When I asked Australian writer Matthew Bush to contribute a guest column on his experiences with sleep and ADHD (below), I expected a well-written and engaging piece. What I didn’t expect was a happy ending, too.
ADHD’s potential challenges to sleep include the behavioral (putting off sleep because anything is more interesting than lying in the dark waiting for nothing to happen) and the physiological (Restless Legs Syndrome, Sleep Apnea, dysregulated Circadian Rhythm, etc.). In my upcoming course, Solving Your Adult ADHD Puzzle: Physical Strategies, I explain all the common ADHD-related sleep issues—and what to do about them.
Meanwhile, here is my post on ADHD and Sleep: Puzzling the Pieces. Look to my 2010 article in CHADD’s Attention Magazine: ADHD Never Sleeps, But You Can
Now, let’s get to Matt’s story! This is an updated post from 2011. You can see how much he was on the forefront in piecing together his ADHD sleep puzzle.
By Matthew Bush
I was the 11 year old ninja master.
I had to be awake for school in six hours.
The creaking kitchen floorboards raised the hair on the back of my neck. The house was dark. I could hear snoring. Good. Dad was a heavy sleeper and that meant mum had her earplugs in. Still, there was risk.
The adrenaline pacified me. I inhaled slowly, my pulse pounded through the swell of blood in my ears. I opened the cabinet door slowly and clicked the torch on. I was on a mission.
If I was successful, I’d take my bounty back to my room and quietly self-medicate with caffeine and carbohydrates. Then I’d curl up on my beanbag and read.
My official bedtime was 8:30. I was allowed to read for half an hour, then my dad would tell me to go to sleep. I rarely did. Eventually, my lamp and torch batteries got confiscated. That just added another objective to my mission dossier.
Mum and dad got good at hiding things. During the day, I was clumsy, impulsive, and unfocused. While I was out playing cat burglar, I was the opposite. In retrospect, it seems obvious that I was just adapting to my untreated ADHD. At the time, it was a total mystery to everyone.
No One Believed I Couldn’t Sleep (At Night)
No one was convinced when I said I couldn’t sleep at night. I just was seen as lazy and unmotivated. Occasionally I’d do extremely well at school, but generally I didn’t do anything at all. To make it all the more confusing, I couldn’t sleep at night, but I seemed to have no problems sleeping through the morning.
As I got older, I tried to reclaim my self-confidence by masking my inabilities as outright rebellion. It didn’t really help my case. I’d been diagnosed with ADHD when I was young, but my parents weren’t convinced. Other paediatricians and psychologists suggested that I was simply oppositional and angry. I responded well to therapy, but nothing really changed. Insomnia was on the back-burner. Everyone wanted to know why I was so lazy.
Several Diagnoses Later, Sleeping Pills
Eventually I was diagnosed with an autism spectrum disorder. It was either that or a type of conduct disorder, apparently. After the autism spectrum diagnosis failed to stick, I was diagnosed with depression by my exasperated GP and given Zoloft. But I still couldn’t sleep. For me, that was the most important thing. I didn’t care about grades, I just wanted some rest.
Fast-forward a few months, and I was the only 15 year old that I knew who was on sleeping pills. They didn’t work all the time, so I started taking them more often. I read online that Zoloft could cause insomnia, and it had seemed to have been making me a lot worse. So I stopped taking them. My sleeping habits got a little better, but I was still largely dependent on sleeping pills.
Finally I was diagnosed again with ADHD. My psychiatrist gave a thorough assessment, that spanned several sessions over a month or so. But I remember him remarking that he picked up on it within a few minutes. That was the first step in the right direction.
So slowly I was introduced to stimulant medications. By this point, I’d been expelled from two schools and had picked up a job that I hated in retail. Once the medications became more effective, and I started to get more confidence, I decided to go back to school. The only problem I seemed to be having was still with sleep. I didn’t quit the sales job, I was simply fired because I slept in once too often.
Finally, a Stimulant
Being able to excel at school, and attending a university with an adult education program meant that I could get away with a lot more. My teachers didn’t mind when a straight-A student would show up half an hour late, and then not wake up properly until after the lunch break.
I was sleeping less, but I was doing better. My weekend job was as a nightclub DJ. I felt suited to the work because I was always more awake than everyone else in the club, whether or not I had indulged chemically. I was depressed too, but hey, wasn’t everyone?
During the day, I’d yawn my way through school, do all my studying at night, and on weekends, enjoy my job. My new GP didn’t like the idea of prescribing sleeping pills every other week, so I took to stockpiling them for test times.
I thought I was functioning. Getting things done for the first time in my life. Doing well at school. I had my own place, and I had a job that I really enjoyed. Then a relationship that I found myself in took a serious turn. My then-girlfriend and I decided to move in together.
Greater Functioning, Little Understanding
Her bipolar disorder, and my ADHD, combined with our mutual ignorance resulted in me paying our first month’s rent on my own, while desperately looking for a housemate. In the first three weeks of living with someone, I’d learned something. I didn’t sleep like normal people did. Being ignorant of circadian rhythm disorders and how commonly they occur with ADHD, I wrote it off as insomnia.
