Treat Sleep Issues Caused By ADHD - How To Improve Sleep Deprivation & Circadian Rhythm Disruptions
Inattention, impulsivity, and hyperactivity often steal most of the spotlight in discussions of ADHD symptoms. However, ADHD can also significantly impair sleep quality, which can negatively impact every aspect of your life.
If any of this sounds familiar, you may be suffering from ADHD-related sleep problems:
Tossing and turning for hours due to restlessness
Painful boredom and irritation at the idea of going to sleep
Racing thoughts, overthinking, and rumination of trivial problems in bed
Cortisol spikes, leading to unusual alertness and motivation to turn your life around after midnight
This article will cover the importance of sleep as the most important habit you can ever build before offering ways to improve your sleep hygiene and treat ADHD-specific sleep problems.
The Importance of Sleep
In our dynamic, fast-paced, work-obsessed world, sleep is severely underrated.
Sleep is often sacrificed for academic success and career development because, very often, it's during the night when you have quiet time for yourself. So, you naturally wish to make the most out of it. Over time, being sleep-deprived becomes the norm. You drown out the symptoms in coffee, energy drinks, pre-workouts, sweets, and snacks and trick yourself into thinking everything is fine.
Not having high-quality sleep hygiene is nothing to be ashamed of.
It's natural to experience sleep passively as just one of the many activities you fall into instead of treating it with intention and conscious effort for improvement. On average, you have to strain your body and mind for 14 to 16 hours before going to bed, so it's not surprising that you wouldn't have much energy to think and care about how you sleep.
There is no need to beat yourself over what you could have done in the past and how it could have been different. Instead, channel any motivation for change toward the future. Just because you neglected it before doesn’t mean you can’t make significant improvements now.
This is because not sleeping enough has been extensively shown in clinical trials and scientific literature to lead to symptoms similar to ADHD - forgetfulness, lack of alertness, attention deficits, reduced willpower and discipline, more frequent and intense mood swings, increased impulsivity, and stronger cravings for stimulation (1)
If you already have ADHD, this means all your symptoms can get significantly worse if you are sleep-deprived and will continue to get worse over time (2)
You can meditate, journal, walk around in nature, work out frequently, and have other healthy habits, but none of that will matter if you are not sleeping enough. Sleep is the source of the energy, motivation, and strength you have for any other habit. No other practice will protect your mental health as much as getting the sleep your body and brain need to function optimally.
Strategies for Better Sleep Quality
Improving your sleep begins with the conscious recognition of the need for improvement. If you wake up in the middle of the night, spend half an hour or more trying to fall asleep, and regularly fall below the bare minimum of 6 hours per night, there is room for improvement.
Once you find the time and opportunity, those are some of the most effective strategies.
Stick To a Schedule
The ideal sleep schedule means going to sleep between 10:30 and 11:30 pm and waking up at around 7:00 to 8:30. However, people with ADHD tend to naturally go to sleep from around 1 am to 2 am because of a delayed starting point for melatonin production (the primary sleep hormone in the body) (3)
Your exact sleeping schedule doesn't matter as long as it's consistent, provides at least seven and a half hours, and remains compatible with your duties, personal needs, and career obligations. The more predictable your sleep hours, the easier it is for your body to adapt by properly releasing sleep hormones, like melatonin, at the correct time and in the right amounts to get you sleepy.
Get Enough Morning Sunlight
The bare minimum is at least five minutes of direct sunlight exposure in the morning. Your body regulates your circadian rhythm (sleep clock) through cues in the environment. The light you see in the early morning helps to keep your body synchronized with the day, improving its ability to get you ready to sleep at an appropriate time (4)
How much you have to stay outside depends on the season and your geographic location. If you are in the northern hemisphere, or it's winter right now, then you need to stay out longer. While cloudy and dark weather can create the perception that the sun has forsaken your land and it’s pointless to go out, you can still get plenty of sunlight even if the sun isn’t directly visible.
Reduce Light Exposure Hours Before Sleeping
The five minutes before you close your eyes shouldn't consist of one final binge across social media. The more light exposure, the harder it is to convince your body it is time to sleep because it struggles to distinguish between natural and artificial light sources.
The effect is even worse if it comes from an electronic device because your brain remains alert and ready to process more information instead of relaxing. If you struggle to get started with a task because switching between contexts can be challenging with ADHD, then it shouldn’t be a surprise that going from awake to asleep should be treated, like a gentle and relaxing transition, and not a sudden switch.
Either remove light sources altogether or find ways to restrain them, like with blue light-blocking glasses and blue light filters for your laptop, phone, and other devices. The best option would be to do something like stretching, yoga, meditation, or any other activity that keeps you in the present and disengages the thinking part of your brain.
