The struggle is real in people suffering from ADHD. Hitting snooze repeatedly, setting quite a few alarms, dragging yourself out of the bed and feeling tired in the first half of the day. Some need a loved one to help them starting the day, be it a parent a friend or a partner. Why is it difficult for those diagnosed with ADHD? Is it a lack of motivation or willpower? There is a complex link between ADHD and the sleep-wake cycle. More than half of those diagnosed with ADHD may actually suffer from an undiagnosed sleep disorder.

‍

Sleep disorders and the ADHD clock:

  • Delayed Sleep Phase: The circadian rhythm disorder is the challenge in falling asleep and waking up at what is considered conventional times. This group of people with ADHD and circadian rhythm problems have a natural tendency to be "night owls," feeling more alert and productive in the evenings. However, this comes at the cost of waking up later in the day or experiencing a sluggish cognitive tempo until after launch time.
  • Insomnia: Racing thoughts, difficulty to relax, and hyperactive impulses can interfere with the sleep initiation phase. Moving from one TV series episode to another, watching videos or playing video games the time runs faster than expected. This often results in staying asleep throughout the night and finding it almost impossible to function the next day. And the cycle repeats endlessly, and nobody is able to understand why.
  • Restless Sleep: Frequent awakenings disrupted sleep cycles leads to daytime fatigue even after spending enough time in bed. Sometimes this experience can be cause by another sleep problem, called restless legs sleep disorder.
    • A picture showing the phone alarm snooze alongside an analog alarm clock.

    How many hours of sleep do people with ADHD need?

    There is no specific number of sleep hours needed. Each individual is different, and the amount of sleep can vary slightly from one person to another. Just like everyone else, people with ADHD generally require 7-9 hours of sleep per night for optimal health and daily functioning. However, achieving this range of sleep duration can be a challenge for many with ADHD due to the sleep problems they experience. This becomes even more problematic if the ADHD diagnosis is linked with a sleep disorder.

    A picture showing a woman sleeping in the clouds.

    Do ADHD brains need more sleep?

    As of 2024 there is no specific research study to provide a definitive answer for people suffering with ADHD. For the general population, we have the following recommendations: teenagers (14-17 years) the optimal sleep duration sits between 8-10 hours. In the general adult population, young adults (18–25 years) and adults (26–64 years), research suggest that the recommended sleep range is somewhere between 7-9 hours. Very interesting with age, for adults older than 65 years there is a slight decrease in sleep recommendations 7-8 hours.

    While there isn't a definitive answer that people with ADHD need more sleep, research suggests they may benefit from getting closer to the upper end of the recommended sleep range (7-9 hours).

    A woman peacefully sleeping on a cozy sofa somewhere in the Mediterranean region.

    Here is why sleep is important:

    Exacerbated Symptoms with less sleep: Studies show sleep deprivation can worsen the inattentive ADHD symptoms. Hyperactivity, and impulsivity seems to be more pronounced when someone is not able to get the right amount of sleep. Some studies suggest that the sleep deprivation can impact the emotional facial expressions in young adults with ADHD and without. Getting enough sleep can potentially help these symptoms to be more under control.

    Brain Repair: Sleep is important for the overall brain health, emotional regulation and memory consolidation. With emotional disturbances such as the rejection sensitive dysphoria (RSD), people with ADHD may need more sleep. Optimal sleep duration and quality is crucial for healing, as it allows our body to regenerate cells and restore the energy levels. Quality of sleep positively impacts our physical health, which is linked with mental health, including in ADHD.

    Stress management: Sleep allows our bodies and minds to recharge the batteries, but also to some extent reset. Sleep helps with improving our ability to handle stress more efficient. Almost half of the people diagnosed with ADHD in the adult life, may as well suffer with a co-morbid condition. An optimal sleep duration and quality, allows regulating neurotransmitters like serotonin and dopamine, which have a role in mood regulation, focus, and motivation.

