If you have Adult Attention Deficit Hyperactivity Disorder (ADHD), you’re probably familiar with the anxiety and frustration that can come from losing your keys, forgetting important meetings, or fixating on one issue when you should be working on something else. But those are problems during the daytime hours. Once it’s bedtime, all your cares slip away, and you get a peaceful night’s rest, right?

If you’re like some of my patients with ADHD, you might be saying “Yeah, right–what is this guy talking about? I have ADHD, and I sleep like garbage.”

Many of my clients that have ADHD complain of insomnia. They might have a hard time going to sleep since their mind is constantly wandering. Some have anxiety at night trying to remember if they actually completed needed tasks throughout the day. Other patients notice that they are restless because they are wondering about the future. Since the stimulant medication that patients take to quell their ADHD symptoms has worn off by the time they’ve gone to bed, how can an adult with ADHD get a good night’s sleep? Optimizing your bedtime routine and exploring sleep medication are two potential options for helping you sleep better.

How ADHD Can Contribute to Poor Sleep

First, let’s review how ADHD can cause some people to have insomnia. Problems falling asleep, waking up throughout the night, and waking up before you want to are all potential presentations of insomnia. These sleep issues also lead to mood and attention problems during the day.

My patients with ADHD tell me that worrying about forgetting important tasks can sometimes keep them up at night. The restlessness that troubles them during the day can make it hard to settle their mind and body enough to sleep at night, as well. Patients also report a vicious cycle of anxiety. They know that their poor sleep can worsen their daytime inattention and other ADHD symptoms; this anxiety makes it harder to sleep, which causes more mistakes and stress the next day, which causes more anxiety and strengthens the feedback loop.

Stimulant Treatment For ADHD

To combat the symptoms of ADHD, patients are most often prescribed stimulant medication, such as Adderall, Vyvanse, or Concerta. Stimulants impact the neurotransmitters (brain chemicals) of dopamine and norepinephrine.

While your stimulant medication is active in your body, you notice a decrease in the distractibility, restlessness, and impulsivity that can come with ADHD.

An extended-release ADHD medication is effective for around 12 hours.

Your stimulant medication regimen should generally wear off in time for bed. For people whose ADHD can contribute to their insomnia, this is kind of a good news/bad news scenario. By their nature, stimulant medications can keep a person awake, making it challenging to sleep. In that way, it’s helpful for your stimulant medication to have passed its active phase in your system at bedtime. However, if your stimulant medication was helping you to feel settled, when your medication’s effectiveness is gone, your restlessness and anxiety could return. Given these challenges, it’s important to consider how your sleep routine can work for or against you.

Sleep Hygiene For People With ADHD

In order to get the at least 7 hours per night of sleep that the CDC recommends, practicing good sleep hygiene is an important step. Sleep hygiene refers to healthy habits that you have surrounding your sleep routine. Most people find it easier to fall asleep and stay asleep if they can try to set a consistent daily bedtime and wake time. Make sure your sleep environment is dark and calming; blackout curtains can be useful if you live in an area with long, sunny days like El Paso, Las Cruces, or Albuquerque.

It’s also helpful to exercise on most days, even if it’s only for a short period of time. Don’t eat heavy meals too close to your bedtime. The Sleep Foundation recommends cutting off caffeine use at least six hours before you go to bed. The Sleep Foundation also recommends that “you should stop drinking alcohol at least four hours before bedtime.”

It can be challenging to follow all of these recommendations. If you’re new to the idea of a consistent bedtime routine, start with the healthy habit that is easiest for you to implement. Once you have that habit down, incorporate the next easiest one. Some of my clients have noticed that even if they have good sleep hygiene, their restlessness and worry still don’t allow them to have a good night’s sleep. If this is the case, it might be time to consider sleep medication.

Medication For Sleep If You Have ADHD

Your bedroom is quiet and cool, you’ve blocked out the El Paso sun, and you never drink coffee in the afternoon anymore. Nice job, you’re making all the right moves! But if you’re still experiencing insomnia, don’t be discouraged. When my patients with ADHD who have developed good sleep habits are still struggling with sleeplessness, I recommend they start a non-habit-forming sleep medication.

Hydroxyzine, Trazodone, Remeron, and Clonidine are all good non-habit-forming sleep medication options. You can try one of these options without the worry of becoming dependent on them.

Seroquel is another non-habit-forming medication that is prescribed off-label for anxiety or insomnia at night.

You and your provider can work together to see if any of these medications are a good option for you to get the good night’s rest that you need. Sleep medication might be something you end up taking regularly, or it might only be needed until your ADHD-induced bedtime anxiety becomes less of an issue for you.

If the worry and restlessness associated with your ADHD are causing you to lose sleep, you’re not alone. Work with your behavioral health provider to learn good sleep habits and to explore sleep medications that can fight your insomnia. If you live in El Paso, Las Cruces , Albuquerque, or one of the other cities we serve, Upper Valley Behavioral Health could be the right ADHD treatment center for you. Please fill out our short application for treatment today, and get ready to sleep better.

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

Tags: adhd

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