Sleep and ADHD20 Jul

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

The common symptoms of Attention Deficit Hyperactivity Disorder (ADHD) are difficulty concentrating, hyperactivity, forgetfulness, and inattentiveness. Patients who are on medications like Adderall or Ritalin can generally overcome these impairments during the day, but at night, it is a different story entirely. What can be managed during the day with drugs is often uncontrolled at bedtime.

For a while, the American Psychiatric Association (APA) ignored sleep disturbance symptoms in ADHD patients, because it subscribed to the theory that all ADHD symptoms would manifest themselves by seven years of age. More recently, it’s been found that sleep disturbances actually do show up in ADHD patients, but not until 12 ½ years old on average. In addition, the symptom of insomnia is often attributed to the stimulant medications used to treat ADHD, rather than the ADHD condition itself.

The truth is, sleep problems are connected to ADHD. The statistics say that 15 percent of children with ADHD have sleep troubles, which is twice the rate found in children and adolescents who do not have ADHD. By age 12 or 13, it’s estimated that more than 50% of people with ADHD will have serious difficulty sleeping. By age 30, more than 70 percent of ADHD patients report spending more than an hour trying to fall asleep each evening.

There are some specific sleep issues that ADHD patients have to contend with from day to day. The four main ones are initiation insomnia, restless sleep, difficulty waking, and intrusive sleep. “Initiation insomnia” is a condition in which the brain won’t shut off. In fact, many ADHD patients report getting a burst of energy in the evening, at roughly the time when other people would be getting sleepy. This problem results in “perverse sleep”––that is, the desire to be awake when you’re asleep, and the desire to be asleep when you’re awake. While not every ADHD patient suffers from this, it is one condition that can crop up.

2 Responses to “Sleep and ADHD”

  1. Steve

    I definately have sleep problems, (1) especially waking up. Also, (2) I have no internal clock or circadian rhythm when it comes to many things, eating meals, etc. but especially regarding bedtime and waking. I never go to bed the same time 2 days in a row(it can vary by many hours each day. (3) Additionally, I never sleep the same amount of hours on any given night. (4) Fatique and inconsistent energy levels and stamina, almost without exception, every day. The hardest part by far is (A) waking up and also (B) never feeling well rested. I hypothesize that possibly the fact that my LIFE SUCKS SO MUCH, probably in large part due to my ADHD, that subconciously my mind/body are saying to me –there is no use in getting up; your life is so miserable and full of frustration and suffering, that you are better off just staying asleep and never getting up. My life while sleeping is not much better than my life while awake… my sleep is full of nightmares, mostly reliving & revisiting my problems and trying to deal with my inadequacy and lack of skill in handling my personal and business affairs and life in general… and dealing with the messed up relationships that were part of those problems. I could really use some help… this is costing me dearly and seriously affecting my physical health & chronic co-morbidities. I have been trying for years to deal with my ADHD and am so discouraged. I wish I could find some professional or resource out there that actually knew how to effectively help people like me… that could give me an action plan / treatment plan that I could have some faith in. signed, Very High IQ (Mensa), Very Poor Quality of Life.

  2. Kari

    Couldn’t agree with you more, Steve. Seriously wrote exactly what was in my mind but I couldn’t find the words to say. Having ADHD sucks, and adderall/doctors choice is just a cover up for us to hide behind. It’s bullsh**.

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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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