Can’t Figure Out How to Fall Asleep With ADHD? Try These Strategies

Attention-deficit/hyperactivity disorder (ADHD) impacts up to 5% of adults around the world. Both children and adults with ADHD may struggle to focus, frequently procrastinate, act impulsively, experience forgetfulness, be disorganized, have mood swings, manage time poorly, and display hyperactive or restless behavior. All of these ADHD symptoms can negatively impact a person's ability to function at school or work, at home, and in social interactions.

Many people with ADHD also struggle with sleep problems. For example, they may take longer to fall asleep and may not experience as deep of sleep as those without ADHD. As a result, they may experience increased tiredness throughout the day, which can further exacerbate ADHD symptoms. Many people with ADHD tend to fall asleep later at night, which can result in sleep deprivation if they must wake up early for life obligations like school or work. These sleep differences can arise from a person's nature or from the use of stimulant medications used to treat ADHD.

Research has found that practicing healthy sleep hygiene seems to improve sleep and other symptoms in people with ADHD. Sleep hygiene generally refers to healthy sleep habits that help people fall asleep, stay asleep, and get the high-quality sleep they need. Those with ADHD may also benefit from therapy alongside improved sleep hygiene practices.

Go to bed and wake up at the same time

Many people have a habit of going to sleep at different times on different days of the week, depending on their obligations. However, this isn't necessarily healthy for the brain and body. Instead, maintaining consistent bedtimes and wake times — even on weekends and vacation — can be important to good health and may reduce sleep difficulties over time.

People with ADHD may find maintaining a consistent sleep-wake schedule even more difficult than their peers without ADHD due to traits like impulsivity and restlessness. Developing a consistent bedtime routine may help. For example, about an hour or two before a person's bedtime, they may begin winding down for sleep by putting away all digital devices and instead engaging in calming activities, like drinking a small cup of tea, taking a warm bath, or reading a relaxing book.

Get bright light exposure in the morning

Regular bright light exposure can help regulate a person's circadian rhythms. Circadian rhythms can be defined as daily physiological changes that fluctuate consistently across each 24-hour period. Circadian rhythms tend to majorly influence when a person is tired and when they are alert. With healthy circadian rhythms, a person is generally alert during the day and sleeps well at night. 

When a person's circadian rhythms are misaligned with the light-dark schedule of their environment, they may be tired during the day and struggle to sleep at night. Light and dark exposure to the eyes is thought to be the number-one driver of circadian rhythms timing.

Sleep in a pitch-black room

Just as light exposure can impact circadian rhythms, so can dark exposure. The body typically produces melatonin, a sleep hormone, in response to darkness. Sleeping in a room with light, such as from a nightlight, a streetlight shining through a window, or a hall light shining in under the door, can reduce how much melatonin is produced and, as a result, may negatively impact a person's quality of sleep.

To darken a room, it can be ideal only to use nightlights in other rooms, like the bathroom or the kitchen, and not in the bedroom. Similarly, blackout curtains can make a room darker by blocking out light that might come in from outside. If you share a bedroom with someone who goes to sleep later than you want to, or you can't block out light for some other reason, wearing a sleep mask over the eyes may be another option for producing darkness.

Try cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is one option available to help people learn to make lifestyle changes that promote healthy sleep. In fact, cognitive behavioral therapy for insomnia (CBT-I) tends to be one of the foremost treatment options when a person consistently has trouble falling or staying asleep. ADHD researchers have recommended CBT as one strategy for improving sleep among people with the disorder.

Get tested for sleep disorders

If you've tried the healthy sleep habits listed above and you're still not sleeping well, consider seeing your doctor to inquire about the possibility of a sleep disorder. Some experts recommend that all people with ADHD undergo testing for sleep problems.

Sleep study research has returned mixed results when it comes to ADHD and sleep disorders. However, some people with ADHD may also have a sleep disorder, such as sleep-disordered breathing, obstructive sleep apnea, restless legs syndrome, or one of the circadian rhythm sleep disorders called delayed sleep phase syndrome. When these disorders go undiagnosed and untreated, they can create their own symptoms as well as exacerbate ADHD symptoms.

Consider medication or supplements

Many experts view sleep medication and supplements as a last resort since they can produce side effects. However, getting adequate sleep can be immensely important in managing ADHD and for overall health. If a person has exhausted all other options and still isn't sleeping well, they may want to consider medication or supplements. It’s vital for individuals to discuss these options with their doctors and inform their prescribing providers if they plan to start, stop, or change the way they take medication.

Melatonin is a sleep hormone produced by the body that is also available as a dietary supplement. Some research suggests that taking a small amount of melatonin before bed can help people with ADHD sleep better. Although melatonin is available without a prescription, you should talk with your doctor to find out if it's a good fit for you and to make sure it won't interfere with any medications you're taking.

Remote therapy for ADHD

While medication is one management strategy for ADHD, people with the disorder also may be interested in therapy. Remote therapy specifically could be an attractive option for people with ADHD, since it generally allows them to meet with a therapist from the location of their choice instead of having to remember to travel somewhere at a specific time. BetterHelp is a remote therapy platform that can connect you with the therapist best suited to your needs.

A 2022 meta-analysis of six research studies looked at how online therapy worked as a treatment for ADHD. The researchers found that online therapy usually helped people with ADHD "improve their attention and improve their social function" in comparison to control groups. As mentioned earlier, therapy is also a treatment often recommended for difficulties with sleep, so it's likely that undergoing therapy could help a person with ADHD both sleep better and improve ADHD symptoms.