Sleep And A Neurodivergent Brain: ADHD Insomnia Symptoms And Treatment
Attention-deficit/hyperactivity disorder (ADHD) can be associated with various comorbidities, including sleep disorders like insomnia. Because ADHD and other forms of neurodivergence often impact sleep health, understanding the connection between these symptoms and how to make lifestyle changes or find support to manage them can help improve sleep. With guidance from a licensed mental health professional, insomnia or symptoms of sleep disorders alongside ADHD can be lessened, and individuals can increase instances of healthy and restful sleep.
Understanding ADHD and neurodivergence
Attention-deficit/hyperactivity disorder is a neurodevelopmental condition listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Depending on which of the three subtypes of ADHD is diagnosed, an individual with this condition may experience impulsivity, hyperactivity, or inattentiveness-related symptoms. Symptoms may impact social, professional, educational, and personal health and well-being.
ADHD symptoms and subtypes
The three subtypes of ADHD include the following:
- Primarily inattentive ADHD (ADHD-PI, formerly called attention deficit disorder or ADD)
- Hyperactive-impulsive ADHD (ADHD-HI)
- Combined type
Although ADHD is a diagnosable condition, some people identify with the neurodiversity model, believing that ADHD symptoms may be the result of natural brain differences in processing, cognition, and sensory connections that tend to vary from “typical” presentations.
This model posits that difficulties experienced by neurodivergent individuals often stem from living in a world that does not accommodate neurodivergent brains. Because symptoms can often be alleviated with accommodations and lifestyle changes, they may result from a lack of accommodation in other areas.
Common ADHD symptoms
ADHD may cause symptoms like the following:
- Difficulty focusing on daily tasks
- Difficulty maintaining attention when working on projects
- Difficulty following instructions
- Forgetting or losing important items like car keys, a wallet, or a debit card
- Clumsiness
- Difficulty sitting or staying still
- Difficulty staying on topic during conversations
- Excess energy, which may cause rapid speech or movement
- Seeming to be “driven by a motor”
- Fidgeting
- Racing thoughts
- Speaking louder than normal
- Struggling not to speak in quiet situations
- Interrupting others
- Difficulty waiting for one’s turn in a conversation or a line
There can be many other symptoms of ADHD. If you’re curious whether you might be living with this condition, consider reaching out to an ADHD specialist for support and diagnosis. You can be diagnosed with ADHD at any age, and the condition is usually lifelong.
What is insomnia? More than just sleep problems
In some cases, ADHD may be diagnosed alongside insomnia. Insomnia can be classified as a sleep disorder and symptom that typically causes difficulty falling or staying asleep. Below are some common insomnia symptoms:
- Difficulty falling asleep (lying awake for hours)
- Difficulty staying asleep (waking up multiple times throughout the night)
- Unwanted early waking
- Excessive daytime sleepiness
- Difficulty sleeping without support, such as medication
What sleep disorders and mental health conditions cause insomnia?
Insomnia can be caused by other sleep disorders, mental health conditions, medical conditions, and stress, among other causes. Family history, age, and gender can also be connected to the risk of experiencing insomnia. Although updated research may be necessary, insomnia is usually most associated with anxiety disorders, which can also be comorbid with ADHD.
Other sleep disorders that may be connected to insomnia can include obstructive sleep apnea, circadian rhythm sleep disorders, restless legs syndrome, delayed sleep phase syndrome, and sleep-disordered breathing. Insomnia can also be diagnosed as a disorder in the form of chronic sleep onset insomnia or insomnia disorder.
Is there a connection between insomnia and ADHD?
Researchers found that insomnia was usually more common in women with ADHD, and between 43% and 85% of participants in the study were living with insomnia when partaking in the research.
The study found that the most common psychiatric comorbidities with mental disorders in ADHD that caused insomnia tended to be anxiety disorders, personality disorders (primarily cluster B disorders), depressive symptoms, substance use disorders, and a family history of mood disorders.
Insomnia also tended to be more common in adults with combined ADHD. Those taking doctor-prescribed medication to treat ADHD were typically less likely to experience insomnia and other sleep problems impacting the circadian rhythm.
Why does insomnia occur in people with ADHD?
