ADHD and Sleep Problems: This is Why You're Always Tired

25 Comments: ADHD and Sleep Problems: This is Why You're Always Tired

1. I’ve found a Bluetooth sleep mask and the Calm app – which has a wide range of Sleep Stories – very helpful.

   I save the one where the narrator reads from the GDPR introduction (UK regulations concerning maintaining personal privacy in data processing) for particularly bad nights.

2. I found this article interesting but do have concerns with the recommendation to take Benadryl. Research has linked long term use of Benadryl with dementia.

   A team led by Shelley Gray, a pharmacist at the University of Washington’s School of Pharmacy, tracked nearly 3,500 men and women ages 65 and older who took part in Adult Changes in Thought (ACT), a long-term study conducted by the University of Washington and Group Health, a Seattle healthcare system….When the researchers examined the use of anticholinergic drugs, they found that people who used these drugs were more likely to have developed dementia as those who didn’t use them. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less.

   https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667

3. I would like to extend a word of caution with the “two-alarm system” discussed near the end of the article. To review, the two-alarm system is: when “the patient sets a first dose of stimulant-class medication and a glass of water by the bedside. An alarm is set to go off one hour before the person actually plans to rise. When the alarm rings, the patient rouses himself enough to take the medication and goes back to sleep. When a second alarm goes off, an hour later, the medication is approaching peak blood level, giving the individual a fighting chance to get out of bed and start his day”.
   I did this for a number of years. What began happening is that if I didn’t take my medication before wakening, I couldn’t wake up enough to be able to get out of bed and have any productivity whatsoever. I am talking extreme sleepiness where I couldn’t function at all. I found this out after I was taken off of the medication. I went to the doctor because it was that bothersome. After having saliva tests to determine my cortisol levels, I found out that my adrenals no longer were releasing cortisol in the AM which is an important part of our waking cycles. Known as cortisol rhythm, the rise and fall of this stress hormone is crucial for helping you wake up in the morning. In the early morning, your body’s cortisol production naturally surges and transitions you into wakefulness. Amphetamines raise cortisol levels, so when taking the medication an hour before wanting to wake up, my adrenal glands stopped naturally releasing cortisol in the AM, because it was being raised by the amphetamine. It took me months before my adrenals began releasing cortisol naturally again in the AM. I am not saying that this will happen to you, but I at least wanted to tell my story in case this is happening or happens to you.

4. oops, sorry, I didn’t mean to post this twice, I only was and to edit it.

5. finally they seem to be starting to get it… But sleep hygiene does not work for me, and caffeine actually helps me to get to sleep faster (probably because of the “paradoxical effect” of caffeine). I wish that they would get that sleep hygiene does not always work for people with ADHD. Probably they use the wrong studies because it is really hard for people with ADHD to consistently practice sleep hygiene. So the doctors just assume that they are like the rest of the patients and tell them to practice it, and it’s their own fault if they can’t sleep and they don’t. Well, I had to change Psychiatrists 3 times and every time I couldn’t sleep for a year, because I had to prove to them that practicing sleep hygiene doesn’t work. And I really had to prove to them that I was practicing it. And eventually I got the meds I needed.
   So I know they just haven’t understood yet.
   I really need them also to understand the paradoxical effect of sugar. It also effects sleep hygiene. A little sugar at night an it talks half the time to go to sleep. I think it’s just not true what all these mothers say about sugar winding up their ADHD kids. There are no serious studies that support this notion. I think people just subconsciously want to believe that, so they feel a little better about all the rough time their kids are giving them. Kind of like a subconscious “punishment”

6. This is a great resource for people about the ways ADHD impairs sleep. It’s interesting that you say many of your patients can’t fall asleep until 4am. One of the criteria for Restless Legs Syndrome is it goes away in the early morning hours, usually around 4am. I screen for RLS with every new patient. Benadryl can make RLS worse so that may account for the difference people experience.

   Another significant factor is the “second wind” – the bane of the existence of someone with ADHD whether they take medicine or not. It’s important for people to recognize when they’re sleepy (when their stimulant wears off at the end of the day) and go to bed before they push through the sleepiness and get a second wind.

   Thank you for this article. Sleep is extremely important for someone with ADHD and they need to realize they can do something about it instead of saying, “I’ve just always been a bad sleeper.”

