Attention deficit hyperactivity disorder (ADHD) is a chronic condition that causes various hyperactive and disruptive behaviors. People with ADHD often have trouble focusing, sitting still, and controlling their impulses.
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The exact cause of ADHD is unknown.
However, researchers believe genetics and certain environmental factors may contribute to its development. There’s no cure for ADHD, but several treatments can help to reduce the severity of symptoms.
Symptoms of ADHD can appear in children as young as 2 years old, and they usually decrease with age.
Common symptoms of ADHD include:
- having trouble focusing or staying on task
- daydreaming often
- appearing not to listen
- having difficulty following directions or finishing tasks
- losing or forgetting things easily
- having problems organizing tasks and activities
- frequently fidgeting or squirming
- talking excessively
- regularly interrupting other peoples’ conversations or activities
- being impatient and easily irritated
ADHD symptoms can affect many areas of life.
Sleep disorders are believed to be one of the most common types of coexisting conditions among adults and children with ADHD.
Researchers aren’t exactly sure why ADHD and sleep disorders often occur together.
However, it’s believed that the symptoms of ADHD can make it challenging to settle down enough to fall or stay asleep. This can cause a variety of sleep problems that make it difficult to get a good night’s rest.
Recent research also suggests that genetics and structural brain abnormalities may play a role.
Many ADHD medications are also stimulants. This can cause sleep issues, especially if they’re taken later in the day.
A lack of sleep can aggravate some ADHD and ADHD-related symptoms. However, poor sleep quality usually affects children and adults differently.
When children don’t get enough sleep, they usually become more hyperactive. Adults, on the other hand, typically feel more fatigued and have a lack of energy.
DID YOU KNOW?
The term sleep architecture refers to the way you cycle through the stages of sleep each night.
Researchershaven’t been able to identify consistent differences in the sleep architectures of people with ADHD and people without ADHD.
Sleep disorders are defined as conditions that interfere with the ability to sleep well on a regular basis.
Most adults require 7 to 9 hours of sleep each night, according to the National Sleep Foundation (NSF). Toddlers and older children may need 8 to 14 hours, depending on their age group.
Common sleep disorders among people with ADHD include:
- restless legs syndrome (RLS)
- sleep apnea
Insomnia is a sleep disorder that makes it difficult to fall asleep, stay asleep, or both. People with insomnia usually don’t wake up feeling rested. This can make it hard for them to function normally throughout the day.
Insomnia can affect your:
- energy levels
- overall quality of life
It tends to become more common with age, as changes in sleep patterns and general health occur.
Symptoms of insomnia often include:
- having trouble falling asleep
- waking up from sleep during the night
- waking up too early
- not feeling refreshed after sleeping
- feeling tired or sleepy during the day
- feeling anxious, depressed, or irritable
- having trouble focusing or remembering things
- making more errors than usual
- having tension headaches
- having digestive issues
Restless legs syndrome (RLS)
Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is characterized by an overwhelming need to move one’s legs. This desire is usually triggered by leg discomfort, such as throbbing, aching, or itching.
These uncomfortable sensations often occur at night, especially when a person is lying down. Moving can make the discomfort go away temporarily.
RLS can affect people of any age, but it typically becomes more intense as time goes on. It may make sleeping difficult, which can result in daytime sleepiness and fatigue. The symptoms of RLS include:
- an uncomfortable sensation in the legs that begins after lying down or sitting for a long period of time
- having an irresistible urge to move the legs
- leg discomfort that temporarily subsides when the legs are moved
- twitching or kicking the legs during sleep
- waking up from sleep due to leg movements
Sleep apnea is a serious sleep disorder in which breathing temporarily stops during sleep. People with sleep apnea often snore loudly and feel tired even after a full night’s rest.
There are three main types of sleep apnea:
- Obstructive sleep apnea. This type which occurs when the muscles in the throat relax abnormally.