Sleep in Colder Temperatures
If it doesn't get you sick, you can try turning the AC on, opening up a window while you are sleeping, or simply taking a hot shower before going to sleep.
You are more likely to get deep and restful sleep if your body temperature is lower during the night. This is why you may intuitively feel as though you sleep better wrapped with blankets in the winter rather than wriggling even with one sheet in the hot summer (5)
Do Physically Demanding Activities During The Day
You are likely to sleep well if you are very physically and mentally exhausted.
Between the two, physical exhaustion feels like the more important bird to shoot because many people can ruminate and overthink endlessly without exhaustion.
If you are currently overwhelmed with work and responsibilities, doing the bare minimum is totally okay. Pacing around your working station during the day, going for a short walk in the morning, taking the stairs instead of the elevator, and commuting on your feet instead of taking the bus for three stops are all tiny steps you can take to get more movement in the day.
However, the most time-efficient results will come from more intense forms of exercise that push your body, especially your heart, to the limit. For example, running and sprinting, swimming, strength training with heavy compound movements (squats, deadlifts, farmer walks, bench press, pull-ups, push-ups, dips, and others).
Personally, I use a stationary bike and do a HIIT circuit of 30 seconds of maximum effort and 1 minute of low-effort cycling for a few repetitions. It doesn’t require me to change clothes, go outside, or prepare anything else. I just jump on the bike and start cycling until I hit failure. This works for me, but you gotta experiment and find something you can sustainably do a few times a week.
Trust me, pushing your body to the limit will be so demanding that you won’t have any energy left to think. While highly intense physical activity will set the stage for better sleep, you shouldn’t do it right before you go to sleep because exercise spikes up cortisol and adrenaline, which keep you awake and alert. So, anything done two hours before bed or longer is good enough.
Experiment With Bed Time Rituals
Having a short ritual can create the feeling that you are no longer working, worrying, and preoccupied with the everyday grind, which reduces rumination and negative thinking about the future.
Ideally, you want to be doing something that isn't too boring but also not too exciting and stimulating because it could keep you awake the whole night. Hitting this sweet spot isn't easy, so experiment until you find something that prevents boredom but doesn't cause you to hyper-focus. For example, journaling, gratitude expression, guided or solo meditation, chilling with music, reading a book, listening to a podcast, yoga, etc.
Optimize Nutrition To Enhance Sleep Quality
What you drink and eat in the hours before sleeping can also influence the quality of your sleep. As a general rule, don't eat heavy meals 6 to 8 hours before bed, and avoid drinking much water 2 hours before bed. You may also want to cut back on coffee and other drinks containing caffeine, often used for self-medication to compensate for lack of energy. If your body is busy metabolizing all you consume, it’s harder for it to shut down and enter sleep mode.
Furthermore, you will want to cut back on many beverages for better sleep quality. First, alcohol can make you more relaxed, but it reduces the quality of your rest, leading to more shallow sleep that’s not as healing and restorative. Second, you need to cut back significantly or eliminate caffeine sources entirely from your diet. Using caffeine doesn’t remove exhaustion but hides it, which creates a dependence that only grows worse over time and destabilizes your mood and motivation because you will eventually crash later into the day (leading you to crave even more caffeine).
If you are adamant about keeping coffee in your life, don’t drink it later than noon. It’s fine to drink green and black tea if it makes your morning more relaxing or go through two espresso shots early in the morning because this is your wake-up ritual, and it gives you a sense of structure. However, anything after noon risks interrupting your sleep because caffeine remains in your system long after you stop noticing the effects for up to 14 hours, depending on your metabolism.
Focus On Resting Instead of Making Yourself Fall Asleep
Remember how you are glued to the bed each morning and want to roll around and enjoy doing absolutely nothing? This is what you should be striving for when you are going to sleep. Enjoying the rest you get at the end of a hard day is much more achievable than making yourself fall asleep quickly.
No matter how many strategies you try to implement, all you can do at the end of the day is create a better environment and get in the headspace for sleep. The more you chase sleep, the more it will run away.
I know “enjoying the sensation” will not resonate with everyone, so you can try an activity that puts your brain in a state closer to sleep without necessarily aiming to fall asleep. А simple exercise is to consciously breathe with the intention of making a double inhale and a very slow and dragged-out exhale for as many repetitions as possible, counting each circle. This will naturally slow you down and shift you toward a state of deep relaxation while preventing intrusive thoughts.
I personally practice some form of meditation before sleep because it naturally knocks me out, and by the 15th minute, I can barely keep my eyes open.