    Chronic sleep problems can exacerbate stress and worsen existing mental health conditions.

    A woman sitting in the cloud holding a luminous spheric cloud in the hands.

    What is the ADHD burnout cycle?

    The ADHD burnout cycle is a well-recognized pattern of stress and exhaustion specifically experienced by people with ADHD. The cycle is a result due to the combination of the constant struggle to manage ADHD symptoms alongside daily life's challenges. There are different interpretations and descriptions of this pattern, one of the most common:

    ‍

    The First Push

    The cycle starts with enthusiasm and commitment to a task that requires sustained focus and effort. Maybe this time is going to be different.

    ‍
    The struggle and frustration

    The ongoing inattentive, and impulsive symptoms combined with difficult in organization starts to make completing the task more challenging. This is the very well-known feeling of here we go again.


    The stress and overwhelm

    The stress takes over the person's life, trying to overcompensate by staying late at the office or working unpaid hours during the weekend. The feeling of being overwhelmed further impairs focus and motivation. Getting distracted with other more stimulating and enjoyable activities, only deepens the current problem. The familiar feeling of not being good enough starts once again.

    ‍
    The avoidance

    To escape the negative experience the curious brain resorts unconsciously to tactics such as procrastination. Although the problems are still there, somehow all of the tasks are erased from the memory which may lead to a temporary pseudo comfort. Although nobody can understand their behaviour, the person slowly retracts in their own shell as a form of self-preservation.

    ‍
    The exhaustion

    The cycle continues with a sense of defeat. Feelings of hopelessness become familiar in conjunction with the constant perceived lack of progress. Here the ADHD sufferer becomes their number one critique and burnout occurs. The ADHD burnout cycle repeats and from here the person may briefly go back towards any of the previous stages. Despite trying their very best, without support the result is usually the same.

    Burned matches suggesting burnout related with sleep and ADHD..

    What is ADHD morning anger?

    ADHD morning anger is a popular term in the neurodiverse community; however, this is not an official diagnosis. This can be explained as a phenomenon experienced by many people with attention deficit hyperactivity disorder (ADHD). It's characterised by feeling irritable, or even experience significant anger upon waking up.

    Some of the potential causes of ADHD morning anger:

  • Poor Sleep Quality: As discussed earlier, sleep problems are very common in ADHD. Insufficient or fragmented sleep leads to fatigue, and difficulty regulating emotions upon waking.
  • Emotional Dysregulation: ADHD often involves difficulty managing emotions. The sudden change from a relaxed sleep state to waking up can be overwhelming. and experience emotional outbursts.
  • Executive Challenges: Planning, and time management difficulties associated with ADHD make mornings more chaotic. The frustration of getting ready on time and facing the day can trigger unwanted feelings.
  • Heightened sensitivity: to noise, light, or other stimuli can be more pronounced in the morning given the secretion of important hormones such as cortisol.

    • ‍
    Please note that morning anger isn't exclusive to ADHD. However, the underlying factors mentioned above can make it more frequent for people with this condition.

    A cozy morning breakfast with coffee.

    ADHD and Top 5 Sleep Tips

    1. Sleep hygiene is the first go to place when experiencing difficulties in falling and staying asleep.

    2. Master routines and consistency: going to bed and waking up at the same time each day, including during the weekend. Aim to improve upon each cycle.

    3. Optimise your sleep environment: dark bedroom, quiet, cool, comfortable mattress and pillows. Some people may prefer having a background noise such as brown or white noise.

    4. Relaxing routine before sleep: Relax for 60 minutes before bed with calming activities like taking a warm bath or practicing mindfulness exercises.

    ‍
    5. Optimising Screen Time: Most of the studies were directed towards the link between blue light and melatonin secretion. However, we do not have a full understanding how a notification emitting device such as a mobile phone, or a tablet can interfere with the ADHD brain. Practice self-compassion and return back to basics or set a technology-free time before bed.

