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Can someone please tell my ADHD to go to sleep?

A woman sitting in a chair and too overwhelmed to relax.

For many years, I’ve had a strained relationship with sleep. I love to sleep. I relish time spent under my weighted blanket with a relaxing sleep story playing to calm my often-racing thoughts. My bed is one of the few places where every cell of my body doesn’t feel just a tiny bit uncomfortable at all times.

Unfortunately, sleep doesn’t seem to love me. What might otherwise be a good night’s sleep is often marred by restless legs, traumatic nightmares, breathing issues, sleep paralysis, and even a frightful condition called “periodic leg movement disorder,” which sometimes leaves me bruised (and my partner sleeping in the guest room).

Sleep is elusive when I need it most, but often attacks me when I’m least expecting — or wanting — it, overpowering me with ill-timed drowsiness. I’ve fallen asleep on buses, in classrooms, and (almost) behind the wheel on I-5 going 75 mph. There was a period of time when my unexpected sleepiness and inability to get decent rest at night made me wonder if I had narcolepsy.

But it was a sleep doctor north of Seattle who may have connected the dots for me. He said, “Just because you’re sleeping doesn’t mean your ADHD is.”

🤯 🤯 🤯

Getting into bed with ADHD

I don’t know why I assumed that my ADHD would somehow decide to cool it and give me a break at night. After a lifetime of dealing with undesired movement in my waking hours — not to mention the years when I worked unusual hours in bars and restaurants and would hyperfocus on marrying the ketchups until 3 a.m. — you’d think I might have put this connection together.

“I don’t know why I assumed that my ADHD would somehow decide to cool it and give me a break at night.”

But then again, why would I? No one else ever had. Not a single doctor had ever even linked ADHD with sleep disorders. Which is weird, considering the research into this connection is actually pretty ample.

Most individuals with ADHD experience some kind of sleep disorder. And by “most,” I really do mean most — the conventional wisdom on this issue is that 75 percent of people living with ADHD experience sleep issues, including restless legs syndrome, excessive daytime sleepiness, and sleep apnea.

This may be due to a variety of factors, both internal and external. Our sleep issues may have to do with the way our brains are wired. But they might also be compounded by outside factors, like meds we have to take during the day to get a handle on ADHD. And our tendency to self-medicate with drugs and alcohol that can damage sleep patterns.

But does ADHD cause poor sleep — or does poor sleep cause ADHD? Or maybe they feed each other? There’s no clear answer to this chicken/egg question, but researchers are working to get to the bottom of it.

In 2017, a group of researchers presented a novel proposal about the connection between ADHD and sleep. “Until now these have been thought to be separate issues,” they stated. “Now…scientists are proposing a new theory which says that much of ADHD may in fact be a problem associated with lack of regular circadian sleep.”

Other researchers have raised similar questions. Could it be that many people with ADHD are actually people with a sleep disorder who show ADHD symptoms during their waking hours because they don’t get enough rest and replenishment during their sleeping ones?

Either way, if you’ve found yourself in a complicated relationship with sleep, it’s more likely to be linked to your ADHD than you may expect.

What to do about it?

Honestly, I wish I had an easy answer. But just as learning to live with ADHD in the daytime takes a lot of practice (and trial and error), figuring out a way to sleep with these mitigating factors requires a lot of patience.

Sleep doctors and psychiatrists alike may be able to help eliminate some of the easier-to-treat parts of poor sleep. For example, my psychiatrist referred me to several studies about the impact of low iron on restless legs, and I found that adding a supplement has been helpful. (It’s inexpensive and easy, but proceed carefully. Too much iron can be dangerous and also create some uncomfortable side effects.)

Tracking your sleep can also help. Apps like Pillow may help offer some insight into when your brain is working against you. Timing your medication so that its stimulating effects are wearing off before bedtime can also be useful. And of course, good sleep hygiene — e.g., putting the phone away before bed—can help your circadian rhythms.

I’ve been to multiple sleep doctors and tried everything from a CPAP machine to a mouthguard to magnetic nose-openers to aromatherapy to white noise and more — all of which, it’s extremely important to point out, take some combination of time, money, health insurance, and privilege. These are areas of exploration that were simply not available to me even 10 years ago.

Regardless of what ends up working (or not working) for you, the aspect of all of this that I’ve found most helpful is just making the connection at all. Once I started thinking as my ADHD as something intimately linked to my sleep patterns and overall health, I was able to narrow down the issues, read up on the research, and talk more clearly with my doctors.

It’s unfortunate that it took this long — or that it required this degree of investment. I just hope that writing this will help a few more people find their own solutions.

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