At first, I thought that maybe it was the stimulant medication that was keeping me awake. It wasn’t. My psychiatrist had monitored me very closely for the first year that I was taking it and prescribed me a rigorous schedule that I stuck to. There were no stimulants in my system by normal bedtime. I just assumed that perhaps my ADHD was keeping me awake.
A year went by. It was my first year of university. At first, it was really easy. Actually, most of it was really easy. I had trouble organizing my life around the work, and so I didn’t do so well. No problem, my tutors said, we’ll just help you work something out. High on their list of things I needed to work with was my inability to attend mourning lectures and tutorials. So we worked out a schedule whereby I could begin classes after lunch.
Then another relationship took a serious turn, and I moved into an apartment with the girl who I considered the love of my life (based, of course, on my twenty years of accumulated wisdom). I told her about my ADHD. But it didn’t prepare her for the experience of living with it. We had a lot of problems, both directly to do with my ADHD, and indirectly from the havoc that a lifetime of failure and anxiety had wrought upon my self-esteem.
So we did the normal couple thing. We fought like crazy, blamed each other, then blamed ourselves, and must have broken up at least once a fortnight. It wasn’t all bad. We went on holidays, we had a fantastic love life, and we would have done anything for one another. Though very much in love, we weren’t very good at managing it rationally.
My sleeping habits became a problem again. I couldn’t sleep, and I’d get bored. That’s when it took a more destructive turn. Some nights, I’d keep her awake with pointless, highly emotional arguments. I was in many ways the typical ADHD-partner-in-denial. But, being on medication, I assumed that I had no problems. It just goes to show that medication only goes so far.
Asking Deeper Questions
In the last few months of our relationship, I had begun to question why I acted out in the ways that I did. I realized that my depression was clinical. I tried to fix my sleeping pattern with various herbs and teas. Then I just resorted to ill-gotten prescription painkillers and sleeping pills. That actually made things worse.
Prior to the break-up, my psychiatrist had decided to monitor my depression more closely. At my then-girlfriend’s behest, I decided that my sleeping patterns where more of a problem than I was willing to admit to him. The day after the relationship finally broke, my psychiatrist told me that he’d found the drug for me. Then he made me wait for the shock of the break-up to disappear before he could start me on the medication.
My first two months on Mirtazapine were unbelievable. Mirtazapine is an antidepressant drug that acts as a sedative eight hours after it is administered. It sounded perfect. At first, I could get to sleep right on midnight. Thereafter, my body took charge and had me asleep at around two a.m., regardless of when I took my medication. But I could sleep, and when I got to sleep, I stayed asleep.
Over time, the depression began to lift and I slowly developed a new lease on life. I enrolled into another university, stopped abusing illicit chemicals, lost my codependent tendencies, and decided to realize my ambition of becoming a writer.
Dr. Wikipedia Had Answers
Then, in the midst of a writing project, I began to monitor my body clock and weigh up the data with what Wikipedia had to say about sleep disorders. After a discussion with a new GP (who I stuck with), my insomnia was confirmed as a simple circadian rhythm disorder. I re-arranged my life around my weird body clock, and my GP prescribed me with some melatonin capsules that I could use to reset it when I needed to.
Circadian rhythm disorders are quite common among adults with ADHD. I’ve found that under medical supervision, they can be effectively managed with relative ease. My psychiatrist has finally stopped asking me to schedule monthly appointments. We only really catch up when my prescriptions are running low.
I’d had problems with getting to sleep since I was a small child. My mother told me that I rarely slept as a baby. That made me the black sheep of the family. My dad likes to tell me that he can sleep anywhere, at any time, and for as long as he wants. Sleep, it seemed, was perhaps the most devastating factor of the impact that ADHD has had on my life. I only really got a handle on my life when I addressed it.
Now, I sleep when my body wants me to sleep. And, with Mirtazapine, methylphenidate, and a healthy lifestyle, I can function–to the extent where people are genuinely surprised to hear that I have ADHD.
Your comments welcome!
For more posts about ADHD and Sleep:
ADHD and Sleep: Puzzling the Pieces
ADHD and Sleep: Organizing Your Brain
42 thoughts on “ADHD and Sleep: Your Elusive Circadian-Rhythm Dream?”
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Your book was recommended to us by my ADD psychiatrist (still in the diagnosis phase). We just bought the MP3 version of your book by accident, but actually it turned out well since my husband would not have read the book. We are listening to it together. Usually I skip through books, so this is forcing me to listen to everything and at a pace that I can follow, instead of fast-forward.
Long story short: I was referred by the ADD psych for a sleep study and am now diagnosed with narcolepsy (extremely fragmented sleep, EDS, etc). I’m still in the care of the sleep specialist psychiatrist, taking modafinil (stimulant) for alertness during the day, and a temporary trial of a sedative to help consolidate my sleep. What a difference it has made!
Anyway, what I wanted to say is that an online friend with bi-polar disorder and ADD sent me a link to some information about bi-polar, sleep and light. If you ignore the references to bi-polar disorder, it still has relevance, for anyone. I bought the amber safety glasses mentioned in the article, as well as some amber lightbulbs, and amber booklights, and it really does help. I use them an hour or so before I go to bed. I still need my meds, they don’t replace that.