Start Tracking Your Sleep Score
Why do you sometimes avoid going to the doctor even if you are not feeling well or skip doing maintenance checks, like getting your blood work done?
Maybe because the discomfort of not knowing and guessing is much less than the pain you’d receive from knowing just how dire the situation is.
This problematic thinking is even worse when it comes to your sleep quality because you can almost indefinitely delay tracking your data and getting an objective view of your sleep performance.
The damage of bad sleep can be felt immediately on the next day, but it’s easy to downplay it, look for excuses, or get used to the lethargy, lack of motivation, and emotional instability. Sleep deprivation absolutely sucks and causes a ton of problems, but if it isn’t the end of the world, you may lack enough urgency to take action.
Tracking your sleep with your phone or an electronic watch (the exact model doesn’t really matter) changes that instantly because you get a clear and quantifiable way of seeing the quality of your sleep. Furthermore, knowing what the current condition of your sleep is makes it easier to get more motivated once you see improvements in your score. Finally, knowing your day-to-day success gives you immediate motivation to perform better than last time and get even better.
Managing Sleep Issues Related To ADHD
There is a significant chance for some sort of sleep problem in children, and adults diagnosed with ADHD have sleep issues. This is a much higher percentage than the average population (6,7,8)
One popular theory suggests a connection between ADHD and Delayed Sleep Phase Disorder (DSPD) (9)
According to the theory, people with ADHD are more likely to have disruptions in their biological internal clock, making the body less capable of accurately assessing when to regulate and produce sleep hormones. This is why you are very likely to be a night owl whose natural schedule, if left completely alone, leads to falling asleep from 2 am to 3 am.
The sleep hygiene strategies described above have much anecdotal evidence and some limited scientific proof behind their effectiveness.
However, they will not work for every person suffering from Delayed Sleep Phase Disorder (DSPD) because they don't tackle the root cause of the problem - disruptions in the circadian rhythm (your body’s biological clock that makes sure you are alert during the day, and sleepy during the night).
If you are working remotely and have a flexible schedule, having a 2 am to 10 am schedule isn't an issue. However, this is not an accessible option for most people, and DSPD can get worse and worse by pushing you to fall asleep later and later into the night.
If you don't have the financial opportunity to seek professional medical help from a qualified circadian rhythm expert, the most accessible option is to try light therapy by yourself. If getting light in the morning for 5 minutes and turning off blue lights in the evening is not enough, it's because you likely need to do it for longer.
Since it's harder for your internal clock to get clues from the environment, light therapy puts emphasis on creating stronger signals so your sleep hormone production falls back in line.
This means using a lightbox for 15 to 20 minutes in the morning. A light therapy box is a device that tries to artificially replicate sun rays and requires at least 10,000 lux of light to be effective. You can also try completely shutting off light sources in the evening for a wider time interval and/or using high-quality blue light-blocking glasses after the sun goes down.
DSPD is a very common issue, but it's not the only piece of the puzzle.
Another ADHD-specific problem comes from hyperactivity persisting during the night and negative self-talk that creates pressure to keep working on salvaging every minute for more work.
Low self-worth and perfectionism can create the illusion of not doing enough, ramping up anxiety and motivation to keep working because rest would mean failure and not meeting your daily goals.
Combined with the fewer hours you have left and the pressure to go to sleep, you get a sense of urgency to remain awake even if it's not in your best interest. If you don’t make the most out of your remaining time, you have to admit that you haven’t done enough during the day, which creates a strong desire to procrastinate going to sleep.
It sucks to admit your day didn’t go perfectly, so you delay admitting defeat as much as possible.
Winding down with relaxing and mildly stimulating activities can work for some people. You can try looking into some techniques for emotional regulation, like brain dumping, journalling, and actively sharing your thoughts and feelings with a close one before going to sleep.
You can technically overcome this stress by working on your motivation and overall productivity. In theory, if you do enough during the day, you won't feel pressured to keep going during the night. Addressing the productivity aspect of the problem will work for some people, but for many others, it won't because the belief is inherently irrational.
You can still feel like you are not good enough because your inner critic is too harsh, and your standards and expectations are unrealistically high.
This is why challenging the premise of your thoughts can be very effective. The more distance you create from those anxious thoughts by putting them out into the world, the better you become at seeing they are not necessarily true or helpful.
Key Takeaways
No matter how you try to calculate it, not sleeping enough is never worth it unless you have a very strict deadline you must absolutely meet.
When we think of sleeping benefits, people talk about longevity, general health, and productivity. However, the length and quality of your sleep are one of the biggest influences on the severity of your ADHD symptoms.
