ADHD and Sleep Disorders Diagnosis and Management
Sleep disorders are common among people with ADHD. If you have trouble sleeping, you’ll probably feel the effects at school or work, in your relationships, and while driving and going about your daily life.
Diagnosing a sleep disorder
Telling a doctor or mental health provider about sleep problems is an important place to start. They’ll need to figure out if anything else might be responsible—your medication, for example, or the dosage of it —or if anxiety or depression might be causing your sleep troubles. They will likely ask you questions about your sleep or ask you to keep a sleep diary for a few nights or weeks.
That will mean you’ll have to write down information about when you go to bed and get up, how many times you wake up during the night, whether you snore, whether it’s hard for you to wake up in the morning, and whether you nap or feel tired during the day. If you wear a personal activity tracker or use an app on your smartphone to monitor your sleep cycles, that information will be helpful, too.
You may be sent to a sleep center or lab. You’ll spend a night there hooked up to monitors that will measure your brain waves and breathing patterns and the amount of oxygen in your blood. Monitors will also track any activity in your heart, muscles, and eyes. Together, they will provide a picture of how deeply you are sleeping and how long, as well as how often you are waking.
Management of sleep disorders
The management or treatment of a sleep disorder depends on the cause.
Adjust your eating and drinking habits. If the problem comes from consuming too much caffeine in the afternoon or drinking too much alcohol, cutting back on those habits—or getting rid of them entirely—can make a huge difference. Another recommendation is to be careful not to have a huge meal right before bed.
Practice good sleep habits. Sleep hygiene is important. Habits to continue or start include:
- Turning off your smartphone and television an hour before bedtime
- Leaving your phone in another room at night
- Keeping the bedroom cool and dark
- Taking naps no later than mid-afternoon
- Limiting the length of time you snooze
- Going to bed and getting up at about the same time every day, even on weekends
Get some exercise during the day for quality sleep. It’s generally recommended that you not exercise too close to bedtime, but some people find that exercising before bed helps them sleep because it causes changes in body temperature that lead to better rest.
Visit your healthcare provider. When the problem seems to stem from medication, changing the time you take it may make a difference, especially if it’s a stimulant. It may also be that you need to switch to a different medication that will change your sleep patterns. But do not stop taking your medication or change the dose or time of day you take it without speaking with your doctor first. If the sleep disorder is the result of an out-of-sync circadian rhythm, taking melatonin in the evening may help—but again, check with your doctor first.
Other over-the-counter sleep aids are not usually recommended by medical and mental health professionals because they can be addictive, meaning it will be hard for you to fall asleep without them after you use them for a while, or you may have to increase the amount you take. They also have lasting effects that can make it hard for you to function in the morning after you’ve taken them. In addition, there is always the risk that they will interact negatively with any ADHD medications you’re taking.
Consider alternative techniques. Some people find relaxation techniques such as meditation helpful. You might also try a weighted ball blanket. The small balls inside the blanket act as a calming mechanism through their pressure and gentle weight and provide a sense of security that may allow you to fall asleep more easily. Bright light therapy—sitting in front of a special lamp or light box in the morning—has helped many people adjust their sleep schedule.
Also in this series:
- Hvolby A. (2015). Associations of sleep disturbance with ADHD: implications for treatment. Attention Deficit and Hyperactivity Disorders 7(1): 1–18.
- Is ADHD really a sleep problem? ScienceDaily, September 4, 2017.
- McDonagh MS et al. (January 23, 2019). Pharmacologic Treatments for Sleep Disorders in Children: A Systematic Review. Journal of Child Neurology.
- Tsai MH et al. (August 2016). Sleep Problems in Children with Attention Deficit/Hyperactivity Disorder: Current Status of Knowledge and Appropriate Management. Current Psychiatry Reports 18(8):76.