The following article was published in ADDvisor newsletter earlier this year. We are publishing this article in our newsletter with kind permission from Alan Graham and Bill Benninger of ADDvisor.
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We get frequent questions, both in our private practices and in our ADDvisor teleconference classes about the sleep problems of children and adults with ADHD. This article will look at this issue in children and adults with ADHD and discuss some possible solutions. If you, our readers, have practical solutions that you would like to contribute please send them to us and we will print them for all to read. Our 1100 plus subscribers can be a powerful resource for practical advice; so don’t be shy about adding in your solutions!
Sleep problems for people with ADHD seems to have two common origins. First, difficulty falling asleep is a common side effect of the stimulant medications. Second, research shows that individuals with ADHD seem to have more trouble falling asleep even if they don’t take medication. A third issue to keep in mind is the possibility that the sleep difficulty is a result of a co-existing disorder such as depression or anxiety (worrying). It is important to narrow down the possible origins of the sleep problem in order to know how to improve it.
Once you have a good guess as to the origin of the problem, start experimenting with possible solutions.
If you think the problem is related to the use of stimulant medication try taking the medication earlier in the day. If a second dose is being used give the second dose earlier or reduce the dose size. Since different medications have different side effects, trying a different medication may be helpful. Some individuals find it beneficial to add a medication, either over-the-counter or prescription, that promotes sleep. Of course, your prescribing physician should approve any medication changes before you start them.
If you think that the origin of the sleep problem is the ADHD itself there are a number of tips that can be utilized to promote sleep. Having passive stimulation at bedtime can be helpful. Common examples include playing an audiotape of relaxing music or even a book tape softly. Try visual aids such as a fish tank, a spinning nightlight, a lava lamp or a ceiling star display. A cooler than normal room and heavy covers helps some individuals relax and lay still. Making sure they get enough exercise during the day can also be important.
In general, a consistent bedtime routine, a back rub or hot bath before bed to relax the muscles, the avoidance of afternoon naps, and not using caffeine can all help improve the chances of falling asleep at bedtime. A word of caution for parents with young children who would prefer to fall asleep in the parents bed, don’t let them do it. In the long run it will create more problems than it will solve.
If it appears that the sleep difficulties have their origins with other impairments, such as depression or anxiety, it is important to seek treatment for this. However, many of the solutions mentioned above, can still be utilized.
Sleep problems do not often go away quickly, so be persistent in the implementation of changes that you make. Try the possible solutions for 1-2 weeks before moving on to something else.