These 10 Suggestions Provide Specific Treatment Considerations for Any ADHD Symptoms Related to Sleep Disturbance. Untreated each of those issues aggravates symptoms of ADHD.
1. Measure TAH: Evaluate the Onset of Sleep, and the Duration in Total Average Hours -TAH. Sleep, in line with circadian rhythm research, is best begun before midnight, and may last, in line with research, 8.25 TAH. Lower than 7 TAH should at all times be systematically addressed, at any age. Consistent length of unbroken sleep is vital, and higher than napping to correct the following day.
2. Assess Sleep Levels – Level 1: Falling asleep, Level 2: Staying asleep, Level 3: Waking too early within the AM and being unable to fall back asleep. Each level suggests different clinical and treatment considerations. Some may claim no problems with either of those first two points, but could have problems with this next measurement.
3. Assess Overall Sleep Architecture: Sufficiently deep sleep, with feeling of adequate rest within the AM. Levels of perpetual dreaming, and levels of physical sleep activity often exhibit significant problems.
4. Assess Lifetime Duration of Sleep Problems: Many live for years with sleep issues and only in middle age begin to point out the numerous wear. Simply because someone has previously done well with 4 hr of sleep and naps doesn’t help the defragmentation process that takes place in a 8 hr sleep at night. Sleep treatment for these challenges normally leads to excessive sleep for days to weeks until the body sets a recent calibration.
5. Assess for Sleep Apnea: So many snore or have significant airway problems. SPECT brain imaging studies often show specific areas of brain hypofunction secondary to sleep apnea, and sleep apnea, with decrease of brain oxygen, will at all times aggravated ADHD. Sleep apnea issues are correctable with specific interventions, and require sleep lab assessment.
6. Untreated ADHD or other Comorbid Psychiatric Problems: Essentially the most frequent reason for Level 1 sleep issues is untreated ADHD and/or depression related to worry and prefrontal cortical dysregulation. Comorbid major depression, mood disorder, and other psychiatric problems might also interfere with all three levels of sleep.
7. Excessively Treated ADHD: If stimulant [or other psychiatric] medications are adjusted inappropriately high, and duration of effectiveness of the stimulant medications will not be properly adjusted, medications will interfere with sleep on many levels. Paradoxically, when stimulant medications are well adjusted, and comorbid depression is corrected, often sleep medications are usually not needed. All the time dose psychiatric medications in line with the principles of the Therapeutic Window noted in my other articles here.
8. Assess for Hormone Dysregulation: Estrogen Dominance will significantly effect sleep patterns, and is at all times related to other hormone related difficulties that need specific correction independently of the ADHD work. Other hormone dysregulations can even occur, corresponding to increased cortisol with stress or adrenal dysfunction, which can even affect sleep. ADHD medications don’t correct hormone imbalances.
9. Assess for Medical/Metabolic Dysregulation: Many medical conditions will significantly affect sleep patterns. Restless Legs Syndrome, for instance, is commonly related to easy magnesium deficiency. Quite a lot of dietary issues can significantly alter sleep patterns and, again, can’t be treated by ADHD medications successfully.
10. Assess Sleep Hygiene: Watching television and eating within the bed, using the bed for exciting activities will break the association of bed with sleep. If bed is for normal play, then where and when can sleep happen?
Sleep challenges with ADHD appear at first as almost inconsequential, with apparently little relevance for either recovery process. Nonetheless, upon careful review, co-occurring sleep and ADHD issues can complete a toxic, impenetrable cycle of degradation that requires simultaneous intervention.