How ADHD Affects Your Sleep And Solutions to Get Better Rest
ADHD and Sleep: Tossing and Turning All Night Due to Restlessness? You're Not Alone!
Sarah, a mom of two who was diagnosed with ADHD in her 30s, describes her nights as a battleground.
"I’d be tired all day, then as soon as I got into bed, my mind wouldn’t stop. My brain was wide awake when I needed to rest the most."
Sarah’s experience mirrors the struggle many women face with sleep and adhd.
In my practice, many of the women I work with have sleep issues. In this post, we’ll explore the science behind adhd and sleep disorders and this connection and provide helpful tips to manage both ADHD symptoms and sleep difficulties.
Common ADHD Sleep Problems
Studies suggest that between 25-50% of adhd adults experience sleep-related challenges such as insomnia, sleep-disordered breathing, restless leg syndrome (RLS), and circadian rhythm disruptions! Women, in particular, report higher rates of insomnia and delayed sleep-wake phase disorder (DSWPD).
Anxiety and Depression can increase when Sleep Issues Exist.
Women with ADHD who are also sleep-deprived often experience heightened levels of anxiety, depression, distraction and, and stress. This can affect work performance, relationships, and overall quality of life. Hormonal shifts can further intensify these feelings, particularly around menopause and perimenopause.
Helpful Tip: If sleep issues persist despite trying different strategies, consider seeking help from a sleep specialist. Sometimes, combining ADHD treatment with targeted interventions can improve overall well-being.
ADHD and Circadian Rhythm: Why It Makes It Harder to Sleep
The link between sleep and ADHD can be traced to shared neurobiological mechanisms. ADHD affects brain regions responsible for attention, arousal, and executive function, such as the prefrontal cortex, which regulates sleep-wake cycles. Disruptions in these systems often lead to irregular sleep patterns. Neurotransmitters like dopamine and norepinephrine—critical for both focus and sleep regulation—are commonly dysregulated in people with ADHD. Additionally, the body's circadian rhythm, or internal clock, is often disrupted, further complicating sleep.
Melatonin, the hormone that signals the body to wind down, is often produced later in individuals with ADHD. In women, fluctuating estrogen levels can impact melatonin production, making it even more challenging for them to relax and transition to sleep. This delay makes it challenging for them to relax and transition to rest at conventional times, contributing to the common issues with rest and recovery in the ADHD population.
Children with ADHD often struggle with sleep problems like difficulty falling asleep, staying asleep, or waking up too early. These challenges help us understand how ADHD affects sleep across all ages, indicating that the same brain mechanisms that impact attention and self-regulation also disrupt sleep patterns.
Sleep Makes ADHD Worse
Sleep problems in adults can amplify executive functioning issues, such as inattention, distraction, trouble with concentration, impulsivity, and emotional dysregulation. For many women, chronic sleep deprivation leads to more incredible difficulty focusing, managing emotions, and staying organized. For many women, chronic sleep deprivation leads to even greater difficulty managing emotions due to the interplay between ADHD, stress, and hormonal changes. Sometimes, this even causes misdiagnosis when the root problem is sleep-related rather than ADHD itself!
This impacts stress and a woman's ability to be emotionally regulated. It may also increase rejection sensitivity dysphoria, a heightened reaction to criticism or rejection.
ADHD makes it Harder to Sleep
ADHD can make achieving restful sleep even harder. Here are some common ADHD traits that interfere with sleep:
Revenge Bedtime Procrastination
Many adhd women who are stressed and overwhelmed try to delay bedtime as a way to reclaim time at the end of the day. This is known as Revenge Bedtime Procrastination. This often stems from lacking control over the day’s schedule, leading women ( mostly) to push bedtime further to carve out time for themselves.
You might find yourself just watching TV, scrolling through social media, or even in hyperfocus working on a project. Before you know it, it’s 2 AM, and you’ve cut into precious hours of rest.
Helpful Tip: Start limiting your nighttime activities and use timers or alarms to remind yourself when to wrap things up. Try to build in small moments of "me time" earlier in the day so you don’t feel like bedtime is your only chance for personal space.
Hyperfocus and Time Blindness
Hyperfocus, a common ADHD trait ( and sometimes a superpower), can cause you to lose track of time—mainly when engaged in stimulating activities. Time blindness, where your internal clock feels disconnected from reality, can contribute to this erratic sleep schedule, further throwing off your sleep patterns.
Helpful Tip: Set a bedtime alarm or reminder on your phone to signal it’s time to start winding down. Even if you don’t feel sleepy, begin your nighttime routine (e.g., brushing your teeth, turning off electronics) to help transition your body and mind into sleep mode.
Restlessness
Restlessness, often experienced as racing thoughts or a feeling of being constantly "on," can prevent your body from relaxing, even when physically tired. Tossing and turning in bed is common, and even when you fall asleep, this restlessness can lead to poor sleep quality, leaving you feeling unrefreshed in the morning.
Helpful Tip: Try progressive muscle relaxation or journaling to help calm your mind and body before bed. Yoga Nidra, a guided meditation technique, can also be highly effective for quieting mental chatter.
What are the Sleep Disorders and Their Diagnosis?
