADHD in children. The CDC recommends getting at least 30 minutes per day of physical activity five times a week, but any physical activity is better than none!

Avoiding caffeine, sugar, and alcohol before bedtime

As mentioned above, some substances like caffeine and alcohol can make sleep more difficult. Avoiding these substances at least 4-6 hours before bedtime can help you feel relaxed and ready for bed at an appropriate time.

Developing a bedtime routine

Your body enjoys routine, and it can be helpful to develop a bedtime routine to help you wind down and get your mind into the right state for a good night of sleep. It can take time to figure out an ideal bedtime routine for you, but it likely involves avoiding screens in favor of relaxing activities like reading, knitting, or taking a warm bath.

Treatment options

Although the above lifestyle changes can help improve your sleep, getting treatment for your ADHD can also drastically improve your insomnia. Two of the most common treatments for ADHD are medications and psychotherapy.

Medications

Many people with ADHD have success with stimulants, which can balance neurotransmitters in the brain and reduce the symptoms associated with ADHD. Other medications include atomoxetine and some antidepressants, which can work for those who can't use stimulants due to side effects.

Your doctor may start you on a low dose of medication and gradually increase it if necessary, or they may have to try different medications before finding one that works best for you.

Psychotherapy

Psychotherapy can help an individual better manage their thinking patterns and behaviors to overcome challenges, and it can also be used to treat depression, anxiety, and substance use disorders at the same time.

Most people with ADHD  respond better to a combination of medications and psychotherapy, rather than just one or the other.

The lowdown

ADHD is a difficult condition on its own, but it can cause even more struggles when paired with insomnia. If you or a loved one are experiencing symptoms of ADHD and/or insomnia, it might be helpful to talk with a doctor to rule out other possible medical conditions and get started on building a treatment plan that can help you better manage your symptoms.

Even if you have ADHD, getting quality sleep most nights is possible with adequate treatment and lifestyle changes.