My ADD psychiatrist mentioned he met someone in Berlin who is studying sleep & ADHD, and that apparently sitting on the computer late at night destroys melatonin production. I find I can still use the computer with the glasses if necessary, they completely eliminate the blue light which is associated with summer sun.
I’m not selling or associated with any of the products mentioned. Here’s the link http://www.psycheducation.org/depression/LightDark.htm
Thank you so much for sharing this! Any information that promotes sleep (whether one has ADHD, bi-polar, or simply trouble sleeping) is so helpful.
I had heard about the blue light of computer monitors; I think it applies to the older monitors, not the new flat-screen types, but I’m not sure about that. And yes, absolutely, lowering the light sources at night triggers melatonin release (just as sunlight in the morning triggers the cycle of production). I had not heard about the amber glasses — cool!
There are many researchers studying ADHD and sleep, thank goodness. I interviewed several of them for an article I wrote for CHADD’s Attention magazine. If you are a member, you can access the article in the archives.
Thanks for contributing the info!
To Matthew: I can soooooo relate to your discovery around the amazing results a little “Melatonin” can bring! I learnt the hard way – it cost me my marriage – all because my husband couldn’t handle the fact that I came to bed anything up to three hours after him!
It was awful. I so desperately wanted to be normal and just snuggle up in bed with him each night. But every time I did so, my relentless tossing and turning in my failed attempts at sleep would drive him crazy. I would just get up again and sit mindlessly in front of the TV until, at some ungodly hour of the morning, I would finally be tired enough to go to sleep properly.
It wasn’t my doctor who told me about Melatonin – it was a motivational speaker at a sales conference I went to. I can’t recall his name off-hand but he had just written a book about “self-improvement” and one of the big things he talked about was the need for a solid 8 hours sleep each night. When I challenged him on how a person with ADHD could ever hope to enjoy a decent night’s sleep, he siad: “Oh, that’s a no-brainer… start taking Melatonin.”
Honestly, after more than 30 years of enduring a nightmare existence with sleep-deprivation, it took me less than two weeks to start enjoying my first really good, deep sleeps – and going to bed at a normal hour (unless there was something on TV I really wanted to watch!).
I agree with Charles – Gina, this is a wonderful blog 🙂
Tender Proposal Specialist
Thanks so much for sharing your story. I am working on a short book for adults with ADHD on sleep (“The ADHD Roller Coaster Guide to Sleep”), and I will be looking for helpful strategies such as this. Stay tuned!
I’m glad you’re finally getting good sleep!
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I have a client that is one of the leading doctors in the state where I live specializing in ADHD and Autism. While obviously I don’t get into his actual work too deeply, during the process of doing research for the project of getting his site good search engine listing, I’ve learned so much about ADHD and Autism.
Reading through these comments is difficult. It’s one thing to be helping a client help more people. It is quite another to read first hand accounts of people and parents who have struggled with ADHD on the most personal of levels.
I’m going to make sure he knows about your blog. I’m sure he will be interested and perhaps can contribute some of his expertise here.
Hi Gina…. I just thought I’d share my own experience with you – or rather, my observations of my step-son’s experience with Autism, ADHD and Obsessive Compulsive Disorder.
As a man who has suffered with Sleep Apnea most of his adult life, I have first-hand experience with ‘lack of sleep’ – not because I can’t go to sleep, but unless I am wearing my CPAP machine mask I wake up gasping for breath many times a night.
I used to think this was as bad as it gets. However, not long into my last relationship I learned that my partner’s 7 year-old son had a sleeping disorder far worse than mine 🙁
His brain is not wired the same as most people – he simply doesn’t experience “tiredness” the same as most people. When most 7 year-old boys would normally be in bed by 8pm, this lil fella wouldn’t have a bar of it. He would lie wide awake through his nightly story-reading sessions – often resulting in us parents falling asleep while reading to him!!!
He just could not go to sleep 🙁
He would get straight back up out of bed as soon as we left the room…and because of his many other issues there was no point in locking the bedroom door or punishing him for “misbehaving”… he would just scream non-stop until either the police arrived or we would give in and allow him to get up.
No treatment or medication or countless sessions with child psychologists ever helped him one iota. In the meantime, my health was deteriorating due to this boy making it almost impossible for me to get ANY sleep.
Then there was the OCD issue. He would get up out of bed as early as 4am (after maybe 3 hours of sleep) and yell at us to get up until we couldn’t take it any more… and then he’d demand food because, as he used to say… “I’m starving”.
We’d stagger out of bed… make him something to eat in the desperate hope that it would calm him down and let us all go back to sleep… and then discover that he’d changed his mind entirely and DIDN’T want anything to eat after all :(:(:(
Instead, he’d want to stay up!!!
I can still remember the night that ‘every single time he got back out of bed, we put him back into it’…and between 10pm and 5.am we repeated this tiresome charade 122 times!!!
I am sharing this with you, even though it’s slightly off-topic, because at the end of the day it’s still a terrifying example of a chronic sleep disorder.
