Hi, my name is René, and I have ADHD.
I feel like that’s one of the most important things a person has to know if they’re going to be interacting with me on a daily basis. ADHD affects almost every area of my life: my job, my social life, driving and getting around, and even the way that I eat.
It also affects the way I sleep — or don’t sleep — every night.
Since my diagnosis, one of the most important things I’ve learned was that getting a good night’s sleep is super important for me in order to help manage my ADHD distraction. Unfortunately, sleep doesn’t always come easy for me.
Over the years, I’ve learned how to manage my ADHD symptoms and consider myself a fairly well put-together adult, but lack of sleep makes it a bit difficult.
All of the behaviors I work so hard to manage get exacerbated — I’m uneasy, hyperactive, and barely able to focus. And working a desk job? Forget about it. It’s difficult to complete my work when I’m either too hyperactive to stay put or because I’m struggling to stay awake.
For many people with ADHD, this is a fairly common scenario, and a lot of us just get used to the idea that sleep is going to be elusive, or that fitful sleep is just another of many symptoms of ADHD.
That’s what I used to think too, until I started doing a little detective work. I found that my sleep issues were the result of restless legs syndrome (RLS) and sleep apnea. — two conditions that often co-occur with ADHD and that, up until then, I knew nothing about.
My search for better sleep started a few years ago, when I realized that I was waking up every morning exhausted. While many of my fellow ADHDers battle insomnia, that wasn’t the issue for me. I was falling asleep and staying asleep, but I didn’t feel refreshed in the morning — I felt terrible.
At the time, I thought I was coming down with something, but a cold or flu never quite materialized. Every night was the same: I’d toss and turn for hours only to wake up in a tangle of bed sheets, exhausted and sweaty every morning.
Let me tell you, there is no energy drink in the world that can ease the effects of a night of restless sleep. During that time period, I found myself anxious, quick-tempered, and very easily distracted — even more than usual.
The more time that passed, the worse my sleep issues became. I was doing the right things — going to bed on time, establishing a good wind-down routine — but I still couldn’t get a restful night’s sleep.
One day, my then-husband casually mentioned that I kept kicking my leg in my sleep. I’d noticed an occasional itchy, tingly kind of sensation in my leg before, but never thought much of it until then.
I’d heard of RLS before, but it wasn’t until my husband mentioned the nighttime kicking that I considered that it could be the culprit behind my fitful sleep. I did what most people do in situations like these: I turned to the internet to try to find answers. In the meantime, I started paying more attention to my symptoms when they arose.
RLS often creates a creepy, tingly sensation in the legs, along with the urge to move or kick, especially at night or when a person is resting. This can wreak serious havoc on a person’s sleep. Imagine someone jostling you awake several times in the middle of the night, every night of the week. It doesn’t sound pleasant, does it? (It’s not.) I started to notice these exact sensations each night when I was trying to fall asleep and finally made an appointment to see my doctor.
I learned that RLS was actually somewhat common in people with ADHD. In one review of various studies on sleep disorders and ADHD, nearly 20 percent of adults with ADHD also showed symptoms of RLS. But the connection between RLS and ADHD isn’t totally clear.
The same review highlighted a few different theories on the relationship between the two.
One theory is that both conditions are signs of a dopamine deficiency in the central nervous system, or possibly even an iron deficiency in the blood.
Another theory is that the two conditions sort of play off of each other — the RLS could mimic signs of ADHD by causing sleep issues, and the resulting tiredness could exacerbate the symptoms of RLS.
I shared my symptoms with my doctor. She agreed that my nighttime kicks were likely caused by RLS, so we worked together to find a suitable symptom management plan. Within a short period of time, I noticed that the tingly, uncomfortable sensations in my legs started to subside.
My sleep issues were solved — or so I thought.
The search continues
Even after I was able to curb my RLS symptoms, I still wasn’t feeling rested in the morning. Every day I woke up with a sore throat and sore muscles, feeling like I had fought a war the night before. During the day, I was a walking zombie, going through the motions of work and home life with little to no enthusiasm. My depression — which I’ve always struggled with to varying degrees — became almost unmanageable.
Once again, I turned to the internet to try to figure out what was making me feel so miserable.
In my research, I came across a few articles on sleep apnea that caught my interest. I read first-person accounts in which people talked about lack of motivation, daytime sleepiness, and severe depression as a result of never getting enough sleep. I had a lot of the symptoms: a constant headache, pains in my neck, the aforementioned sore throat, and moods that swung on a pendulum, from happy to sad in an instant.
I went back at my doctor and got a referral for an in-home sleep study, where I wore a monitoring device that collected data while I slept (or tried to) in the comfort of my own home.
With sleep apnea, you actually stop breathing in your sleep. As your airway constricts, you gasp for air and wake up in order to resume breathing. I have always been a snorer, which is a hallmark symptom of sleep apnea. Surprise, surprise: During the sleep study, it was determined that I did indeed stop breathing several times per night. I was diagnosed with sleep apnea and shortly afterward worked out a treatment plan with my doctor.
Some studies have found a high rate of sleep apnea in people diagnosed with ADHD, but there still isn’t a clear connection between the two. One theory is that the symptoms and effects of sleep apnea — like memory issues and inattention — can be misdiagnosed as ADHD. Other studies suggest that the two conditions could be co-occurring, but more research is needed to figure out how they are related.
With my sleep apnea under control, I felt like a whole new person. I found my energy improving and my daytime sleepiness receding, and eventually my mood swings and depression lessened. I’ll likely always battle with my mood, but hey — I’ll take a reduction in symptoms any day!
Get your zzz’s
If you’re an ADHDer like me and think you might be experiencing symptoms of either RLS or sleep apnea, it’s really important for you to go talk to your doctor. These disorders can rob you of good sleep, leading to increased daytime sleepiness and putting you into a sleep deficit.
Managing sleep issues can lead to better concentration, lighter moods, and an overall better management of your ADHD symptoms. Don’t suffer for years like I did. Go talk to your doctor and start getting the rest you need to be your best ADHD self.
While you’re at it, try these tips to get a better night’s sleep:
Observe good sleep hygiene
This doesn’t mean cleaning your room… though that won’t hurt, either. Having good sleep hygiene means sticking to a nightly routine that readies you and your environment for a good night’s rest.
Removing TVs or other electronics that emit blue light from your bedroom (that means cellphones too), making sure the temperature is suitable for sleep, and going to bed at the same time every night are all good habits to improve your sleep hygiene. Establishing these routines helps your body to adhere to a rhythm and makes it easier to shut down at the appropriate time.
Get moving (during the day, of course)
An exercise routine is a great way to stay fit and can often help minimize symptoms of many ailments. When it comes to sleep, a bit of exercise might help you to feel more rested when it’s time for bed. When you get a chance, take a walk. Get out and move around. You’ll notice the benefits for your mind and body once you get into the habit.
Practice winding down
Set a time — say, an hour before your bedtime — each night to create a relaxation routine. That might mean reading a book, doing some light stretching, or taking a warm bath. Sometimes I like to listen to binaural beats to help chill out before I go to bed.
NPS-US-NP-00308 May 2018