    ‍
    Additional healthy tips: Regular exercise during the day and optimal timing by avoid strenuous workouts close to bedtime. A balanced diet, and limited caffeine and alcohol intake all contribute to better sleep quality. Exposure to bright light in the morning can help regulate circadian rhythm naturally.

    A nice picture with witting on a photo saying self care isn't selfish
    Source Pexels.com

    Addressing Underlying Issues:

    Sleep Disorders, if you suspect you may suffer from an undiagnosed sleep disorder, consult your health care professional or an ADHD specialist for diagnosis and treatment. Medication optimisation: Discuss with your healthcare provider if adjusting the dosage or timing of your ADHD medication can improve sleep. Personalised therapy can help dealing with sleep problems, start developing strategies for managing ADHD symptoms and addressing any underlying issues.
    ‍

    Top tip: Change takes time.

    A time capsule with sand, suggesting that change in ADHD and sleep takes time.

    Conclusion

    Remember, a good night's sleep isn't just about willpower. By addressing the underlying issues and implementing healthy routines, you can break the cycle of sleep deprivation and be in control. Patience and consistency are a must since often results are not taking place overnight. Each individual is unique with their own circumstances and way of life.  Like food and oxygen, sleep is a vital component for a healthy life, start prioritising your sleep! With dedication and the right support system, you can achieve quality sleep and experience a brighter, more productive day.  

    A lovely picture of a woman surrounded by sunflower suggesting success and happiness.

    ‍

    ADHD Specialist Support: assessment and accurate diagnosis

    Wondering if you might have adult ADHD? Our guide walks you through step-by-step in the journey of Adult ADHD Diagnosis: Private Adult ADHD Assessment | London and U.K (adhdspecialist.com)

    If you live in London or the UK and looking for private psychiatrist specialist in ADHD support:

    Read more about the ADHD Specialist's approach in diagnosing and treating ADHD and sleep problems: Adult ADHD & Sleep Problems: Causes, Symptoms & Treatment Options (adhdspecialist.com)

    ‍

    References and resources

    Insomnia test- NHS (www.nhs.uk)

    MONDAY (ouh.nhs.uk) NHS Sleep Diary

    Sleep disorders in patients with ADHD: impact and management challenges - PMC (nih.gov)

    The effects of sleep deprivation on the processing of emotional facial expressions in young adults with and without ADHD | Scientific Reports (nature.com)

    What Is the Link Between Attention-Deficit/Hyperactivity Disorder and Sleep Disturbance? A Multimodal Examination of Longitudinal Relationships and Brain Structure Using Large-Scale Population-Based Cohorts - PMC (nih.gov)

    Stress and work-related mental illness among working adults with ADHD: a qualitative study - PMC (nih.gov)

    The association between insomnia and bedroom habits and bedroom characteristics: an exploratory cross-sectional study of a representative sample of adults - PubMed (nih.gov)

    News: A Warm Bedtime Bath Can Help You Cool... (NPR News) - Behind the headlines - NLM (nih.gov)

    Benefits of a bedtime routine in young children: Sleep, development, and beyond - PMC (nih.gov)

    The effect of screen use on sleep quality among adolescents in Riyadh, Saudi Arabia - PMC (nih.gov)

    Adult ADHD & Sleep Problems: Causes, Symptoms & Treatment Options (adhdspecialist.com)

    Why People with ADHD Struggle to Sleep? | ADHD Specialist (adhdspecialist.com)

    Fall asleep faster and sleep better - Every Mind Matters - NHS (www.nhs.uk)

    ‍

    Disclaimer: The information is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, and information, contained in this article is for general information purposes only and does not replace a consultation with your own doctor/health professional. Information about mental health topics and treatments can change rapidly and we cannot guarantee the content's currentness. For the most up-to-date information, please consult your doctor or qualified healthcare professional. For more information, you can check the Royal College of Psychiatrists (rcpsych.ac.uk) The NHS has available a free guide about How to fall asleep faster and sleep better.

    ‍