Does ADD make you tired? Sleep disturbances caused by ADHD have been overlooked for a number of reasons, including the late age of onset. But recent studies confirm that ADD symptoms do not go away at night. Here, understand the ADHD and sleep link and common manifestations.

Trouble Falling Asleep due to ADHD

Adults with ADHD rarely fall asleep easily, sleep soundly through the night, and then wake up feeling refreshed. More often, ADHD’s mental and physical restlessness disturbs a person’s sleep patterns — and the ensuing exhaustion hurts overall health and treatment. This is widely accepted as true. But, as with most of our knowledge about ADHD in adults, we’re only beginning to understand the stronger link between ADHD and sleep, which creates difficulties:

• Falling asleep
• Staying asleep
• Waking up

In early attempts to define the syndrome, sleep disturbances were briefly considered a criterion for ADHD, but were dropped from the symptoms list because evidence of them was thought to be too nonspecific. As research has expanded to include adults with ADHD, the causes and effects of sleeping disturbances have become clearer.

For now, sleeping problems tend either to be overlooked or to be viewed as coexisting problems with an unclear relationship to ADHD itself and to the mental fatigue so commonly reported by individuals with ADHD. Sleep disturbances have been incorrectly attributed to the stimulant-class medications that are often the first to be used to treat ADHD.

Common ADHD Sleep Problems

The four most common sleep disturbances associated with ADHD are:

Difficulty Falling Asleep with ADHD

About three-fourths of all adults with ADHD report the 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. Unfortunately, many of these adults describe their thoughts as “racing,” prompting a misdiagnosis of a mood disorder, when this is nothing more than the mental restlessness of ADHD.

Restless Sleep with ADHD

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.

Difficulty Waking Up with ADHD

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.

Intrusive Sleep with ADHD

As long as persons with ADHD are interested in or challenged by what they were doing, they don’t 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.

Marian Sigurdson, Ph.D., an expert on electroencephalography (EEG) findings in ADHD, reports that brain wave tracings at this time show a sudden intrusion of theta waves into the alpha and beta rhythms of alertness. We all have seen “theta wave intrusion,” in the student in the back of the classroom who suddenly crashes to the floor, having “fallen asleep.” 

This was probably someone with ADHD who was losing consciousness due to boredom rather than falling asleep. This syndrome is life-threatening if it occurs while driving, and it is often induced by long-distance driving on straight, monotonous roads. Often this condition is misdiagnosed as “EEG negative narcolepsy.” The extent of the incidence of intrusive “sleep” is not known, because it occurs only under certain conditions that are hard to reproduce in a laboratory.

Why People with ADHD Have Problems Sleeping

There are several theories about the causes of sleep disturbance in people with ADHD, with a telling range of viewpoints. Physicians base their responses to their patients’ complaints of sleep problems on how they interpret the cause of the disturbances.

The simplest explanation is that sleep disturbances are direct manifestations of ADHD itself. True hyperactivity is extremely rare in women of any age. Most women experience the mental and physical restlessness of ADHD only when they are trying to shut down the arousal state of day-to-day functioning in order to fall asleep. 

At least 75 percent of adults of both genders report that their minds restlessly move from one concern to another for several hours until they finally fall asleep. Even then, they toss and turn, awaken frequently, and sometimes barely sleep at all.

The fact that 80 percent of adults with ADHD eventually fall into “the sleep of the dead” has led researchers to look for explanations. No single theory explains the severe impairment of the ability to rouse oneself into wakefulness. Some patients with ADHD report that they sleep well when they go camping or are out of doors for extended periods of time.

Neurofeedback Training at NHA

Here at Neurohealth Associates, we specialize in Neurofeedback training. Neurofeedback may be helpful for training your mind, especially if you are unsure about putting yourself or your child on medication. This easy, noninvasive training can painlessly improve your mental health condition and outlook on life. Schedule a consultation with NeuroHealth Associates today and find out how we can help you.

Original article published by ADDitude Mag.