A new study from Baird and colleagues from the National University of Ireland recently published results of a study examining a series of variables related to sleep and circadian rhythms in a group of subjects with adult ADHD and controls.
The sleep patterns of adults with ADHD are less well studied than those in children. However, research evidence exists for disruption of sleep and circadian rhythms in adult ADHD including: evening preference (being a night owl), delayed sleep onset, reduced efficiency of sleep (% of time in slow wave sleep) and reduced time spent in rapid eye movement (REM) sleep.
The title of their study, Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels, suggests, these variables can be divided into three domains:
- Behavioural: sleep onset latency, physical activity during the night, sleep efficiency and morning versus evening preference
- Endocrine: absolute melatonin and cortisol levels and rhythmicity of these levels
- Molecular: rhythmic expression of the clock genes BMAL1 and PER2
The February/March 2004 issue of ADDitude magazine had an article Stating: Sleep disturbances have been incorrectly attributed to the stimulant-class medications that are often the first to be used to treat ADHD..
1. Initiation Insomnia
About three-fourths of all adults with ADHD report inability to “shut off my mind so I can fall asleep at night.” Many describe themselves as “night owls” who get a burst of energy when the sun goes down. Others report that they feel tired throughout the day, but as soon as the head hits the pillow, the mind clicks on. Their thoughts jump or bounce from one worry to another.
2. Restless Sleep
When individuals with ADHD finally fall asleep, their sleep is restless. They toss and turn. They awaken at any noise in the house. They are so fitful that bed partners often choose to sleep in another bed. They often awake to find the bed torn apart and covers kicked onto the floor. Sleep is not refreshing and they awaken as tired as when they went to bed.
3. Difficulty Waking
More than 80 percent of adults with ADHD in my practice report multiple awakenings until about 4 a.m. Then they fall into “the sleep of the dead,” from which they have extreme difficulty rousing themselves.
They sleep through two or three alarms, as well as the attempts of family members to get them out of bed. ADHD sleepers are commonly irritable, even combative, when roused before they are ready. Many of them say they are not fully alert until noon.
4. Intrusive Sleep
Paul Wender, M.D., a 30-year veteran ADHD researcher, relates ADHD to interest-based performance. As long as persons with ADHD were interested in or challenged by what they were doing, they did not demonstrate symptoms of the disorder. (This phenomenon is called hyperfocus by some, and is often considered to be an ADHD pattern.) If, on the other hand, an individual with ADHD loses interest in an activity, his nervous system disengages, in search of something more interesting. Sometimes this disengagement is so abrupt as to induce sudden extreme drowsiness, even to the point of falling asleep.
To us ADDers it’s no surprise. Most of us know that sleep can be elusive. I find it interesting that it’s now documented. Now what can we do about it? On Jeffsaddmind.com there is an interesting post Help Getting to Sleep and Staying Asleep that I comment something many of you may find strange:
“I had a conversation with my sons pediatrician about sleep issues.
It started out as a discussion about how late he could take his meds as he tends to stay awake late doing homework. and he was off his meds making it that much harder to focus on the work causing a vicious cycle. She told me something interesting: (paraphrase) some people need to be on the medicine at night because it allows there minds to focus on sleep rather that all of those thoughts racing through their head keeping them awake. ”
I’d be very interested in your experience and suggestions with dealing with your sleep issues.
Do you use medication? What kind?
Exercise? Sound? Light? Aroma?
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