Yes, Sleep Problems Are Extremely Common With ADHD

Sleep problems affect roughly 60% of adults with ADHD. Sleep disturbances and ADHD are complex. Sleep problems can exacerbate ADHD symptoms and vice versa, leading to a vicious cycle.

If you have ADHD and are wondering, "Do people with ADHD have trouble sleeping?” Yes, it is a common problem for people with ADHD, and you are not alone.

ADHD and sleep problems tend to go hand in hand. Understanding this complex connection is your first step to a better night's sleep. So let's take a closer look at why sleep is so difficult for those with ADHD and then look at some solutions to help you take control of your ADHD sleep issues.

Why Sleep Is So Hard When You Have ADHD

So why can’t I sleep with ADHD? ADHD affects the brain in different ways, including the mechanisms that regulate sleep and wakefulness. It has nothing to do with willpower; it involves changes in the brain that disrupt a normal sleep cycle.

Your Brain Doesn't Want to Wind Down

If your brain doesn't seem to want to settle down, it can be so hard to relax and fall asleep. Racing thoughts, or replaying conversations, making grocery lists, or any other sort of mental hyperactivity at bedtime can be challenging for people with ADHD to get to sleep.

People with ADHD have a significantly delayed circadian rhythm, which doesn't let the mind know it is time for bed until later than usual. Many people describe this as a "second wind" and can become fixated on mentally stimulating projects or thoughts late into the evening. This hyper-focusing at night makes it more challenging to stop and quiet the mind down when you lie down to go to sleep.

You may have trouble disengaging at night. For example, phones, video games, projects, and even heated conversations can be harder to break from in the evenings and simply unwind.

Your Internal Clock Runs on a Different Schedule

As stated earlier, people with ADHD have a delayed circadian rhythm, which simply means that their internal clock runs a bit differently than others. You may feel more alert in the late hours after others are ready for bed.

Around 75% of adults with ADHD have delayed circadian rhythms about an hour and a half later than normal.  So if you are a "night owl," it's because of your internal clock, not because you just choose to stay up late every night.

ADHD sleep patterns often mismatch with traditional work and school schedules, making it hard to get up early if you stayed up late. 

Melatonin production is also different in a person with ADHD's brain. Due to the delayed internal clock, melatonin production is also delayed. Melatonin, which is needed for sleep, is created in the pineal gland, and some research suggests that people with ADHD have smaller pineal glands.

Your healthcare provider may suggest a melatonin supplement if you still have sleep issues even after taking ADHD medication.

Restlessness Doesn't Stop When You Lie Down

Having ADHD comes with a sense of restlessness and hyperactivity. It doesn't always go away just because you lie down in bed. You may still have physical restlessness at night and even find it hard to stay in bed.

So you could be lying down, getting ready to sleep, and then jump up and head to your computer because you remembered you forgot to send that email to your boss. Then you lie back down, jump up to check the dryer, and if the clothes are finished, you decide to fold them.

You could also experience what is called restless leg syndrome, which is when you are lying in bed, and you have impulses to move your legs around and can't seem to keep them still.  Many people with ADHD also have co-occurring restless legs syndrome (RLS).

This sensation of feeling unable to lie still can even occur when you are mentally exhausted. So while you're tired and ready to get to sleep, your body doesn't seem to want to cooperate.

Common Sleep Problems People With ADHD Experience

ADHD and sleep issues are complex issues and can take many forms. You may experience one or several of the following problems, but let's take a closer look at some common sleep problems that people with ADHD tend to experience.

Trouble Falling Asleep (Sleep Onset Insomnia)

Sleep onset insomnia in ADHD is a chronic issue for many adults with ADHD. You may be lying in bed for hours, tired and switching positions, but unable to fall asleep. You could have constant racing thoughts, or even replaying conversations or music in your head.

Knowing this, you could suffer from bedtime procrastination and stay up late on your phone or playing video games because you know that if you lie down, you are just going to toss and turn and overthink anyway, so what's the point? Then, once you finally lie down, you keep looking at the clock to see that another hour has passed, and you are still lying there wide awake. This anxiety about falling asleep only makes matters worse.

Waking Up Throughout the Night

If you are lucky enough to fall asleep, you may wake up frequently in the middle of the night. You may even have nightmares that wake you up and keep you from being able to go back to sleep, as nightmares are common for people with ADHD. 

Even if you aren't having nightmares, you just can't seem to be able to go back to sleep once you wake up, so you never really feel refreshed during the day. It's because you aren't getting enough uninterrupted sleep.

Why Mornings Feel Impossible

Morning comes all too soon, and you just can't seem to get out of bed. Maybe you have been late for work or getting the kids off to school because it is so hard to get out of bed since you didnt sleep well. 

