ADHD (Attention Deficit Hyperactivity Disorder) and sleep are deeply interconnected. Sleep problems are common in people with ADHD and poor sleep often exacerbates ADHD symptoms. This relationship can create a vicious cycle where ADHD disrupts sleep, and sleep deprivation worsens the condition’s core challenges.
THE IMPACT
How ADHD affects sleep
Delayed Sleep Phase Syndrome (DSPS): Many with ADHD have disrupted circadian rhythms, making it hard to fall asleep and wake up at conventional times.
Hyperactive Mind: Racing thoughts and restlessness make winding down at night difficult.
Co-occurring Sleep Disorders: Insomnia, restless leg syndrome (RLS) and sleep-disordered breathing (SDB) are more prevalent in people with ADHD.
Medication Effects: Stimulants used to treat ADHD may interfere with sleep if taken late in the day.
THE EFFECT
How sleep affects ADHD
Worsens Symptoms: Inattention, hyperactivity and impulsivity are amplified by sleep deprivation.
Reduces Emotional Regulation: Lack of sleep makes it harder to manage emotions, increasing irritability and mood swings.
Impairs Executive Functioning: Sleep loss hinders planning, organisation and decision-making, core areas of difficulty in ADHD.
The importance of sleep
Sleep is essential for physical, cognitive, and emotional health. It’s during sleep that the body and brain repair, process information, and regulate essential functions.
Key Roles of Sleep
- Memory and Learning: Sleep helps consolidate memories and integrate new information.
- Emotional Regulation: Adequate sleep stabilises mood and reduces stress responses.
- Brain Recovery: Sleep allows for synaptic downscaling, a process that balances neural connections, ensuring the brain is ready for new learning.
- Physical Health: Sleep strengthens the immune system, supports hormonal balance, and aids tissue repair.
THE SHORT AND LONG TERM EFFECT
What Happens When You Don’t Sleep?
Sleep deprivation has wide-ranging effects on the body and mind. Missing just a few hours of sleep can cause noticeable declines in performance and emotional stability.
Short-Term Effects
- Reduced focus and alertness.
- Poor decision-making and slower reaction times.
- Increased emotional reactivity and irritability.
Long-Term Effects
- Risk of chronic conditions like obesity, diabetes, and heart disease.
- Greater likelihood of developing mental health issues, such as anxiety and depression.
- Impaired memory, learning, and problem-solving abilities.
"Managing ADHD without prioritising sleep is like trying to drive a car with a flat tyre—you might move forward, but you’ll never reach your full potential."
Dr Raffi
THE KNOCK ON EFFECTS
Impact of Poor Sleep on ADHD
When someone with ADHD experiences poor sleep, their symptoms often worsen significantly:
- Amplified Inattention: Sleep deprivation makes it harder to focus or sustain attention.
- Increased Impulsivity: Fatigue impairs decision-making, leading to rash or poorly thought-out actions.
- Heightened Emotional Sensitivity: Poor sleep worsens emotional regulation, increasing irritability, frustration, and rejection-sensitive dysphoria (RSD).
- Physical Restlessness: Sleep deprivation can mimic hyperactivity as the body struggles to stay alert.
Impact of ADHD on Sleep
ADHD itself can make getting restful sleep challenging:
- Difficulty Relaxing: Hyperactive thoughts or physical restlessness prevent falling and staying asleep.
- Circadian Rhythm Disruptions: People with ADHD often feel naturally alert at night, making early bedtimes difficult.
- Co-occurring Conditions: Sleep problems like insomnia or sleep apnoea are more common in ADHD, further disrupting sleep quality.
Breaking the Cycle
The relationship between ADHD and sleep is bidirectional, but taking steps to address one can often improve the other. Strategies include:
- Improving Sleep Hygiene:
- Stick to a consistent bedtime.
- Limit screen time before bed.
- Create a calming pre-sleep routine.
- Adjusting ADHD Treatment:
- Optimise medication timing to minimise sleep disruption.
- Explore non-stimulant medications if sleep problems persist.
- Treating Sleep Disorders:
- Address insomnia, sleep apnea, or other conditions with a healthcare provider.
- CBT for insomnia is the gold standard approach
- Adopting Holistic Approaches:
- Incorporate exercise, mindfulness, and relaxation techniques into daily routines.
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Conclusion
Sleep and ADHD are closely linked, with each influencing the other. While ADHD can disrupt sleep, poor sleep significantly worsens ADHD symptoms, creating a challenging cycle. Understanding this relationship is key to managing both issues effectively. By prioritising sleep, addressing underlying conditions, and adopting tailored strategies, individuals with ADHD can experience better focus, mood stability, and overall quality of life.
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Dr. Raffi
Dr Asad Raffi is the Founder of Sanctum Healthcare, Medical Director and Lead Consultant Psychiatrist on the Specialist GMC register. As Medical Director Dr Raffi had over 20 years experience as a psychiatrist and brings a plethora of experience from the NHS and private sector.
