If you've got ADHD, the risk is high that you also have sleep problems. And as is so often the case, standard tips often don't work for us.
Unfortunately, only a few studies specifically look at the effectiveness of interventions for sleep disorders in adults with ADHD. So if a common suggestion doesn't work for you, chances are there's no scientific evidence that this tip is effective in ADHD. But that doesn't help us when all we want is to get some rest to keep ourselves and our brains from becoming even more frazzled.
Two researchers from the prestigious Harvard University have compiled all available studies on the effectiveness of interventions to improve sleep in ADHD in adults (Reference 1 - all references at the bottom of the post). There's not much but at least it's a start.
Read on to learn what recent research studies suggest might actually help with ADHD sleep problems.
Sleep problems are very common with ADHD
People with ADHD have a significantly increased risk for a wide variety of sleep problems. The reasons for this are still unclear. There are many different theories about how ADHD affects sleep and why sleep problems are so prevalent in ADHD, but more research is needed. The bottom line right now is simple: many of us with ADHD don't feel sufficiently rested.
What might help us get more rest
In case you're wondering why I'm so hesitant in my wording, there are few studies. Therefore, the evidence base for what truly helps with ADHD sleep problems is extremely small. In a previous post about (ADHD) research, I've explained how we arrive at evidence-based recommendations (take a look, it's really easy to understand).
As much as we'd like it to be otherwise, much of what you find on the internet and elsewhere about ADHD sleep tips, even from experts, is based on empirical data at best (if at all), but hardly ever on actual research data in people with ADHD.
The researchers from Harvard University were only able to find six studies that explored what really helps with ADHD sleep disorders in adults. Unfortunately, all six studies had very few participants (between 13 and 51 people per study). But hey, it's a start.
Light therapy in the morning - the tip with the best evidence for ADHD
Therapy with daylight lamps in the morning was tested in three studies with a total of 96 adults with ADHD. All studies found a positive effect. The therapy appears to improve both day-night rhythm and alertness during the day.
Unfortunately, in my experience, most people with ADHD have a hard time staying disciplined in front of a daylight lamp in the morning and repeatedly looking into the light briefly. I have exactly one client so far who has followed through with this diligently.
So for the first time on this blog, I'm promoting a product because I think it's simply brilliant and very ADHD-friendly.
Luminette are light therapy glasses that you simply put on in the morning (for 20-30 min, depending on the light intensity). If you wear glasses like I do, you just put them on top of your glasses. You don't have to sit still, which massively increases the chance that you'll actually use them.
Because I'm so excited about the glasses, I wrote to the company and asked for a discount code. With the code KARG, you should get 10% off the Luminette. If you purchase through the link and allow cookies on your site, I get a small commission. But I would promote the product anyway because I benefit so much from it myself.
Light therapy is also, unfortunately, the only intervention for which researchers could find multiple studies that all showed efficacy in adults with ADHD.
What might also help: behavioral therapy and weighted blankets
As I said, the scientific evidence is really meager. The researchers concluded that behavioral therapy or weighted blankets might also help adults with ADHD.
My experience with weighted blankets is that my clients with ADHD either love them or hate them. They either find them comforting or constricting. Of course, this is far from scientific what I am writing here, just experiential.
As for (cognitive) behavioral therapy - here there is good evidence for moderate efficacy (which is already a lot) of sleep-specific cognitive behavioral therapy in otherwise healthy people and people with various other conditions or impairments besides ADHD (reference 2). One can only hope that treatment protocols will be adapted and tested for ADHD.
Be sure to discuss your sleep problems with your health care professionals - they can help you find solutions tailored to your situation
Because of the lack of data for ADHD, I think it's especially important to discuss our sleep problems with professionals who specialize in ADHD.
Because the standard approaches that are recommended even by sleep specialists without experience with ADHD can be more frustrating than helpful.
Your psychiatrist, psychotherapist, or ADHD coach can help you find solutions that fit you individually. Of course, the best solution would be a sleep specialist with experience in ADHD - so if you know such a person, please reach out and let me know about them?
Many of us have silently given up and don't even mention our sleep problems. But it's especially important for your medical professional who specializes in ADHD to know about your trouble sleeping or getting rest. Science says ADHD often seems to co-occur with sleep apnea or restless legs syndrome for example (Reference 3). So please: mention your sleep problems or lack of feeling rested.
The package insert for most ADHD medications lists sleep problems as a side effect. But in a new publication, researchers compiled and analyzed all studies that systematically monitored the sleep of adults taking stimulants for their ADHD (Reference 4).
Surprisingly, they found that according to the studies, sleep often improved rather than worsened with stimulants, especially once the dose was properly adjusted.
Even though research is still missing, some standard tips can help, especially when customized
If you want to learn more about ADHD and sleep, check out the first chapter of my free online self-study course on ADHD and self-care. You might find a tip or two there that you'd like to try.
For me personally, it was the combination of some common sleep hygiene tips and the support of a really good psychiatrist who looked very closely that really helped. Now I have a really restful night every now and then, which I'm really grateful for every time it happens.
As long as there are no studies, there is no way around simply trying things out - preferably with the support of ADHD specialists.
Wishing you as much rest as possible for you in your current circumstances!
References:
1. Managing Sleep in Adults with ADHD: From Science to Pragmatic Approaches. Surman CBH, Walsh DM. Brain Sci. 2021 doi: 10.3390/brainsci11101361 Link to review summarizing studies on the effectiveness of interventions to improve sleep in ADHD in adults
2. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, Sateia MJ, Troxel WM, Zhou ES, Kazmi U, Heald JL, Martin JL. J Clin Sleep Med. 2021 doi: 10.5664/jcsm.8988 Link to publication with very solid evidence on the effectiveness of behavioral and psychological interventions (not specific to ADHD, though)
3. Associations of sleep disturbance with ADHD: implications for treatment. Hvolby A. Atten Defic Hyperact Disord. 2015 doi: 10.1007/s12402-014-0151-0 Link to review describing sleep disturbances that often occur with ADHD
4. Understanding the Impact of Stimulants on Sleep in ADHD: Evidence from Systematic Assessment of Sleep in Adults. Surman CBH, Walsh DM. CNS Drugs. 2022 doi: 10.1007/s40263-022-00905-5 Link to review on the effect of stimulants on sleep in ADHD
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