7. Thank you for this article. I have moderate to severe ADHD Combination (Hyperactive/Inattentive). I am a 52 year old woman. I have always been a night owl and struggle to get to bed at a reasonable hour. I have always grinded my teeth at night and dreamt like a crazy person. Still to this day, my dreams are wild—I dream in color or black and white with specific things only a little color. I have soundtracks, I speaks some Spanish passably, but I dream fluently in Spanish, I have some really trippy dreams about weird worlds where dimension and proportions are not right spatially. My dreams have complex story lines that weave together completely disjointed worlds and narratives. It’s exhausting. You are supposed to secrete a chemical in your brain that blocks your dreams. I don’t think I have any of that chemical. I remember every dream. It’s exhausting. However, in from 1990-2002 I was a wildland firefighter and a hotshot for 4 of those years. Hotshots they estimate burn 10,000 -12,000 calories a day when actively fighting a fire and cutting handline. I was able to sleep on command because it was almost life or death, especially when we would not sleep for days or only get 3-4 hours of sleep for weeks on end. If we had to wait for a helicopter to pick us up or a dozer to build a safety zone on some other delay, I could sit down and sleep in about 2 minutes. Plus, working that hard, I was out the minute my head hit the pillow. So, going to sleep it not a problem for me. But waking up after feeling like I was running through a trippy world all night is exhausting.
   But thanks for posting about the Benadryl thing. I am part of the 10% that it majorly screws with and have had doctors look at me crazy when I tell them I can’t take it. I was pregnant and got a bad head cold and my Obstetrician told me to take Benadryl. It was the first time I took it in 1992. I could not wake up for 2 days—no joke. I was drugged out of my mind. I was so mad, because I thought: If this stuff drugs me that bad, what’s it doing to my baby? I also have huge issues with the cocktail of anesthesia they give most people for surgery. It makes me sick to my stomach and will take me many hours to days longer to wake up than most people–which pisses post-op nurses off. I now warn people. If you have a sensitivity to Benadryl, you may have a problem with anesthesia too, if you ever have to use it so, FYI. Thanks for including that in this story, I no longer will feel like I am weird when a doctor tells me to take Benadryl and then shames me when I say I can’t.

8. Sunrise/set lamps are not that expensive any more. Cheapest I saw was $25. I purchased the Casper Glow Light for $140 CAD and find it easy to use. TBD on whether it helps me get to sleep and wake up more alert. (37yo F)

9. I feel like an anomaly. I do have the boredom induced sleepiness which makes me crazy because there are times I really want to get something done but feel like crashing. I plan to add a workout to help with energy because drinking caffeine just makes me sleepy.
   At night I will sometimes play a game on my phone to fall asleep, which is the opposite of what “experts” recommend. (I do have a filter on my phone for at night) I usually fall asleep before even finishing one level. Then I will sleep for 3 hours, get up to use the bathroom, then sleep another 3 hours.
   I learned from Mel Robbins that our sleep patterns are 90 minutes long and I noticed if I wake up 30 minutes before my alarm that I should just get up because falling back to sleep is just going to disrupt the REM cycle and I will be lagging for hours. So even though I average only 6 hours a night, I’m doing ok and I usually wake up on my own before my alarm goes off.

10. Slept a lot yesterday. Slept a lot today. Woke up and decided to search for information about sleep and ADD. Have known about my ADD for years and am on medication for it. What’s working for me now is having a night job instead of a day job. I work on a printing press. I sometimes yawn a lot while I’m there, but that’s about it. Been there almost three years. I’ve learned a lot, taken on more responsibility and gotten raises. But I’m young and single, which is much more common than it used to be, yet I still feel a kind of self-imposed(?) stigma.

11. Wow, this article seem like a biography of mine.
    Thank you for sharing 🙂 Now I know that’s not completely my fault not to get asleep at night!

12. It’s the sleep of the dead bit I’m most interested in, it’s what I was looking for on here and must admit I’m guilty of the unintentional skipping several bits for disinterest so may have missed it.

    I quite often struggle to fall asleep but find guided meditation useful (must be guided to remind me what I’m meant to be doing) and once my mind slows enough I drift off, rarely getting to the end of a good meditation. However, often when I do asleep, nothing, literally NOTHING will wake me. I even slept through a lightening strike hitting the house as a baby which, according to my mom, sounded like a bomb going off in the house. More recently I fell so asleep in my tiny little campervan (literally slightly smaller than a double bed and which wobbles madly at the slightest touch) that I didn’t even notice my boyfriend letting himself in, getting changed for bed and lying down next to me. He literally would have been all but treading on my to do it and the van would’ve been rocking a lot. Me, not a clue – thank God it was my boyfriend!

    So does anyone know what this actually is, how common it is, causes etc.? Links to articles specifically about this ‘sleep of the dead’ would be appreciated, thanks.

