Hello to my ADHD peeps and ADHD loved ones living with ADHD, Raquel here. Today we’re talking about not getting enough sleep, what some causes are, and problems that can arise. In the next post we’ll go over how to build good sleep hygiene and solutions to try for better sleep.
Difficulty sleeping is a common problem with ADHD, which makes sense… if your brain is constantly going a mile a minute it can be hard to shut it down. But falling asleep is not the only sleep problem you can have. Getting an adequate amount of sleep and high quality sleep are also common problems, though maybe harder to resolve than trouble falling asleep.
So before we dive into causes and outcomes of poor sleep, what is good sleep? The average adult requires 7-9 hours of sleep a night, while there are people who do best with less and some who need more, 7-9 is typical. But your exact ideal hours of sleep is very individual and often very specific. For example, I do best with 8. I can go through my day fine with 7 but definitely notice I’m not as efficient, and with 9 I tend to actually be more tired throughout the day and often take a nap. It is much more common for people to not get enough sleep than to get too much, and when you chronically live on too little sleep it starts to feel normal. But being adjusted to something doesn’t make it healthy. But just as important as the appropriate amount is the quality of sleep. A typical sleep cycle lasts around 90 minutes and gets repeated several times throughout the night. When you first fall asleep you start in a light sleep and if you wake up in this stage you won’t know that you were asleep. You then go into a slightly deeper, but still not deep sleep for 10-60 minutes. Then comes a deep sleep for 20-40 minutes, which is finally followed by REM before repeating. As you fall into a deep sleep your muscles relax, pulse and respirations decrease, and your brain waves slow. This stage is critical for restoration, growth, memory, and immunity. When you get to REM sleep your brain activity gets faster, nearly to the same level as when you are awake. REM is very important for cognitive functioning including memory and is where most dreams occur. As the night goes on you’ll spend less time in deep sleep and more in REM.
As I’m sure you can tell from my brief explanation, sleep is complicated. And it is important. You need to spend a certain amount of time in each stage to get healthy sleep. People with sleep apnea or who wake up a lot at night don’t cycle through the stages properly, while people with insomnia don’t spend enough time in each stage.
So onto causes of disrupted sleep. As I’m sure many of you can relate, anxiety is a major disruptor. Lying in bed at night is the perfect opportunity for any anxiety to pop up. Whether its running through your to-do list for the next day, being nervous about a meeting, or reliving that one embarrassing moment back in 7th grade, anxiety at night can keep you awake for hours. Having this happen every once in a while is inconvenient and will leave you tired the next day, but having it happen every night is very disrupting. Similarly, high levels of stress can prevent falling asleep easily. Stress has a profound effect on your entire body and can make it very difficult for your body to wind down and relax enough to fall asleep. Having poor sleep hygiene can also affect your ability to sleep. Using your bed as a place to hang out not just to sleep, watching tv or scrolling through Facebook before bed, and having erratic bedtimes are all contributors to poor sleep hygiene and therefore poor sleep. Pain, mental, and physical illnesses can also cause problems. Pain is a distress signal that your body doesn’t want to ignore, and chronic pain that is uncontrolled can have a major impact on sleep because your body is constantly in that alert, distressed state. I already mentioned anxiety but other mental illnesses like depression, OCD, schizophrenia, etc. can keep you awake for hours. Disrupted circadian rhythms also pose difficulties falling asleep, this goes along with sleep hygiene with the blue light emitted from screens. That light disrupts your circadian rhythm, telling your brain it’s still daylight which decreases melatonin release. Other things like working weird hours (hello nightshift) will disrupt your rhythm. Before we moved I was working 12 hour nursing nightshifts and let me tell you, sleeping from 8am to 3pm throws your rhythms all out of whack. Obviously, there are many more things that can prevent and disrupt sleep so it’s impossible to cover them all, but these are the more common ones.
ADHD brains have a harder time shutting down for sleep at a baseline. Like I already said, it’s a lot harder to calm down when you have a constant barrage of thoughts running through your brain. Especially when they’re cool and interesting like wondering who’s winning the octopus war of Octopilus in Australia (not kidding, its real, look it up). But this can easily be compounded by any of the sleep disruptors listed above.
While a lot of these sleep disruptors are intuitive, the problems that not enough sleep causes are not. Many people don’t realize the damage that poor sleep causes and it is commonly accepted in society that being tired and running on 5-6 hours of sleep is normal. It is not. Chronic sleep deprivation causes problems with memory, learning, critical thinking, concentration, and mood. Many of your learning connections and memories are formed during sleep. Sleep deprivation can make you irritable and short tempered as well as cause depression and anxiety, which can become a vicious circle very quickly. With having decreased thinking and concentration you are more at risk for injury and accidents. You always hear about the dangers of driving drowsy, but driving sleep deprived is nearly as dangerous but people do that every day. Sleep deprivation also takes a serious toll on your organ systems. Your immune system is weakened, making you much more susceptible to infections as well as less able to fight them. You are more at risk for high blood pressure, diabetes, heart disease, stroke, and obesity. Sleep is when your body gets to rest and restore, not getting enough sleep throws many hormones and other chemical transmitters out of balance. There is also an interesting paradox with sleep and aging. Many middle aged and older people will tell you that they don’t need as much sleep, which is not true, they often just have difficulty sleeping. But not getting adequate sleep actually causes you to feel older and have a poorer outlook on aging. So if you know anyone in their 50s who complain about being old but also talk about how they sleep 6 hours a night…
Thankfully there are many things you can do to build good sleep hygiene and promote high quality sleep in appropriate amounts that can be helpful for everyone. When I first met Michel he was getting maybe 6 hours of sleep a night. That was partially due to taking three very difficult classes with no background knowledge and staying awake studying, but also partially due to difficulty falling and staying asleep. Since we’ve been married we’ve created a good sleep routine and Michel now gets a solid 8 hours most nights. And while he certainly still has trouble falling asleep, it’s improved from what it was 2 years ago.
Make sure to come back to check out the next post to learn about a variety of strategies to implement to help with both falling asleep and getting high quality sleep.
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