All the best 🙂
Digital Dictation Technician
Thanks for sharing your story. That poor child. The poor people who sleep around him (or try to)!
This reminds of people who are not “wired” to feel pain. The parents of these children have to watch them constantly because they can severely injure themselves but not know it.
Your step-son’s example is one that illustrates how one disorder can exacerbate brain function, by depriving it of sleep.
I hope you’ve come up with a solution to help him get sleep. Some people with ADHD will sleep better with a stimulant in the system. Just a thought.
I have ADD and have always had an awful time going to sleep. As a child (around 8 or 9) I was prescribed anti anxiety medication on top of my ADD meds. Talk about crazy-making. Before the anti anxiety meds were prescribed my mum used to give me Benadryl to help me go to sleep…. But even then I would wake up at least three to four times at night.
My dad is a psychologist but back then the affects of ADD on sleep were not as well documented so the correlation was never made. Same with my younger brother who was (and is haha) ADHD. While I had trouble going to sleep and staying asleep, my brother had trouble going to sleep. He would stay up until an hour before school reading, playing games or eating pilfered candies and then when morning came and it was time to get ready for school none could budge him. Once he went to sleep he would just stay asleep. He probably would have sleep well into the next evening if left to his own devices.
I am currently unmedicated, but I deal with my evenings by adhering to a routine. I am ADD-lite and have the most success when I make follow a predictable schedule (naturally, when something unpredictable occurs I have panic attacks, but oh well!) I try to not watch TV or be on the computer an hour before my projected bed time (typically around 10 p.m.) and then do the same “bed time” routine every night: potty, brush teeth, wash face and then jammies. Sometimes my hubby and I will talk a bit before turning off the light, if not I read for a bit. I tend to read the Bible right before I try to sleep because it gives me something specific to focus on. Some nights are still really rough but for the most part things are better than they were when I was a kid.
I’m glad I am not the only one who struggled (and continues to struggle) with sleep. Loved the post and hope to see more from you=D
Thanks for stopping in, Chelsea, and sharing your experience.
Wow, this has been a fascinating read; Matthew’s article and everything following. There is so much I’m relating to. I don’t have trouble falling asleep or sleeping until morning, its the going to bed, as another commenter shared. I’ve always been like this. And, I do find myself seeking carbs in the evenings. Crunchy carbs. And the comment of lee’s, not spending time on herself because there is so much to do – that is me also. Yet cognitively I am well-aware that the better I take care of myself the better I can function and do my job. I know all about getting enough sleep, eating write, exercising, etc. Yet, I find myself putting off the task due the next morning even if I have arrived home with plenty of time to complete it. I will set my alarm an hour early and wake up and do it in the morning, which then often makes me a little late for work, which is a very bad thing especially if it was at that early morning meeting that the report was due. I so often function on 5-6 hours of sleep as a norm. And yes, self-esteem and self-confidence are in the toilet as well. Especially since missing a deadline resulted in everyone else having a hard time too – I impacted my team. Not good. Luckily when it happened once again, I had already been recommended for rehire. So I have a second year, but woah – it will be my make it or break it year! My prescribing doc (Vyvanse, Lexapro) insists it is not a medication issue but that I must use an ADHD coach. But woah, the cost! One I did find and use was too adhd herself to be able to help me – what a disappointment. The year is ending now, all I can do is hope that I will and do use the summer productively. I must set the stage for a successful 2nd year or I’ll be job hunting yet again…
Hi MK — thanks for stopping in. Matt did a nice job, eh?
Do you think your doc is right? Some people with ADHD have the worst time at night because that’s when the stimulant is wearing off, so ADHD symptoms come to the fore at bedtime. Meaning, procrastinating about going to bed, etc.
Some people find that a low dose of stimulant in the evening helps them to better plan the evening (and next day) and also get to bed when they need to. Something to consider.
I’m so glad you found the information useful. Don’t be surprised if your therapist has never heard of this. Most haven’t. Same for psychiatrists.
I am working on a short guide to ADHD and Sleep. Stay tuned….
Thanks for sharing this story. This could be a life changing moment for me – I have been suffering for years from insomnia, and have never heard of circadian Rhythm Disorders until reading this article! I am also clinically ADHD, but was only recently diagnosed a few years ago. I’m calling my therapist tomorrow.
Lee comments that she can’t spend time on herself because there is so much to do. That is a very ADD way of thinking- and I have fallen into that trap myself.
However, I am slowly learning that if I take better care of myself it gets easier to do stuff- because I function better. Sometimes my attempts to be a superman become self destructive.
I look at attention as a quantity that can always be improved (ADD or not) with proper self management (sleep, exercise, anxiety and anger management, not to forget pain management- an issue in a somewhat arthritic 49 year old body).
At least it is nice to know that everybody else finds this a plague.
It is pretty much the last remaining problem I have.
I can be focussed and have a quiet mind all day- then into bed and the brain starts into “random thinking mode”.
Fortunately now I can meditate or do progressive muscle relaxation in bed and not thrash around all night keeping my wife awake. It also is about 2/3 as helpful as actually sleeping- so that is something to be pleased about.