You may have multiple alarms set, but you still oversleep. Or after you get the kids off to school, you lie back down and try to sleep a little bit more. No matter how many hours you lie in your bed, you just don't feel well-rested and ready to face your day.

You are not alone; these are very common occurrences for people struggling with ADHD insomnia.

How ADHD Medications Affect Your Sleep

ADHD medication and sleep issues are another complex situation. Some people can find it difficult to go to sleep after taking stimulant ADHD medication later in the day. In contrast, others benefit from the medication, which slows down their thoughts at nighttime. 

Medication effects can vary widely between people, so if you are taking ADHD medication and it is causing some sleep issues, there are ways to adjust dosage or formula to help reduce the "rebound effect" that can make it harder to unwind at night.

Stimulant Medications Can Make Sleep Harder

Stimulant medications can disrupt your sleep. They are designed to keep you alert and focused, which can make it difficult for you to settle down at night and fall asleep. This side effect is made worse if you take the medication too late in the day. To rectify this issue, you can take your medication earlier so it wears off sooner, allowing your body to go into a more restful state at night.

Medication affects everyone differently, so if timing doesn't help, your provider may be able to switch you to a different medication that allows you to sleep more easily. There are short-acting and long-acting all-day formula options that may help.

The Paradox: Sometimes Medication Actually Helps Sleep

Medication can actually help some adults with ADHD fall asleep better. These medicines can help to reduce racing thoughts that many people with ADHD experience as soon as they lie down to go to sleep.

There are many different ADHD medications and dosing schedules, and your healthcare providers are the best judges of how to tweak your medication or even change it to help reduce unwanted sleep problems. It can be a bit of trial and error to find the perfect fit with ADHD medication and sleep concerns, but this is a normal part of the process.

Practical Ways to Sleep Better With ADHD

Improving sleep with ADHD involves a different approach than with someone who doesn't have ADHD. Typical sleep advice doesn't work well for ADHD brains. Instead, let's look at some ADHD-friendly techniques that can help your brain and body get into a more relaxed state before bed.

Create an ADHD-Friendly Bedtime Routine

Individuals with ADHD thrive on a routine, so a bedtime routine is also important. With a delayed sleep phase, your body may not know when to shift into relaxation mode, so you may not be ready to sleep when it’s “bedtime.”  It's a good idea to practice these relaxing techniques to signal to your brain that it's time to get rested now.

Some calming activities that you can try that work well for ADHD include:

• Breathing techniques: Breathing exercises can activate the parasympathetic nervous system, helping you relax and prepare for bed.
• Meditation/mindfulness: These practices at night can signal to the body that it's time to unwind.
• Listening to calm music: Calm, or instrumental music, can reduce hyperactivity and racing thoughts in people with ADHD and improve mood.
• Reading: Reading reduces stress.
• Reducing screen time: Blue light can mess with your circadian rhythm, so it's a good idea to put screens away at least an hour or two before bed. Blue light can suppress melatonin, keeping you awake.

Now you certainly don't have to try to do all of these every night, as that would be overwhelming and counterintuitive. Instead, try a couple of calming techniques that work well for you, and set timers or reminders to use them every evening at about the same time.

Work With Your Brain's Natural Rhythm

Instead of setting hard limits, like when you "should" go to bed, just go with the flow of your natural circadian rhythm. When you feel tired, try to go to bed. Lying in bed at a certain time just because you think you should be ready to sleep can leave you lying there, overthinking.

If you have to adjust your sleep schedule due to work or life demands, try to do so gradually rather than abruptly.

Try going outside in the morning to get some sun exposure to help your circadian rhythm. Early morning sunlight exposure has been shown to influence your circadian rhythm positively.

Maintaining consistent wake times also helps to keep your rhythm about the same every day. When you try to fight this natural balance, it usually backfires, and you end up losing sleep rather than gaining it. So try to go with the flow of your natural circadian rhythm cycle.

Manage Evening Stimulation Strategically

Screen time is a part of our lives, but it can disrupt sleep. There are several ways you can mitigate your exposure to blue light. You can purchase blue-light-blocking glasses or filters for your devices. You also want to avoid highly stimulating content before bed. So save the scary movies for daytime hours.

But the best way to tackle blue light is simply to shut off your devices a few hours before you go to sleep. Avoiding screen time altogether may not be realistic in the modern world, but you can try some of these tips to limit your exposure before bed.

Address Physical Restlessness

Some nights, your body may feel like it's pulsing with electricity, and there are ways to combat this and help you rest. For one, you can try gentle stretching, light exercise, or Yin yoga to relax. All of these types of exercises are good for telling the body it's time to chill and relax.

It's important to keep your room tidy and your bed clean to create a comfortable sleeping environment. People with ADHD can get overstimulated by a messy room, so try to keep your sleep area tidy and don't do activities in your bed other than sleeping.

