Managing ADHD Sleep Issues: How To Improve Sleep

Experts typically agree that most adults need at least seven hours of sleep each night, while children and teens usually need more to support healthy growth and development. Quality sleep can be essential for good health and well-being. For instance, it’s often involved in maintaining heart, immune, and cognitive functioning. 

For people with ADHD, however, sleep may not always come easily. ADHD may contribute to trouble quieting the mind or managing sleep-disrupting distractions before bedtime. Some people with ADHD may also experience sleeplessness as a symptom of common co-occurring conditions, like depression or anxiety. In addition, the stimulant medications that many people take to manage ADHD symptoms can make it difficult to fall and stay asleep.

Sleep problems and ADHD often influence each other in ways that can significantly impact the daily lives of individuals navigating this complex intersection. Making lifestyle changes and seeking help from professionals like doctors and therapists can effectively address sleep issues and other symptoms of ADHD.

Sleep troubles can be common for those with ADHD

Online therapy can help you get restful sleep

Common sleep disorders associated with ADHD

Distractibility, stimulant medications, and racing thoughts attributed to ADHD may contribute to insomnia. Still, while it tends to be one of the more common sleep disorders, insomnia isn't necessarily the only condition affecting people with ADHD. Others can include the following:

Sleep apnea

People with sleep apnea typically experience breathing problems throughout the night that can interfere with sleep and cause daytime sleepiness. Research indicates that some people with ADHD may be at an elevated risk for obstructive sleep apnea (OSA). Symptoms can involve loud snoring, waking during the night gasping for air, sore throat or dry mouth upon waking in the morning, headaches, high blood pressure, and mood dysregulation.

Restless legs syndrome (RLS)

Studies reveal a strong co-occurrence between ADHD and RLS, with up to 33% of adults and 42% of children with ADHD experiencing symptoms. People with RLS often experience a strong urge to move their legs during sleep, as well as aching, itching, and throbbing sensations in the legs.

Delayed sleep phase syndrome (DSPS)

DSPS is a circadian rhythm sleep disorder that usually affects how the body regulates sleep patterns. DSPS often delays sleep for two or more hours beyond usual sleep patterns, often creating difficulties with waking. Up to 75% of adults with childhood-onset ADHD may exhibit DSPS.

Tips for managing ADHD sleep issues

Keep a regular sleep schedule

Going to bed and waking up at the same time every day can influence the circadian rhythms that regulate the sleep-wake cycle. There are a few techniques you may use to encourage consistency in your sleep schedule:

• Pick a specific bedtime and wake-up time that allow you to get seven or more hours of sleep each night. 
• Adhere to these times every day, including on weekends.
• Try adjusting your sleep schedule in small increments each day to make it easier. For example, begin by going to bed 15 minutes earlier than usual each night. When you're able to do this consistently, add 15 more minutes, and so on, until you can fall asleep at the same time every night. 

Create a relaxing bedtime routine

A bedtime routine can encourage the repetition of behavior patterns that facilitate better sleep. For example, you may brush your teeth and wash your face each night before bed. Effective bedtime routines may vary between individuals, so establishing one that works for you may take some trial and error.

Suggestions for calming ADHD symptoms before bed

• Drink a warm cup of soothing tea.
• Read a book.
• Listen to relaxing music.
• Engage in some light stretching.
• Take a hot bath.
• Write in a journal.
• Do something quiet and creative, like sketching or crocheting.

Limit screen time before bed to help sleep regulation

Research shows that high levels of screen time before bed usually lead to shorter sleep duration and more difficulty falling asleep. This is likely because the blue light emitted from electronic screens can upset the body's production of melatonin, a hormone involved in sleep regulation. 

To avoid sleep disruptions caused by blue light, the Sleep Foundation recommends turning off electronic devices at least 30 minutes before bedtime. 

