Sleep and ADHD 227 Jul

Robert Wilford, Ph.D. and Sarah Ferman, Psy.D., L.M.F.T.

“Restless sleep” is essentially light, fitful sleep, which can of course be brought about by initiation insomnia. It’s the kind of sleep where there’s a great deal of tossing and turning, and ADHD patients will wake up to find that they don’t feel sufficiently rested. Along with this is “difficulty waking,” which stems from the earlier problem of restless sleep. Basically, after tossing and turning until about 4 AM, they’ll fall into extremely deep sleep––so deep that they sleep through morning alarms. When they finally do wake up, they tend to feel sluggish and lethargic for the rest of the day until about the evening, when initiation insomnia starts again.

One other condition that might show up is something called “intrusive sleep”––or, if you prefer, “hyperfocus.” This is a condition in which ADHD patients who are awake will suddenly find themselves extremely drowsy, and sometimes immediately fall asleep. This occurs when patients are disengaged from an activity. This is a sudden shift from paying attention to extreme boredom, and in non-ADHD individuals, it can be likened to a feeling of highway hypnosis.

While it can be difficult to completely eliminate these issues, they can be helped by adhering to a few general guidelines. First, it is advised to avoid caffeine after 5 PM. As a stimulant, caffeine can make most people hyper to the point where they have difficult falling asleep on time, but an ADHD patient should be extra wary about ingesting anything that could make him or her more tired within a few hours of bedtime.

The next thing to avoid is video games. Video games have their place as entertainment, but not close to bedtime. They are good at getting you excited, not calming you down. For those who predisposed to get more energetic at sundown, video games are likely to exacerbate the problem. Likewise, it’s a good idea not to do anything strenuous or demanding. If you limit physical activity at least a few hours before bedtime, that will help a great deal.

Finally, try your best to set a consistent bedtime and stick to it. One of the biggest difficulties that faces ADHD patients is the Circadian rhythm disorder (in other words, it’s possible for them to sleep well, but not at a typical time of day). Many sleep fine from 4 AM to 11:00 AM, but not from 10 PM to 6 AM, for example. If you can adhere to a consistent bedtime, this will improve the odds of a proper Circadian rhythm.

Hopefully these nuggets of wisdom can help, but either way, it is important to seek an expert in both sleep and ADHD for guidance and advice, as well as possible treatment options. There’s no doubt that ADHD can make sleep challenging, but once you are armed with knowledge and strategies to compensate for it, you may be able to overcome sleep problems once and for all.


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Most medical doctors who treat ADD/ADHD do so as part of a larger practice. ADHD Specialists focuses primarily on only treating ADD and related conditions. This intense focus allows us to continually sharpen our clinical skills, attend specialized training, utilize the latest therapies, and build our process to meet the specific needs of our clients.

Often medical, testing and counseling services are all separately owned and located practices. It just does not make sense to have to travel from one location to another to treat the same condition. Besides the issue of time and travel, how cohesive and effective is care being delivered in multiple locations by multiple, unrelated providers who don’t have time to talk to each other?

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