The Connection Between Sleep and ADHD

Connection Between Sleep and ADHD

Everyone can agree that we’re not in tip-top shape without a good night’s sleep. Unfortunately, it’s on trend for our population to miss out on the amount of sleep we really need to be able to function effectively during the day. It can also be difficult to differentiate these symptoms from mental health disorders in diagnostic testing.

According to the CDC, approximately 35 in every 100 people in the United States report having a short-sleep duration (less than 7 hours of sleep per 24-hour period.) Additionally, those who reported sleeping less were more likely to report substance abuse and chronic health conditions—including depression, heart attack, and stroke.1

For mental health, there are prevalent complications that come with a lack of sleep, as well as a consistent connection between those who have mental health disorders and significant sleep disturbances.

Americans in general are sleep-deprived, but chronic sleep problems affect 50-80% of patients in a typical psychiatric practice. Sleep disturbance is even more commonplace for those struggling with anxiety, depression, bi-polar disorder, and ADHD.2

While most of us have periods where our sleep isn’t great, those with chronic sleep difficulties can have significant changes in behavioral issues and overall mental health. Some of these signs of disturbance can include:

  • Feeling very tired during the day
  • Falling asleep in the middle of a task
  • Trouble staying focused, especially during schoolwork
  • Increased irritability
  • Mood swings
  • Emotional dysregulation (i.e. literally crying over spilled milk)
  • Difficulty with changes in schedule/organized patterns

Many of these signs of sleep disorder or deprivation, are also common traits/symptoms of those diagnosed with ADHD. Problems with distractibility, poor focus and issues with inadequate motivation and follow-through are often found in individuals who have ADHD and those who have poor sleep.

Identifying the root cause for these changes in mood and behaviors can be tricky, especially when they frequently coexist, and when the symptoms for both are so similar. However, it is important to rule out the possibility of a sleep disorder prior to seeking diagnoses that have treatment options which may be ineffective or perhaps more intensive than necessary. 

If an individual is exhibiting symptoms that could present for either a sleep disorder, or ADHD and other mental health diagnoses, it is often worth going through the less invasive/intensive treatment options associated with sleep disorder treatment first.

Sleep specialists can run special tests, or sleep studies, to determine whether a client is experiencing notable sleep disturbance. If sleep disruption/deprivation is found, and treatment for these disturbances results in significant improvement in the client’s symptom presentation, further diagnosis and intensive treatment/medication may not be necessary.

Additionally, behavioral and relaxation treatments for sleep disorders will provide net benefit regardless of whether a client has another mental health condition. An individual who has ADHD will benefit from improved sleeping patterns and habits just as much, if not more, than an individual who is experiencing a sleep disorder without a comorbid mental health condition.

Here are some examples of effective interventions for sleep disturbances:3

Positive Sleep Routines

  • Developing a consistent bedtime routine; consistent quiet and calming activities beginning at a set time, with the latter portion of the routine within the preferred sleep setting (bed, crib, etc.)

Bedtime Fading

  • Temporarily delaying bedtime to assure rapid sleep, followed by small adjustments to earlier and earlier times (“fading”) to a desired bedtime.

Sleep Restriction

  • Limiting the ratio between the amount of time spent in bed to actual sleep time; setting limits to time in bed for desired length of sleep, with slow adjustments/fading to achieve sleep efficiency

Stimulus Control

  • Reinforcing the association between the bed and sleep, instead of the bed and sleep disturbance; only going to bed when sleepy, getting out of bed when not tired, avoiding naps, and only using the bed for sleep.

How people react to these interventions can say a lot to what may be causing the disturbance, and whether the dysfunctional behaviors and emotional dysregulation is tied solely to sleep disturbance or another condition. Additionally, other factors such as age, profession, location, health, and socioeconomic status can have significant effects on an individual’s appropriately expected sleeping patterns, lengths, and behaviors.

Overall, it’s important to consider multiple factors that can go into the most effective treatment (and the most reflective diagnosis) for someone experiencing dysfunction in their life. When considering a potential diagnosis or discussing mental health symptoms with your doctor or clinician, try to keep an open mind to the potential of sleep disturbance as a significant source of these symptoms.


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