ADHD and sleep disorders occur together. We call this comorbidity. Unfortunately, sleep clinics rarely screen adults for adhd. Here are some to know about.
Insomnia
Insomnia is a frequent complaint characterized by persistent trouble falling or staying asleep. If you struggle with insomnia, your mood, concentration, alertness, and daily functioning will be impaired.
Helpful Tip: Keep your bedroom cool (between 60-67°F) and dark for optimal sleep. Try using a white noise machine or calming sounds like ocean waves to help maintain a restful environment.
Restless Leg Syndrome (RLS) Treatment Options
Restless Leg Syndrome (RLS), a condition where you experience an uncontrollable urge to move your legs, is more common in people with ADHD. This can disrupt falling asleep and reduce sleep quality.
Helpful Tip: RLS may improve with lifestyle changes like increasing physical activity and iron intake. If it severely affects your sleep, speak to your doctor about potential treatment options. Medications are available.
Obstructive Sleep Apnea (OSA) and Insomnia: Understanding Their Connection
Obstructive Sleep Apnea (OSA) occurs more frequently in women with ADHD. It’s marked by interrupted breathing during sleep, which fragments your sleep cycle and can lead to daytime fatigue and trouble with alertness and concentration. Left untreated, OSA can significantly impact attention and impulse control.
Helpful Tip: Consider seeking a sleep study if you suspect sleep apnea. Treatments like Continuous Positive Airway Pressure (CPAP) can significantly improve sleep quality and reduce daytime ADHD symptoms.
Delayed Sleep Phase Disorder
One common sleep issue for adults with ADHD is Delayed Sleep Phase Disorder (DSPD). This means your brain naturally signals you to fall asleep and wake up later than the typical schedule. For women with ADHD, hormonal cycles can make this issue more prominent, especially around menstrual periods and during perimenopause. This often leads to late nights and groggy mornings, creating a tough cycle of fatigue to break. This is especially impacted by an early work schedule or, for teens, an early school start.
Learn more about Delayed Sleep-Wake Phase Disorder
Breaking the Cycle: Sleep Deprivation, ADHD, and Effective Treatments
Chronic sleep deprivation and ADHD symptoms feed into each other, creating a vicious cycle. Poor sleep exacerbates ADHD symptoms like inattention, impulsivity, and mood dysregulation, which then make it harder to establish healthy sleep habits. To break this cycle, it’s essential to address both ADHD and sleep issues together.
Helpful Tip: If you’re struggling with sleep, talk to a healthcare provider who can assess both your ADHD and any potential sleep disorders. Comprehensive treatment plans can help you manage both conditions effectively.
Management Strategies for ADHD-Related Sleep Issues
Non-Medical Approaches
Effective sleep hygiene practices are critical for women with ADHD. This includes maintaining a consistent sleep schedule, creating a calming bedtime routine, and optimizing your sleep environment. Cognitive Behavioral Therapy for Insomnia (CBT-I) is beneficial for breaking the cycle of insomnia, as it focuses on changing negative sleep-related thoughts and behaviors.
Helpful Tip: Try incorporating calming rituals like dimming the lights an hour before bed or reading a physical book. Avoid screens, as blue light can disrupt melatonin production and make it harder to fall asleep.
Medical Interventions
For those who continue to struggle with sleep problems, medical interventions like melatonin supplements can help regulate the sleep-wake cycle, particularly if you’re experiencing delayed sleep phase issues. Bright light therapy is another effective treatment to help reset your internal clock, especially for those with circadian rhythm disruptions.
Helpful Tip: Start with a low dose (0.5-3 mg) and avoid long-term reliance when using melatonin. Pair it with lifestyle changes like getting morning sunlight to regulate your sleep cycle naturally.
Key Takeaways for Women:
- Women with ADHD often face more severe sleep issues due to hormonal influences.
- Insomnia and circadian rhythm disorders are more prevalent in ADHD women, especially during hormonal transitions like menopause.
- Hormonal shifts can exacerbate mood swings, anxiety, and stress, further complicating sleep.
Frequently Asked Questions
Q: Can ADHD medication affect my sleep?
A: Yes, stimulant medications can sometimes make it harder to fall asleep, especially if taken later in the day. Try taking your medication earlier, or speak to your doctor about adjusting your dose or trying non-stimulant options. Surprisingly, stimulants can also sometimes improve sleep.
Q: What are some tips for sleeping better?
A: Start with simple steps like:
- keeping a consistent wake-up time,
- avoiding screens before bed, and
- creating a calm, relaxed environment.
- trying light therapy in the morning to reset your circadian rhythm.
Remember: small changes can lead to significant improvements in sleep problems. Start today by committing to one change—whether winding down earlier or trying relaxation techniques—and see how it transforms your nights and days.
Kristen McClure: Neurodivergent-Affirming ADHD Therapist and Coach with 30 years experience in North Carolina and South Carolina Offering virtual therapy and coaching services across North Carolina, including Ashville, Raleigh, Durham, Wilmington, Greenville, and more. Also serving major South Carolina cities such as Charleston, Columbia, Greenville, Spartanburg, Rock Hill, and more.