Like everyone else- I will be watching this space keenly for solutions.
Your comments about having a compulsion to stay up late really resonated!! According to my family, I have been that way since I was 2 years old (I am now 58). Maybe I was born with messed-up circadian rhythms?? I didn’t know that was a part of ADD!!
My husband & I have both been recently (~18 mo.) been diagnosed. We both are in counseling and take medication, and it helps, but the sleep issue is still very problematic, especially for me. It seems like there are always so many more things I need to get done (due to HUGE challenges with decision-making/prioritizing), that I can’t stay ahead of my basic taks; so I stay up late to organize.
Of course, lifelong sleep deprivation (4-6 hrs/night), along with the ADD, impairs me at work and affects my coworkers. My confidence and self-esteem are in the toilet. I feel COMPELLED to stay up late, almost every night. Also, I can fall asleep, but not stay asleep.
I know I need to exercise and activities I’ve always enjoyed pursuing, but now lack the time/confidence. Also how can I justify spending the time on myself when my house is a mess, errands undone, etc.?? It’s a vicious cycle, and I feel like a failure in all areas of my life.
My husband is brilliant and does his part, but his job is very challenging with a LOT of paperwork involved. Any ideas?? Also, are there any other couples out there with a double ADD diagnosis?
Thanks for listening!
I’m glad the info here has resonated for you. Stay tuned for my upcoming booklet on ADHD and sleep.
Yes, I know many couples where both have ADHD. Usually very different presentations, though; it’s helpful if you both have different strengths and weaknesses.
This is very interesting – I’ve always had trouble getting to sleep but never associated it with my ADD.
For a couple of years I took melatonin, and got up to 10 mg per night without it helping much. I could stay awake all night and then sleep from 6 or 7 am until afternoon. Several of my managers during my career have been unhappy that I arrive at work at 8:30 or 9 and can’t regularly show up earlier. They of course thought I didn’t value my job or care about their criticism.
Ambien CR helped a little, but not a lot. Now I’m taking Klonopin 1 mg each night. I can get to sleep more easily. I still sometimes wake between 2 and 4, but no longer wake up wide awake and restless – I can go back to sleep.
I am taking Straterra 80 mg and 10 mg Prozac each day for my ADD and depression.
OMG, Matt–you told my story! I have never be able to sleep; I did the same excursions into the kitchen as a kid; sometimes I still do. And Shimke, I’m right there with you. I don’t want to go to bed. There’s always one more thing to do, even when I know I’ll pay for it in the morning.
I’ve been on something for sleep (on Lunesta for the last 4 year) for 30 years…most of them turned me into a vegetable for the first 3 hours after awakening. Melatonin works for three days and then gives me restless leg syndrome–to the point where I can’t sleep. Lunesta works well to put me to sleep, but I can’t say that I get good quality sleep. I just started taking folic acid before bed, and that seems to have helped my sleep quality.
My biggest concern is that the medical community frowns on continuous use of sleep medication, so I find myself obsessing about what I will do when my current GP retires. I know it issue is circadian rhythm, but I can’t rearrange my job as a writing teacher to fit my own rhythms! I keep telling myself that once I’m retired, I won’t have to beg a doctor for Lunesta. Sad to feel that way, but finding a doctor sympathetic to ADHD phenomena is a rare thing.
Thanks to all of you for letting me know I’m not the only one.
Just to follow-up:
I’ve just finished reading this book called “59 Seconds” by Prof. Richard Wiseman (how Dickensian!). It’s the psychologist’s answer to the Self-Help industry. It’s fantastic, and fascinating. I think that anyone could benefit from the information contained in that wonderful little volume.
I’m doing very well, thank you!
I’d be about the same age as your son, so I can only really say what seems to be working out for me now. I’m working with theory here, rather than a track record of reliable foresight…
But I will say this: I’m still writing, every day, and I’m getting better at it. The decision to become a writer was totally insane — where I live you literally have to explain what a writer does (“everybody can write!” they say), and the pay will be pathetic until I get good enough to move to a country where the two major chain bookstores aren’t being liquidated.
Despite that, I get the sense that I’m sticking with this because it is something that I always wanted to do. I think that when you really want something, if you can find the courage to pursue it, it will keep you focused.
I keep myself in check by having what I want quantified — that is, it isn’t just “be a well-paid, well-fed writer”. I made myself a spreadsheet with goals, and columns to keep score. I effectively turned my developing career into a video game — a system that gives me instant feedback and a clear map of what to do next. Like any other ADHD kid, I was a sucker for complex video games but I wouldn’t even register complex math homework (which is funny because in retrospect, they’re basically the same thing!)
I do change some of the variables each week, and tweak some of the minor goals, but so far the underlying urge to do this despite the sheer craziness of it has been the fuel that’s pushed me along. It sounds cliché, but ‘follow your dreams’ seems to work for me — though it might take a bit of soul-searching to figure out what those dreams are. I’d add “quantify your dreams” though, because that way you aren’t just shooting in the dark.