Create a sleep-friendly environment

The atmosphere in your bedroom can significantly impact your ability to sleep well. Here are a few things you can do to create a better sleep environment

• Dim the lights as bedtime approaches. Use blackout curtains or close your shades if there are lights outside your window.
• Keep your room cool. Because preferences vary, you may need to experiment until you find the most comfortable nighttime temperature for you. (60 to 67 degrees is usually considered optimal.)
• Invest in comfortable bedding and a supportive mattress.
• Try to avoid putting a television in your room. If you do have a TV in your room, keep it off during your bedtime routine.
• Use your bed exclusively for sleeping and sex, and avoid activities like eating or working in bed. This can encourage a direct association between your bed and sleep. 

Exercise regularly

Research consistently shows that exercise can regulate sleep patterns and improve sleep quality. However, engaging in physical activity at night, particularly high-intensity activity, can negatively affect sleep patterns. Avoid physical exercise (apart from relaxing activities like restorative yoga or tai chi) for three or more hours before bedtime. 

Practice mindfulness and relaxation techniques

Integrating mindfulness activities, like meditation and mindful breathing, into your bedtime routine may be beneficial for calming the mind, potentially making it easier to fall asleep at night. To relax the body, try light stretching or progressive muscle relaxation by consecutively tensing and relaxing each muscle group, beginning with the feet. 

Make nutritious food choices

Some people find that eating nutrient-rich foods improves their ability to sleep. Making nutritious food choices can also be integral to managing obesity, which can be associated with sleep-disordered breathing. Consider the foods you eat and how they may affect your sleep. If you aren't sure where to begin, consult a physician or nutritionist for guidance.

Address daily stress to help combat ADHD

Stress management can be vital for people with ADHD for many reasons, including its impact on sleep quality. If you have trouble managing everyday stress, try using time management techniques and stress-relievers like practicing breathing exercises or engaging in activities you enjoy. Therapeutic techniques like CBT are often an essential part of stress management for people with ADHD. 

Manage comorbid conditions 

Anxiety disorders, depression, and personality disorders are often prevalent among adults with ADHD. Symptoms of these co-occurring conditions, including sleep dysfunction, often overlap with those of ADHD. Additionally, there tend to be strong connections between ADHD and substance use disorders that can contribute to various sleep concerns. 

Try sleeping tools

Other tools may also facilitate a good night's sleep. For example, morning light therapy, weighted blankets, and therapeutic methods like CBT have often been proven effective in assisting people with ADHD. 

Again, it can be essential to take into consideration that each person's experience with ADHD tends to be unique. While tools such as these may help some, they can present challenges for others. If you're considering light therapy or weighted blankets to combat sleep dysfunction, speak to your physician to determine whether they're right for you. 

The impact of substances on sleep

Certain substances can impact sleep patterns, leading to difficulties falling asleep, staying asleep, or experiencing restful sleep. With this in mind, here are additional suggestions for improving sleep:

Limit caffeine, nicotine, and alcohol intake

Because caffeine and nicotine are usually classified as stimulants and alcohol can also have stimulant effects on the body, ingesting these substances before bedtime can significantly contribute to sleep disturbances. Although research on caffeine intake before bed tends to yield mixed results, studies suggest that nicotine and alcohol use within four hours of bedtime can disrupt sleep duration and continuity.

Manage ADHD stimulant medication timing

Taking stimulants too late in the day can interfere with sleep. If you're taking stimulant medication for ADHD, discuss the best time of day to take it with your healthcare provider.

Benefits of online therapy for managing ADHD sleep issues

Virtual therapy can offer several benefits for individuals with ADHD who may be experiencing difficulties with sleep. For example, online therapy through platforms like BetterHelp typically eliminates geographical barriers to treatment and provides access to a broader pool of licensed mental health professionals with experience in treating ADHD. In addition, individuals with ADHD may find it more convenient, less distracting, and less stressful to attend sessions from the comfort of their own space.

Sleep troubles can be common for those with ADHD

Online therapy can help you get restful sleep

Effectiveness of online therapy for those with ADHD

Online therapy is often more affordable than traditional treatment without insurance, and research indicates it can be just as effective for treating ADHD and comorbid conditions like anxiety and depression, all of which can contribute to sleep issues.