Adult ADHD and Sleep Problems

Date:April 10, 2023
Source:University of Missouri-Columbia

Written by WebMD Editorial Contributors
 Medically Reviewed by Smitha Bhandari, MD on March 14, 2023

Full Story

Everyone needs 7-9 hours of sleep each night to feel productive and well during the day. But people with ADHD often have a hard time falling or staying asleep.Because you feel tired, your ADHD symptoms get worse, and that makes it harder to sleep the next night. This cycle repeats. And it happens to a lot of people. One study found that roughly two thirds of people with ADHD — 67% — found it hard to get a good night's sleep.But why? And what's the solution? While experts don't know exactly how sleep woes and ADHD are linked, they do know about some of the possible causes and what might help.

On top of the normal things that can keep anyone from getting a good night's rest, there can be extra challenges if you have ADHD. These include:

Trouble keeping a schedule. People with ADHD are often easily distracted and find it tough to stop projects, tune out interruptions, and go to bed. Even once you're in bed, it can be hard to quiet your mind and relax enough to sleep.

Stimulants. The stimulant medications often used to treat ADHD can make you feel more awake and can make sleeping harder. That's on top of any caffeine you get from sources like coffee, tea, soda, and chocolate.

Other conditions. Often people with ADHD also have anxiety, depression, mood disorders, or substance abuse problems that can make falling and staying asleep difficult.

Sleep disorders are more than a bad night's sleep. And if you have one, it can steal your rest and make you more distractible and impulsive during the day. These conditions are so common among people who have ADHD that experts often check on sleep problems when they're diagnosing ADHD.

Insomnia. Along with medications and trouble sticking to a schedule, there are other reasons people with ADHD are at risk for insomnia. You may get a burst of energy at night, along with racing thoughts that make it hard to get to sleep. Even when you do sleep, it might not be particularly restful — especially if you also have nightmares. And stressing out about being unable to sleep can make your insomnia worse.

Sleep apnea. People with sleep apnea stop and start breathing throughout the night. It messes with your rest and leaves you feeling tired. About 3% of all people and 25% of those with ADHD have sleep apnea or some other "sleep-disordered breathing" problem. If you snore loudly, you may want to mention this to your doctor because it can be a sign of sleep apnea.Restless legs syndrome (RLS). Symptoms include limb discomfort and a strong urge to move your legs while you sleep. Some people describe the feeling as pulling, throbbing, aching, or itching inside your leg. About 2% of all people and 44% of those with ADHD have RLS.

If you have ADHD and trouble sleeping, you should tell your doctor. You might need a change in your medications to make sleeping easier, or you might do a sleep study to see if there is another underlying cause of your sleeplessness.

If you've ruled out other causes, then your ADHD symptoms may be to blame. You may be able to improve your rest by doing the following healthy habits and routines. You should:

  • Avoid napping 4 hours before bedtime.
  • Avoid drinking caffeine 4 hours before bedtime.
  • If you take stimulant medication, make sure you are taking it as early as possible.
  • Have a calming bedtime routine.
  • Go to bed at about the same time every day.
  • Sleep in a comfortable bed in a dark and quiet room.
  • Avoid looking at screens (TVs, smartphones, etc.) and electronic media in the evening.

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Materials provided by WEBMD.

References: 

  • National Sleep Foundation: "How Much Sleep Do We Really Need?"
  • National Institute of Mental Health: "Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics."
  • Neuropsychiatry: "Identifying and Managing Sleep Disorders Associated with ADHD."
  • Acta Psychiatrica Scandinavica: "Prevalence and Clinical Correlates of Insomnia in Adults with Attention-Deficit Hyperactivity Disorder."
  • Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): "ADHD, Sleep and Sleep Disorders."
  • The Mayo Clinic: "Sleep Apnea," "Restless Legs Syndrome."
  • Sleep Foundation: "ADHD and Sleep."
  • Attention Deficit Disorder Association: "Adults With ADHD and the Sleep Problems They Face."

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