I’ve done the same thing with my university degree too. I have to be honest, this is secondary to my main goal, so I don’t do as well as my own mother would probably like. And my money — and while I’m still in debt, I’m actually slowly digging myself out — frugal living isn’t so bad when you see those negative numbers edging ever closer to zero on a score card.
Adequate sleep is definitely important. I can only suggest what has worked for me; melatonin and mirtazapine (Remeron). I was on ambien years ago, but I found it ineffective, and after that I tried temazepam — not recommended. Melatonin and mirtazapine seemed to ensure that I got normal and healthy sleep. Everything sort of fell into place once I got through that hurdle, not to say that it did on its own, but rather that I suddenly had the mental energy to figure out exactly what was going on and to find ways to deal with it.
I’m a big believer in quantifying things. If I can turn mundane tasks into something I can keep score of, things don’t seem to overwhelm me as often. I only really needed to extract the one consistent thing in my life (aside from girlfriends) and then I could attach everything else to it. Once the drive to consistency is there, things like “Getting Things Done” (David Allen) and “7 Habits” (Covey) become a real joy to try out, and with instant feedback the useful stuff actually starts to stick.
I hope that helps!
I hope that you are still doing well. Im really glad I stumbled upon this blog.
My son was diagnosed with ADD after his 4 years in high school. I tried so hard to get him help during grade school and high school, but the teachers insisted that he just needed to ‘apply himself’. It has been a difficult ride for him and he is still trying to find ‘something’ that will help him sleep, and help him find his way.
He graduated high school but went back because he wasn’t sure what he wanted to do yet. After a couple of months in University, he quit. He then started taking night school courses and could not comple that either. He has worked on and off since then. He is currently working part time at a restaurant and has applied to College. He does not sleep at night! He did join a gym, and that seems to help a bit, but Im afraid that he won’t keep up with the gym either. He has trouble handling money and is usually in debt and we have to help him out. It a vicious circle. I don’t know what else to do to help him thru this. He is 22 years old and I don’t know what I can do as his mother to get him thru this. Please write back…
My husband (of 7 years) is undiagnosed with ADHD. Sleep is an issue, however not the biggest one. Getting him to GO to bed or even get ready for bed is problematic. THese have been some of our HUGEST arguments! The biggest challenge is his work schedule and him getting enough rest…which he says he’s always so tired. Then, will drink a couple cups of coffee and push himself to “get busy” or go to work. He is an Engineer on freight trains. (I’ve always said ‘Thank God that the train is ON tracks!’ ) Train engineers, just by trade, are so often sleep deprived and self-medicate. I’ve always been concerned that my husband is sleep deprived. He works (in general) 36 hours “on” – 36 off. He can be called to work at 3AM, 3pm or 11pm or 6pm….it’s never consistent. He can be ON the train for 5-12 hours and have OFF 10-30 hours! He cannot (which, WHO could?) get off work and go to bed and to sleep. Many times he must as he would be scheduled out again in 10-12 hours. He does self medicate. At home, mostly with herbal forms. There are times he does take sleeping pills and then stays UP…almost as a compulsion. Reading these earlier comments is helping me to understand.
thanks to you all for sharing. I’m feeling some comfort in understanding.
My son also suffers from Night Terrors – I’m going to have him read these. He’s done so many sleep tests…no on meds. Better, but not great! Thanks again!
Wow. I knew I was ADHD, and that it was probably why I didn’t sleep well, but now I want to find out more about it. Both my exwives found sleeping in the same bed with me frustrating because when I do sleep, I’m thrashing around, getting up a couple times a night and making their sleep difficult. What’s actually kind of funny is that my whole life I’ve had no problem getting up early, my “problem.” which can actually be a good thing, is that I nod off early falling asleep on the couch with a book or TV and then waking up about 4 or 5 in the morning. Sometimes earlier. But tired? yeah… I told my best friend, in all seriousness, that sometimes it’s hard to be me. He laughed and I laughed with him but I’ve never known anything else. What the heck is “normal?” I’ve never known what that means.
P.S. I’ve just posted a blog entry detailing my experiences in school as an undiagnosed “talented” ADHD child.
My website link got messed up in the last post. This one will work.
So much of Matthew’s story sounds so familiar. It is 4:00 am, and I feel more productive now than I did all day. When daylight breaks I will be more tired than I was all night. It’s a vicious cycle I’ve been in for as long as I can remember, which in my memory is about age 7. Back then I would lay in bed in the room I shared with my sister, and listen to her sleep as I counted floaters I could see with my eyes closed, prayed rosaries, made up stories, stressed about the following day’s challenges, stressed about not falling asleep.
Now I spend most nights waiting for everyone in the house to fall asleep (living with my parents again—long story) so that I *can* think without distraction. The calm of silence allows my brain to figure things out uninterrupted. SO I resist sleep, even when I am tired. When I do fall asleep, I wake several times a night in either a deep sweat or uncomfortably cold. Yes, I’ve had bloodwork done, all clean. Hormones normal.
I’m newly diagnosed (1 week now) at the age of 37 and not yet medicated w/stimulants. My psych recommended getting a handle on my anxiety first before introducing anything more powerful. For now, it’s Venlafaxine and Wellbutrin. My previous doctor prescribed an antiquated anti-depressant to help me with sleep. It interfered with the anti-anxiety meds. I’ll bring up mirtazapine with my new doc to see what she thinks.
