Got ADHD? Chances are you’ve got insomnia symptoms, too. About 92 percent of the subjects in a recent study of adults with ADHD reported going to bed late because they were “not tired” or “too keyed up to sleep.”
Results of this study, from University of Alabama at Birmingham, show that the sleep problems of adults with ADHD are due to delayed (and possibly less stable) circadian rhythms. (Circadian rhythms are controlled by the body clock.) And, say UAB researchers, delays in sleep timing—and daytime sleepiness—correlate with more severe hyperactive-impulsive and inattentive ADHD symptoms. If you’ve got ADHD-related insomnia, treatments aimed at advancing circadian phase may help.
The Larger Picture
The new findings are in line with the results of other work. Investigators have found, for instance, that ADHD is associated with differences in type or expression of these circadian genes: CLOCK, BMAL1, and PER2.
The body’s production of sleep- and wake-friendly hormones is correspondingly delayed. Investigators in The Netherlands reported in a 2010 study that secretion of melatonin—which helps with sleep at night—began an average of 83 minutes later in adult subjects with ADHD than in adults without. Production of cortisol, which helps with waking up in the morning, is also delayed in people with ADHD.
Across the board, ADHD subjects tend to fall asleep later and wake up later than subjects without ADHD. The medical diagnosis for this delay in falling asleep, when uncomplicated by ADHD, is Delayed Sleep Phase Disorder. Treatments that work for people with DSPD may work for you if you’ve got ADHD.
Better Sleep, Less Sleepiness
- Bright Light Therapy: A two-hour exposure to bright light (sunlight, or light from a light box) immediately upon waking up every morning is the most effective way to shift sleep to an earlier hour. But this may not jibe with your morning routine. In the winter you wake up to darkness, and continuous use of a light box may not be an option if you have to care for children or get ready for work. Do the best you can by turning up lights in your home full force, and spend as much time as possible by a light box in the first few hours of the day.
- Melatonin Supplements: Over-the-counter melatonin supplements may also help shift your sleep forward when used every day. But melatonin is not a sleeping pill. It’s effective only when taken well before your internal melatonin secretion begins. For best results, take a tablet 5 to 7 hours before your normal bedtime (rather than right before bedtime, as advised on the label).
- Rozerem: Ask your doctor about Rozerem (or ramelteon) if you’re interested in going the prescription drug route. Rozerem, approved by the FDA in 2005 for people with trouble falling asleep, purportedly behaves like a super-melatonin. Unlike most sleeping pills on the market today, it’s not known to have many side effects. Take it half an hour before you go to bed.
Shifting circadian rhythms forward may improve your sleep, cut down on daytime sleepiness, and—possibly—help control your ADHD symptoms.
If you’ve got ADHD, how often do you find yourself too keyed up to sleep?