13. I’ve always been tired. My Mum would obsess that I was anaemic (which I was once when I was about 14), but I’ve often had trouble falling asleep. I’ve never thought about it much because I just thought it was me, same as most of my symptoms. I obsess about all sorts of things. If I’ve had a confrontation or a problem that day, or I think I’ve upset someone or I’ve had an embarrassing moment I will go over and over it in my head. Sometimes I just think horrible thoughts, as if my mind hates me. At times my brain switches on and I want to listen to music at midnight, so instead of going to sleep I’m listening to music till 3am completely awake and wanting to go out dancing.

    I also think I get very tired when I’ve had a busy day. I’ve just realised that my mind must go into overdrive throughout the day just trying to function like everyone else, which leaves me exhausted. Add some sleep issues into the mix, and we have a right party going on!

    1. Exactly like me.

14. Benedryl may be over the counter, but it isn’t necessarily a benign medication for anyone with comorbidities. It has anticholinergic properties, which have been implicated in dementia and, as the article rightly points out, can cause extremely unpleasant side effects in sensitive populations.

    Please don’t take Benedryl or its generic equivalent, diphendydramine, without consulting a psychiatrist. It’s not a safe sleep aid (or a safe antihistamine) for people with depression or bipolar disorder, for elderly people, for people taking contraindicated medications, for people with conditions like glaucoma or thyroid problems, for people taking too many other anticholinergic medications, and on and on.

    This article should have given more information and caveats before mentioning an OTC option that has so many strikes against it for so many patients.

    1. Thanks, Elemele, for strengthening my own caveats. Articles that are not thoroughly researched can do harm and cause suffering. OTC medications are particularly problematic, because of their apparently benign nature.

15. This article is both interesting and disturbing,
    As an adult with ADHD and RLS, which is co-morbid for many of us, chronic insomnia is a constant drain on energy and often a full-stop on a constructive life.
    However, please be aware that, if you have RLS, melatonin, anti-histamines and SSRIs are absolutely contra-indicated.
    As this co-morbidity is common, it would be best that the article add these caveats as serious issues in the treatment of insomnia.

16. I have always had the worst time waking in the morning and never understood why I could never really start to be productive until after 9pm.

    I’m wondering if anyone else experiences the same issue as I do.
    I can take medication that states it will make you drowsy, like gravol or Benadryl, but instead I seem to be more awake/hyper in some cases.

    There are some medications that can make me drowsy but it isn’t consistent. One day it will and then the next it won’t. I have even fallen asleep drinking coffee.

    This article touch on falling asleep while driving and I always found it odd when I was in university that I was more prone to get drowsy behind the wheel during the day then at night. At night it was more common that I would just drive home on auto pilot.

17. I’m surprised Strattera wasn’t mentioned. The first difference I noticed was my brain actually shut down when I went to bed. I was leery of stimulants and even though Strattera was said to be less effective, I think the fact that it’s 24/7 makes up for it, both because it doesn’t wear off at bed time so I can rest better, and because it’s a constant. Glad I tried it first because I might still be struggling with insomnia.

18. I’m very thankful for this article. I’ve been struggling for 20 years.
    Tried a few of these things, but I now have some ADHD specific ideas. The standard “sleep hygiene” process doesn’t work for me.
    Starting work at 8:30 was always a nightmare for me. Half the time I was 15-30 mins late and then working in a state of ‘jet-lag’ until lunchtime.

    I think I need one of the medical options to ‘knock me out’ at an appropriate time, but not make me lethargic all the time.
    My old psychiatrist gave me Endep to use, problem was it made me sleep for 16 hours a day in the end.

    My new psychiatrist that I just saw this week is going to a conference soon. Apparently there’s a new drug for ADHD and sleep.
    He’s going to talk to the expert about it before considering it for me.

    1. What did the psychiatrist recommend and did it work for you?

19. I would like my husband to read this article, as it really describes the difficulties he experiences. Unfortunately , he does not have the patience, (for want of a better word), to read what he would describe as a long article. I wondered if your articles could have summaries in short bullet points? He is very resistant to reading things that he is not very interested in, and this would include more or less anything other than specialist music magazines.

20. Oh man, I had an episode of intrusive sleep while I was being tested for ADHD, the psychologist was so pumped since he’d never seen it in-action.

21. I’be been on Xyrem for about 2 months and it’s been a miracle with my sleep and ADD issues.

    1. If you cant sleep Jacky soilan technique work greats, and it work for everyone. I was founded him on the facebook.