9 Sleep Deprivation Solutions for Adults with ADHD
Sleep deprivation and ADHD often feed off one another. How? Racing brains, impulsivity, and poor time management keep us up too late. Then exhaustion exacerbates our symptoms, and the cycle continues. Learn how to take control of your sleep here.
Q: “I have trouble getting to bed on time. There is always something that tempts me to stay up later. I average about five hours of sleep a night. Not until recently did I link my sleep shortage with other problems in my life — doing a poor job at work, doing a poor job in my marriage, and overreacting to life’s bumps in the road. Could poor sleep be the cause, and how do I overcome my inclination to stay up much later than I should?”
A: ADHD brains need more sleep, but find it doubly difficult to achieve restfulness. It is one of those ADHD double whammies: ADHD makes it harder to get enough sleep, and being sleep deprived makes it harder to manage your ADHD (or anything else).
In fact, research shows that sleep deprivation has a particularly detrimental effect on attention functioning among young adults with ADHD, according to a study recently published in the Journal of Attention Disorders.1 Sleep deprived participants with ADHD experienced relatively worse omission errors, commission errors, and delayed reaction time. Additionally, lack of sleep will affect stimulant medication efficacy. You won’t get the full benefit from the medication because your tired brain is operating less than optimally before you take it. You will then perform worse at work (or school), especially on tasks that are tedious or that require complex thinking. And you will likely be more irritable and short-fused.
Sleep Deprivation Solution #1: Consistent Sleep
If you are sleep-deprived, sleeping late on Saturday and Sunday may not be enough to help you feel good. In fact, yo-yoing between short bouts of sleep during the week and long sleep on the weekends causes your sleep/wake cycle to become dysregulated, so your body doesn’t know if it’s time to be alert or to downshift into sleep mode. It may take a week or two of consistent sleep for your body to reset its clock, and for you to know what “rested” feels like. And, by contrast, how much worse you felt before you got steady sleep.
Sleep Deprivation Solution #2: Increase Hours
Ideally, you should get eight hours of sleep a night, but even going from five to five-and-a-half hours makes a difference in how you can feel. A night of five hours may not be so bad if you had a couple of seven-hour nights before it, since the benefits of sleep can be cumulative. So give yourself credit for the progress that you are making. And regardless of how you did with sleep last night, make tonight a good one.
Sleep Deprivation Solution #3: Set a Bedtime
Many of my clients who are sleep-deprived don’t have a set bedtime. It could be midnight or 2 a.m. This vagueness may be somewhat intentional, but it makes it impossible to manage time through the night, since there is no deadline to manage time against. Therefore, set a bedtime and think of it as you would a deadline at work. Count time backward from that time to plan your evening, and push yourself to honor it.
Sleep Deprivation Solution #4: Think About Tomorrow
Staying up too late is about enjoying the present and paying the price in the future. This is tempting, especially for folks with ADHD. To counter this temptation, take a moment to imagine what tomorrow will be like if you stay up too late. Think about how painful it is to drag yourself out of bed, how stressful it is to rush to work, how long the day feels when you’re tired and exhausted. Then think about how much better the day is when you get a good night’s sleep.
Sleep Deprivation Solution #5: Identify the Obstacles
Think about why you stay up too late and why that happens. Ask yourself, is it mostly about “near causes”—getting stuck hanging out on Facebook at the end of the night? Or is it mostly about “far causes” — getting to work late and having to stay late to finish up? What are the first dominoes to fall that set events in motion? What are those choice points that send the day or evening down one path rather than another? These are your effective points of intervention.
Sleep Deprivation Solution #6: Get Rid of Naps
Naps can recharge you for the rest of the day, but they can also become part of the problem. If you are doing more than a 15- or 30-minute power nap in the afternoon or early evening, you aren’t getting enough sleep at night. Long naps (one to two hours) definitely mean you aren’t getting enough sleep and also disrupt your sleep/wake cycle, making it impossible to fall asleep at a reasonable time. This sets you up to need another long nap tomorrow. Break the circle by slogging through the day without the nap, and go to bed at the right time — tonight will be bad, tomorrow will be better.
Sleep Deprivation Solution #7: Stop Lying to Yourself
We all tell ourselves little lies to permit us to do what we know we probably shouldn’t. When it comes to sleep, you might say to yourself, “I don’t need that much sleep” or “I can make up for it on the weekend.” You might also misjudge how long an activity will take or, on an impulse, get involved in doing something that you know will take longer than you’re telling yourself: “I’ll just take a quick look at social media before I go to bed.” These little lies may have some truth in them, but if we are honest with ourselves, we would admit that they are less true than we would want them to be. So remind yourself that such little lies are, at best, overly optimistic, and that you will predictably be unhappy later.
Sleep Deprivation Solution #8: Ask Yourself “Why”
Are you stealing time from sleep to do the things that you otherwise might not do? For example, is staying up late a way to get some private quiet time, or to have some fun after a day of hard work? These desires are valid, but are you unintentionally making your life harder by taking time from sleep? Perhaps you can find other times to make the trade-off. There probably won’t be any easy answers, so hang in there and think it through. What things do you need to change in your life, so that you feel fulfilled and well-rested?
Sleep Deprivation Solution #9: Revisit Medication
Extended-release stimulants can get you through a workday, but how far do they carry into your evening? If your day is going well, but you are off track at night, talk to your prescriber about adding a short-acting dose in the late afternoon. Some people have trouble falling asleep with too much medication in their system, but untreated ADHD can make it harder to manage the evening schedule and get into bed on time. See what works best for you.
Ari Tuckman, Psy.D., CST, is a psychologist, ADHD expert, and certified sex therapist. His fourth book is ADHD After Dark: Better Sex Life, Better Relationship (#CommissionsEarned).
Dan, O., Cohen, A., Asraf, K., Saveliev, I., & Haimov, I. (2020). The Impact of Sleep Deprivation on Continuous Performance Task Among Young Men With ADHD. Journal of Attention Disorders. https://doi.org/10.1177/1087054719897811
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Updated on November 23, 2020