ADHD & Sleep: The Explanation that makes a difference

May 21, 2021 - neurocare group

Attention Deficit Hyperactivity Disorder, or ADHD, makes it difficult for a person to concentrate and control their behaviour.  Difficulties with concentration, called inattention, can include getting bored quickly, having trouble following directions, struggling to start and complete tasks, getting easily distracted, and finding it hard to organise your thoughts and new information.  Difficulties controlling behaviour, called impulsivity and hyperactivity, can include feeling restless and fidgety, being constantly active and on the go, interrupting others and acting out of turn, getting impatient, and rushing into decisions without thinking.    

The ADHD symptoms of inattention, impulsivity, and hyperactivity significantly disrupt everyday life.  For children and adolescentsADHD undermines their foundation for learning, putting them at substantial risk of poorer skill development and reduced scholastic performance.  Motivation, confidence, and self-image can all suffer, and they can become isolated from their peers.  In adults, ADHD similarly compromises work performance, creating difficulty organising and managing time, multitasking, and problem solving and meeting deadlines.  Difficulty coping with stress and controlling impulses can also strain personal and professional relationships, and many adults with ADHD also experience symptoms of anxiety and depression and overuse alcohol and other drugs.   

There are a number of different explanations for what might cause ADHD.  ADHD tends to run in families, and this may be a result of both an inherited genetic risk as well as shared experiencescommon environments, and learned behaviours.   The networks in the brain that manage attention and control behaviour may not be functioning optimally, possibly due to brain injury, poor nutrition, substance misuse, developmental abnormality, or neurochemical imbalance.  Unfortunatelythe presence of these factors varies considerably from one person to another, which has limited attempts to identify a common and effective target for treatment. 

waking up tired

However, sleep problems are very common in ADHD.  Over 70% of adults and children with ADHD have difficulty falling asleep.  Shockingly, for most people with ADHD, sleep problems have existed since before the age of 3.   Sleep is crucial for maintaining healthy body and brain function.  Over time, the cumulative effects of even a slight reduction in total sleep time can progressively erode critical cognitive and emotional functions, including attention and concentration, learning and memory, problem solving and creativity, emotional reactivity and regulation, and the ability to cope with and manage stress.   

Appreciating the importance of sleep provides a powerful model for understanding and treating ADHD.  Inattention in ADHD is seen as a direct consequence of fatigue and drowsiness due to chronic sleep-restriction.  The characteristic hyperactivity aspect of ADHD is seen as a direct response to that same fatigue and drowsiness, as the individual tries different over-active behaviours to try and keep themselves awake.       

Importantly, this model of ADHD not only explains the symptoms of ADHD, but also provides a target for treatment: sleep!  At neurocare, we utilise the sleep model to design individualised treatment programs for ADHD.  These programs promote quality sleep using cognitive-behavioural therapy techniques to establish healthy patterns of behaviour, and neurofeedback programs to optimise sleep networks in the brain.  Combining cutting edge technology with scientific principles of learning, our programs significantly decrease the time taken to get to sleep, and significantly increase the total time spent asleep.  Improved sleep corresponds with significant reduction in ADHD symptomsand following a course of treatment over half of our patients are free of any ADHD symptoms.   Unlike with medication for ADHD, there is no need for continuing treatment to maintain these improvements, and no side effects.  


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