ADHD can impact the sleep cycle and may change the way individuals sleep and wake. There may be various causes of sleep difficulties related to ADHD, but a few theories include the following:
- Comorbid psychiatric disorders that can cause insomnia
- Racing thoughts and difficulty focusing on sleep at night
- Anxiety or stress
- Impaired regulation of brain activity
- Disruptions and distractions at night or in the sleeping space
- Stimulant medication
If you are taking a medication that makes falling or staying asleep difficult, talk to your doctor for advice. Do not start, change, or stop a medication without consulting your prescribing physician.
How to manage insomnia and fall asleep with a neurodivergent brain
Being neurodivergent and having ADHD can make it challenging to get healthy sleep. Below are some tips for improving your sleep each night.
Maintain a comfortable and distraction-free sleeping environment
Research has found that people typically sleep better when they have a comfortable sleeping space free of distractions. In addition, the proper temperature, noise, and light levels can also aid in sleep.
Before you sleep, ensure you have comfortable sheets, pillows, and blankets. If you get hot at night, a fan or air conditioner might be helpful. If you are cold at night, layering several blankets could be beneficial.
Remove books, electronics, toys, and unwanted items from your bed. In addition, keep your door closed and ensure a level of light that makes you comfortable. Sleeping with the overhead light on may be more likely to keep you awake, so consider a night light or lamp if you don’t like to sleep in the dark. If you have pets that make sleeping difficult, it can be best to keep them out of the room at night or train them to sleep in pet beds on the floor.
Use assistive tools to help you fall asleep
If you struggle to sleep independently, an assistive tool like a sleep app might be helpful. Apps like BetterSleep and Sleep Tracker generally enable individuals to track their sleep patterns, use guided meditations, and learn more about what helps them sleep and wake up.
Some apps may also show you how long you stay in certain sleep cycle stages, such as REM sleep. These tools can give you insight into how you might optimize your sleep, and you can use the data to talk to your doctor about your sleep quality at your next checkup or appointment.
Consider medication or supplements for sleep disorders
Some people may experience severe insomnia that causes extreme daytime sleepiness. In these cases, it may be helpful to take medication before bed to fall asleep. Some sedative medications may be prescribed to help an individual fall asleep quickly. However, a few of these medications can be dangerous, so talking to a doctor about your symptoms can help ensure your safety and well-being. If you notice unwanted side effects, talk to your doctor immediately. Do not stop your medication without consulting your provider.
Supplements like melatonin might also be used to help people fall asleep. However, talk to a doctor before taking them, as taking the wrong amount may worsen symptoms. For some people, melatonin may not work or have unwanted side effects.
Use sleep hypnosis or guided meditation audio
If you enjoy having audio in the background while you sleep, trying a sleep hypnosis audio or guided meditation might be helpful. These tools can guide you through mental visualizations with the intent of helping you fall asleep. In addition, they often last over six hours and may play calming music or ambient sounds in the background. One study found that sleep hypnosis audios could increase slow-wave brain waves by 80%, which may help individuals fall asleep quicker.
Put away devices and avoid eating before bed to alleviate sleep problems
Electronic devices can be distracting and are frequently linked to poor sleep and insomnia. Studies recommend not using electronic devices at least 30 minutes before bed. However, putting away your phone or other devices at least an hour before you sleep may be more helpful. In addition, it can be best to avoid caffeine and alcohol and try not to eat heavy meals before you sleep.
Talk to a therapist for help navigating your ADHD insomnia symptoms
Insomnia is often connected to mental health conditions like anxiety, depression, and obsessive-compulsive disorder (OCD), which are commonly comorbid with ADHD. It may be helpful to talk to a therapist about your sleep schedule, sleep hygiene habits, and symptoms to develop a personalized treatment plan together.
Online therapy for combatting ADHD insomnia symptoms
Sleep challenges can make it difficult to find the energy to attend in-person appointments. In these cases, an online platform like BetterHelp may be more convenient, allowing clients to participate in sessions via phone, video, or live chat from home or anywhere with an internet connection.
Studies show that online therapy can be effective. A 2022 study found that social function and attention were typically improved in 95% of participants in an online therapy intervention targeted at managing ADHD symptoms in clients.
Another study found that online CBT could be more effective than in-person therapy in treating depression, anxiety, and social anxiety disorder, which are commonly present in individuals with ADHD and may be causes of insomnia.
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