If you still have restless sleep with ADHD, you can try weighted blankets to create a sensation of heaviness on your body. You can also try changing your sleep position, placing a pillow between your legs, or using a cervical pillow to support your neck and upper back to reduce any pain. If you think you have restless legs syndrome, you may want to discuss it with your healthcare provider

When to Seek Professional Help for Sleep Problems

When ADHD bedtime struggles become persistent, it is a good time to seek professional help, as sleep deprivation is not healthy and can definitely exacerbate ADHD symptoms.  

Signs Your Sleep Problems Need Medical Attention

There are some key indicators that it's time to see a doctor about your sleep issues. These include:

• Mood changes: Lack of sleep is causing irritability, anxiety, or worsening of your ADHD symptoms.
• Chronic insomnia: If you have trouble falling asleep or staying asleep regularly.
• Extreme daytime fatigue: Falling asleep during the day, feeling tired constantly, taking naps at odd times.
• Physical concerns: Headaches or restless legs, especially at night.
• Snoring or paused breathing: These are signs of sleep apnea.
• Sleepwalking, talking, or other behaviors: If you are doing these behaviors while asleep or upon waking, they may indicate a more serious sleep disorder.

When sleep issues disrupt your day-to-day living, then it's probably best to seek professional help. Sleep disorders and ADHD are common occurrences, and clinicians know ways to treat both.

How ADHD Specialists Can Help

As ADHD and sleep issues often go hand in hand, ADHD specialists are prepared to screen for both. They will determine if the issues are ADHD-related or if you have a coexisting condition like sleep apnea, restless leg syndrome, or even anxiety.

If you already have an ADHD diagnosis and are having some sleep concerns, your provider can adjust your medication dosage and maybe have you take it sooner or even try a different formula. If you are experiencing any rebounding" effects after your ADHD medication wears off, they may adjust your timing a bit to see if that helps. Everyone is different, and they react to medication a little differently.

Treatment Made for Both ADHD and Sleep Problems

There are cognitive behavioral therapy interventions that are aimed at helping people with ADHD and sleep conditions, such as SIESTA- blended CBT.

ADHD Advisor offers a holistic approach to treating sleep issues and ADHD, offering therapy, medication management, and behavioral strategies together to address sleep and ADHD symptoms.

The Bottom Line on ADHD and Sleep

To fully answer the question, “Do people with ADHD have trouble sleeping?”  Yes, it is a very real and very common part of ADHD. 

ADHD-related sleep issues do not indicate that you're doing anything wrong. If you're already on medication for your ADHD, be open with your clinician about your sleep concerns. Whether you need to have your dosage adjusted or if you need to change some of your evening activities, you can learn how to sleep better with ADHD.

You can get started making small, easy lifestyle changes, and soon you should be able to see a real difference. 

If you think that you might have undiagnosed ADHD and sleep issues are bothering you, reach out to the ADHD Advisor and take our short quiz to see if you qualify for an online ADHD diagnosis. Let's help you get your sleep and ADHD symptoms under control now.

Frequently Asked Questions

Do people with ADHD have trouble sleeping?

Yes, according to some studies, over half of the adults with ADHD also experience a sleeping disorder.

Why do people with ADHD have sleep problems?

People with ADHD experience sleep problems due to their delayed circadian rhythm, racing thoughts, overstimulation at night, and other less common reasons.

How does ADHD affect sleep in children?

ADHD can impact children's sleep by causing delayed sleep onset and frequent awakenings during the night, sometimes due to ADHD medication.

What are the symptoms of ADHD sleep problems in adults?

Common ADHD sleep problems in adults include:

• Delayed sleep phase
• Racing thoughts at night
• Frequently waking up
• Restlessness
• Excessive daytime tiredness

How can I fall asleep with ADHD racing thoughts?

To help reduce racing thoughts with ADHD at bedtime, consider incorporating a relaxing bedtime routine that includes reducing screen time, calming mindfulness practices, and "brain dump" journaling to quiet the mind.

Do ADHD medications cause sleep issues?

Yes, ADHD medications can cause sleep issues. To remedy this, your practitioner may have you take it earlier in the day or switch to a different formulation.

Does poor sleep make ADHD symptoms worse?

Yes, not getting a restful night of sleep can make ADHD symptoms more severe.

What is the connection between ADHD and delayed sleep phase syndrome?

People with ADHD experience a delayed biological clock by about an hour to an hour and a half, causing them to get sleepy later than other people.

Why can't I wake up in the morning with ADHD?

It's often hard to wake up in the morning when you have ADHD because you didn't get a good night's sleep.

What percentage of people with ADHD have insomnia?

Recent studies indicate that about 40-70% pf people with ADHD also experience insomnia.