Thanks for this, and also Gina for suggesting that I not rule out ADHD when I joined the “living with an ADHD partner” mailing list. This was a monumental help in steering me in a better direction.
I love the comment that there is an unrecognized difference btn problems sleeping and problems going to bed. I used to have problems falling asleep. A shrink diagnosed ‘obsessive (or compulsive?) thinking’ and prescribed Trazodone (Desyrel). This solved that problem 85% of the time. But after a while, I started to have problems again, this time problems going to bed. All the doctors and my therapist agree that ‘that’s just your personality’ or ‘that’s your choice’ or ‘just decide when you want to go to bed and do it.’ All of that sounds very rational, and if I knew someone else who complained about this, that is probably what I would tell him. The only problem is, it doesn’t help to hear that. I feel a compulsion to remain at the computer / book / TV or whatever I am doing at 2 AM, similar to what I imagine a gambler feels at the slot machine. And the syndrome someone mentioned on your other blog: “Just one more” and when that’s over, I find myself automatically clicking on ‘new game’, ‘new puzzle’ or a news source link. I am frustrated and don’t know what I can do about this.
Thanks for your comment. Your situation is often-reported among adults with ADHD.
Some pwADHD find that a stimulant helps them to get to sleep — and to GO to bed, leaving behind the other kind of stimulant: headlines, one more website, TV show, etc. Some listen to guided meditation tapes as they drift off; it can help to focus the mind so it doesn’t seek stimulation elsewhere. Or listen to a relaxing but slightly engaging book on tape (not too interesting or you’ll want to keep listening!).
I’ll be including a range of strategies in the ADHD Roller Coaster Guide to Sleep.
I do SO wish I could get in touch with “shimke,” who posted the comment above, to see if he or she has found help with this compulsion to stay awake and do more of whatever you’re doing at the moment. The word for this– “compulsion”– came to me this morning after I woke and was just lying there thinking about how ridiculous it was for me the night before to be soooo tired and sooooo sleepy and yet NOT GO TO BED. I’ve wondered so many times: WHY DON’T I GET INTO BED WHEN I START NODDING OFF AT 2 A.M.? WHY DO I FIGHT HAVING TO GO TO BED? There’s just no rational explanation.
Gina, I’d never thought of taking a stimulant late in the day to help with the “executive function” of initiating a task (that is, retiring for the day). It sort of makes sense; but it also seems like I’d end up with insomnia once I initiated the task of going to bed!
I would sure like to talk to “shimke” to see if progress has been made and to discuss this “compulsion” concept. The analogy of the gambler in Las Vegas at the slot machine really hits home. I totally identify. I hope “shimke” is alerted to my reply and can get in touch with me here. I need some insights. And maybe some cognitive behavioral therapy.
Maybe “shimke” will respond.
I can tell you that I know many other adults with ADHD who experience this phenomenon.
You might call it a “compulsion,” but I think it might actually be “stimulation-seeking” and fighting the boredom of sleep. Plus, it’s sometimes a bit of opposition to the idea of “having to” sleep.
If you take a stimulant during the day, why not try a lower dose at night. Try it on a night when you don’t have to get up early or be functional the next day. See what happens. 🙂
Meanwhile, check out this other blog post I wrote on ADHD and sleep — and check the comments, too. Might find something useful.
ADD never kept me from sleeping but it has often kept me from going to bed. Most doctors don’t understand the difference, but there is one, and it is significant.
I am also the mother of someone who, like the guest author, did not sleep in childhood. Once she went three nights in a row with fewer than 3 hours sleep. On the third morning, she hallucinated. I kept copious data on her sleep. What time she was in bed, what time she actually went to sleep, when she woke up. For several years during middle childhood, her nightly average for sleep was under 6 hours. That is not what we want for good brain development.
One year when she was about 10, her friends all were over for a birthday slumber party. As the girls got themselves settled on the guest room floor, I walked by the door and heard one of her friends announce, “Josephine doesn’t sleep.” The kids laughed, but it was so not funny to me. Hours later, when the giggles and shrieks died down, I went to the door and found everyone sound asleep, draped over each other in stuporous oblivion. Everyone except my daughter, who was lying on her back, staring at the ceiling, tears coursing out of the corners of her eyes.
I can’t say this one has had a happy ending, though she got some relief – and sleep – from a combination of nightly melatonin (“Don’t you know that stuff hasn’t been tested for safety in children?!” people said. “I do know that. But sleep deprivation HAS been tested, and melatonin can’t be worse,” I’d say) and her stimulant medication, a dose taken an hour or so before bedtime.
To this day, she takes medication around the clock. She stopped melatonin because there were signs her body had ceased to make it at all. She does go to bed and to sleep later than most people, but is able to sleep long enough, usually.
An oft overlooked cofactor in sleep problems in children, is that someone else in the family is usually also sleep deprived. I never thought it right to make an eight year old spend hours and hours alone and awake at night. Sleep deprivation in adults has also been tested, and I am here to say, the results are not good.
