Up to 75% of people diagnosed with ADHD struggle with sleep issues, and that’s because ADHD can delay our body clocks. Here’s how to deal with that.
My entire life, I’ve had a convoluted relationship with sleep. I’m forever struggling to feel tired at acceptable hours, and I’ve always identified more as a night owl than an early bird.
When I was diagnosed with ADHD – a neurodevelopmental condition that’s typically associated with trouble paying attention, controlling impulsive behaviours and more – at 23, I learned that there was a reason for my terrible relationship with sleep. I was struggling with delayed sleep phase syndrome (DSPS).
It’s little surprise: studies demonstrate that 50% of children with ADHD have difficulty falling asleep almost every night. This statistic worsens with age: by age 30, upwards of 70% of adults spend more than an hour attempting sleep. Dr Rachel Taylor defines DSPS as “a disorder in which a person’s sleep is delayed by two hours or more beyond what is considered an acceptable or conventional bedtime. This causes difficulty in being able to wake up at the desired time, and it is considered a disruption to normal circadian rhythms.”
Why ADHD makes sleep and energy so much harder to predict
Dr Hana Patel, a GP with a special interest in sleep and mental health, explains that DSPS is the most common sleep disorder among people with ADHD, impacting up to 75% of those diagnosed.
“The reason for this is that people with ADHD have a delayed body clock – or circadian rhythm – compared to people who don’t have ADHD,” she tells Stylist. “This can lead to a delay in the hormone melatonin being produced, affecting the timing of when their body clock tells them to sleep.”
In fact, DSPS manifests differently depending on the type of ADHD present in an individual. As Dr Taylor outlines: “Those who have inattentive symptoms are more likely to have a later bedtime, and hyperactive-impulsives tend to suffer from insomnia.”
And it isn’t just people with ADHD that can struggle with DSPS. Dr Taylor explains that it can affect anyone experiencing any form of disruption to their circadian rhythm. This can be facilitated by travelling, shift work, pregnancy, mental health and even some types of medication.
Many people with ADHD live on a different body clock: we are natural night owls, and that isn’t ideal in a society that’s based around being an early riser for a typical 9-5 work pattern. Before I was diagnosed, I thought I was lazy because I was – and still am – physically incapable of rising before 8am. Societal stigma is detrimental and demonising to late risers and does nothing but enforce harmful workplace standards, normalising tiredness and decreasing productivity.
London-based Erica Vonderwall, 38, was diagnosed with ADHD at the age of 36. She’s always had a terrible relationship with sleep but failed to realise the relentless tiredness her undiagnosed ADHD was enabling. “I would go days without sleep in my 20s. I worked in hospitality, so I worked until late, went out with my friends, got into bed in the early hours and crashed until I’d get back up and do it all again,” she explains. “No matter how hard I tried, I was never able to ‘just go to sleep’. I was given sleeping pills and told to try yoga.”
Using alcohol to self-medicate, Vonderwall’s mental health quickly hit an all-time low. On receiving medical intervention, she was informed that being prescribed ADHD medication might affect her sleep, at which point she laughed. Her GP soon introduced her to the concept of DSPS.
“I cried. An ADHD diagnosis throws up so many emotions, and the news that my life-long struggle with sleep was because of ADHD was just overwhelming.” Before her diagnosis, she too felt shamed for not fitting into orthodox sleeping patterns. “It used to be a joke around the office not to talk to me before my second coffee,” she smiles.
She also struggles to share a bed with someone due to taking longer than others to fall asleep. “It’s made having intimate relationships very hard, and while I’m single by choice, not sharing a bed is one of the reasons I plan to stay that way.”
Similarly, Samantha Hiew is the director of ADHD Girls and works to empower women and girls with the condition through advocacy and education. She too has struggled with unconventional sleep patterns and, as a mother, has felt shamed. “In the evening, what tends to happen is I fall asleep at 9pm. If I stay up past this then my brain naturally wakes up at 11pm, when I’m meant to be winding down for bed,” she explains, typically tackling a host of tasks late at night.
“The shaming is because I’m normally not able to help with parenting and getting my kids ready for school in the morning as I’m still waking up. I’m now overcompensating by waking up early and doing the school run.”
How to deal with delayed sleep phase syndrome
Having a burnt-out and overtired brain is no good for anyone, least of all someone with ADHD. A lack of sleep can impact mental and physical wellbeing, worsening metabolism and triggering artificial hunger, and it can even impact relationships with family and friends.
Reduce alcohol and caffeine consumption
So, if you’re struggling with DSPS, is it possible to tackle it? “Limit electronics and introduce a bedtime routine. Don’t have alcohol or any stimulants in the afternoon, and limit fluids before bedtime,” Dr Patel recommends.
Keep a sleep diary
Keeping a sleep diary might prove helpful for tracking progress. White noise and brain games – including counting sheep – can also be useful.
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Get outside within 15 minutes of waking up
Dr Taylor recommends accessing bright light through the visual cortex within 15 minutes of waking up, generating vital boosts of serotonin and producing melatonin – the natural hormone produced by the pineal gland that helps control the sleep cycle – in the evening.
Choose serotonin-rich foods
Food can also be used to encourage serotonin production: turkey, seeds, soy, oily fish and nuts have a track record of fostering this. “We get a burst of energy around 10pm, which is when most people think they are getting a second wind. That energy should be used to detox the body and brain while we sleep,” Dr Taylor warns.
Acknowledge your natural sleep pattern
Evidently, there are coping mechanisms for dealing with a sleep cycle that is naturally a little disrupted, but it’s important to remember that there’s no shame in dealing with DSPS. Healthy, adequate sleep takes priority over any social stigma: eight hours is eight hours, whether it ends at 6am or 9am. We aren’t all destined to be early birds.
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