- Central sleep apnea. This type occurs when the brain doesn’t send the right signals to the muscles that control breathing.
- Complex sleep apnea syndrome. This type occurs when someone has both obstructive and central sleep apnea at the same time.
While there are different types of sleep apnea, they all share the same common symptoms.
These symptoms include:
- snoring loudly (this occurs mostly in people with obstructive sleep apnea)
- breathing that starts and stops during sleep, which is observed by another person
- waking up during sleep and feeling short of breath (this occurs mostly in people with central sleep apnea)
- waking up with a dry mouth or sore throat
- having a headache in the morning
- having trouble staying asleep
- being very sleepy during the day
- having trouble focusing
- feeling irritable
ADHD AND NARCOLEPSY
According to a 2020 literature review, 33 percent of people with narcolepsy experience symptoms of ADHD.
Doctors must take extra care when screening for sleeping problems in people with ADHD. Sleep disorders and ADHD have overlapping symptoms, which can lead to misdiagnosis.
If someone with ADHD complains of sleeping problems, their doctor will request a thorough sleep history.
This involves asking the person about:
- their usual bedtime
- the amount of time it takes them to fall asleep
- awakenings during the night
- problems waking up
- daytime naps
- daytime energy levels
The doctor may also give them a sleep diary. They’ll be asked to use the diary to record their sleeping habits over several weeks.
If the doctor suspects a sleep disorder, they may order different diagnostic tests. There are two main tests used to diagnose sleep disorders.
Nocturnal polysomnography test
A nocturnal polysomnography test is done in a laboratory while a person sleeps. The person is connected to equipment that monitors vital signs as well as activity in the heart, lungs, brain, and legs during sleep.
People with sleep disorders:
- usually have a shorter overall sleep time
- move their limbs more during sleep
- may exhibit other irregular behaviors while sleeping
Home sleep test
As the name suggests, this test is done at home. It’s performed in the same manner as a nocturnal polysomnography test.
The person will be given the monitoring equipment to use at home while they sleep. Abnormal vital sign measurements, movements, and breathing patterns tend to indicate a sleep disorder.
In people with ADHD, it’s important to establish a good treatment plan for sleep disorders. This often involves psychotherapy or medical treatments that help promote normal sleep.
Some common psychotherapy techniques include:
- cognitive behavioral therapy (CBT), which can show you how to manage or eliminate feelings of anxiety and thoughts that keep you from falling asleep
- relaxation techniques, such as meditation and deep breathing exercises, which can help reduce stress before bedtime
- stimulus control, which can teach you how to limit the time you spend in bed while not sleeping so you only associate your bed with sleep
- sleep restriction, where you intentionally limit the time that you spend in bed lying awake or not sleeping
- light therapy, which can help reset your internal clock so that you fall asleep at a later or more appropriate time
Some medical treatments that can help with sleep disorders include:
- prescription sleeping pills, such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata)
- calcium channel blockers and muscle relaxers, which can help those with RLS
- a continuous positive airway pressure (CPAP) machine, which helps keep airways open and prevents sleep apnea
- oral appliances, which can help to keep the throat open and prevent sleep apnea
Making certain lifestyle adjustments is also important.
Some lifestyle changes and home remedies that can help with sleep disorders include:
- going to bed and waking up at the same time every day, even on weekends
- avoiding caffeine in the late afternoon and evenings
- avoiding alcohol and nicotine close to bedtime
- avoiding the use of electronics before bedtime
- using the bed primarily for sleeping and never for activities like working
- keeping the bedroom dark, quiet, and cool
- getting enough exercise during the day
- avoiding heavy meals close to bedtime
- establishing a relaxation routine before bed, such as reading, doing yoga, or taking a warm bath
- use a weighted blanket
Having a sleep disorder in addition to ADHD isn’t easy. However, with the right treatment and lifestyle modifications, you can greatly reduce your ADHD symptoms and improve your sleep.