It would have been helpful if someone – anyone – had given us some help, but I don’t think anyone knew what to do and most truly did not believe us when we explained the sleep pattern. That’s insulting, to say the least. But that is another post.
Thanks for the suggestions. There was one week where it was better and I was at a higher dose then, but there were too many other negative effects.
What I didn’t mention is that it’s just that first part of getting going — if I push through I’m usually fine within 15-20 minutes (that’s after I’ve laid in bed for 20 minutes) and do fine during the day. As far as energy, this was true even before the adhd diagnosis (once I finally was established with exercise).
Unless of course I’m sick or something, or if I got less than 7 hours; but normally I don’t.
Incidentally, if I only get 3 hours I can get up a lot easier, but obviously I feel it later in the day and in the long run is a lot worse, so I don’t do that.
I’ll raise these issues (combined w/ meds being less effective during my period) and the others with my psychiatrist. Thanks again.
Ah….those are important clues! 🙂
Again, I’m no medical sleep expert, but I’ve read much of the research on ADHD and sleep.
It could be that you are suffering a classic (but in this case subtle) ADHD symptom: low motivation/initiation.
If you think about it, sleep is the ultimate unmotivated state. People with ADHD have to get themselves from sleep to awake (motivation/initiation). That can be a tough transition: to rouse yourself from 0 to up-and-moving-about.
If that is your main issue, it could be that this strategy might help: Keep your stimulant medication and a water bottle by your bedside. Get one of those two-alarm alarm clocks. When the first alarm goes off, reach over and take your stimulant (do try to sit up, though, so you don’t choke!). Then go back to sleep while it kicks in. By the time the second alarm goes off, you might better be able to arouse yourself!
Sleep is the one thing that I’ve continued to struggle with since stabilizing on adhd meds.. It is the most noticeable problem to me now (except when I have my menstrual period; then everything is a problem again).
I wake up every day, never feeling rested. But I usually fall asleep within a half hour and I don’t usually wake up at night, and I’ve been much better about sticking to a bedtime routine. It doesn’t seem to make much of a difference…
It’s the next topic of discussion with my dr for sure. Any suggestions?
I’m no physician, but some areas to explore might be your cortisol levels and sleep apnea.
There is a lab test that measures adrenal function throughout the day. The last time I did one of these tests (with Dr. Parker, at http://www.corepsychblog), I was really dragging in the morning. I felt like I might as well not have bothered to sleep the previous 8 hours (which I did), for all the good it did.
Dr. Parker suggested some amino acids that support adrenal function/cortisol normalization. They seem to have helped! Soon I should re-test so I can see what the data says.
Testing for sleep apnea (or whether you’re getting sufficient oxygen at night) is another possibility. Have you ever tried going to sleep with some of the stimulant still active in your system? It could be that might help to “regulate” your sleep much the same way it helps to regulate other functioning during the day.
My friend says she got the most restful sleep in decades the night she fell asleep on the sofa without removing her Daytrana patch. 😉
I hope this helps.
Here I sit at 3:02am reading and watching tv trying to fall asleep. I also have two children with ADHD who also have difficulty falling asleep. Melatonin helps very little for me. I’ve had this “sleep disorder” since I was a young child and so much of your story is what I experienced, although no one thought about or eventually believed in ADHD in my family (I’m 47). I too, “was lazy, selfish, impulsive and unfocused” and my mom was relentless about screaming at me to “get up” on Saturdays. I was exhausted all the time which contributed to my short fuse and inability to pay attention (I was sooo tired all the time – still am, but better able to cope as an adult). I’ve read a bit about circadian rhythms but have invested a lot of time researching it more. Your story has motivated me to do so! Thanks for sharing, wow.
I’m sorry to hear about your long history of difficulties around sleep. It’s amazing, isn’t it, how clueless our medical system has been (and largely still is) on this subject. It’s the rare sleep clinic that will identify ADHD-related challenges around sleep. Instead, all sorts of other procedures (even drastic-sounded surgeries) will be recommended. This is why I’ve taken it up as a cause.
If you are a CHADD member, you can read the article on ADHD and sleep that I wrote for CHADD’s Attention magazine. It’s in the magazine but also the online archives. If you’re not a CHADD member, I highly recommend it. http://www.chadd.org
What an interesting post!! Through the whole story I so wanted Matthew to get a good night’s sleep. Researchers have found that 25-50% of adults and children with ADHD have a related sleep disorders. The sleep onset delay disorder that is described here is very common and is what I and my Inattentive ADD son suffer from.
I have found regular exercise to really help me with my sleep onset problems and my son takes 3mg of Melatonin when an Epsom salts bath has not made him drowsy enough to fall asleep. The magnesium in the Epsom salts can be sedating and it is no wonder that our grandmothers used so much of it to soothe whatever ailed them.
Great read! Thanks.
Thanks for your comment. I love that your son takes an Epsom salts bath!
Some day I will post information on magnesium (which, for the uninitiated, is absorbed through the skin from the Epsom salts) and it’s role in potentially decreasing anxiety and helping people with ADHD (and all of us) to relax.
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