Adult ADHD: Alarming Dangers of Daytime Sleepiness on Cognition

Attention Deficit Hyperactivity Disorder (ADHD) is often associated with boundless energy and a constant buzz of activity in children. However, for adults diagnosed with ADHD, the reality can be quite different. Daytime sleepiness, a feeling of sluggishness and fatigue despite getting enough sleep, is a common and often under-recognised symptom in adults with ADHD. This sleepiness can further exacerbate cognitive difficulties, creating a frustrating cycle that can significantly impact daily life. 

In this article, we learn the connection between ADHD and daytime sleepiness, which are often associations that are highly overlooked. We will also look into the other effects of sleep deprivation for an ADHD mind, cognitive dysfunctions, poor working memory and much more. There are also solutions that work specifically for ADHD individuals, which we will try to uncover. 

What is the Connection Between The ADHD and Sleep

The exact relationship between ADHD and sleep problems is complex and not fully understood. Some studies suggest that adults with ADHD may have difficulty falling asleep, staying asleep, or both. Others experience restless sleep, characterised by frequent movements and arousals throughout the night. This fragmented sleep leads to daytime sleepiness, impacting focus, concentration, and overall cognitive function.

Several factors may contribute to this connection:

• Disrupted Sleep Regulation: Individuals with ADHD may have an imbalance in the chemicals in your brain that help regulate sleep-wake cycles (melatonin and dopamine). This can lead to difficulty falling and maintaining sleep.
• Hyperarousal: The constant mental stimulation and hyperactivity associated with ADHD can make it difficult to wind down and prepare for sleep. People with ADHD often have busy minds that race with thoughts, making it hard to quiet down at night. This can be like having a million tabs open on your mental browser!
• Comorbid Sleep Disorders: Adults with ADHD are more likely to experience other sleep disorders like sleep apnea, which further disrupts sleep quality and contributes to daytime fatigue.
• Sleep Disorders: Adults with ADHD are more likely to have conditions like restless legs syndrome or sleep apnea, which disrupt sleep quality.
• Narcolepsy: Some studies suggest a connection between ADHD and narcolepsy. Some adults with ADHD also have narcolepsy, a sleep disorder that causes excessive daytime sleepiness and sudden sleep attacks. 
• Treatment Side Effects: Stimulant medications, which are commonly prescribed for the treatment of ADHD or subside its effects, can sometimes interfere with sleep, leading to insomnia and daytime sleepiness.

Relation Between Daytime Sleepiness and Cognitive Function

It is crucial to note that individuals with ADHD might have uneven levels of a hormone called cortisol throughout the day. This can lead to low cortisol levels in the morning, making it harder to wake up and feel alert. Studies show this delay in cortisol release can be up to 2 hours in people with ADHD. Daytime sleepiness has a significant impact on cognitive function, regardless of the underlying cause. 

Here’s how it affects adults with ADHD:

• Reduced Attention and Concentration: Sleep deprivation makes it harder to focus and maintain attention, a core challenge in ADHD. You may find it difficult to stay on task, easily get distracted, and struggle to complete tasks requiring sustained focus.
• Executive Function Deficits: Executive functions, including planning, organisation, and decision-making, are already challenged in ADHD. Daytime sleepiness further impairs these abilities, making it difficult to manage time effectively, prioritise tasks, and plan ahead.
• Memory Problems: Sleep is crucial for memory consolidation. When sleep is disrupted, the brain struggles to store and recall information. This can worsen memory difficulties commonly experienced in some forms of ADHD.
• Emotional Dysregulation: Both ADHD and sleep deprivation are linked to increased impulsivity and emotional instability. The combined effects can lead to difficulty managing emotions, outbursts of frustration, and increased sensitivity to stress.

The Vicious Cycle: Sleep Deprivation Worsens ADHD and Vice Versa

This bidirectional relationship creates a vicious cycle. Poor sleep quality amplifies ADHD symptoms, making it even harder to focus, manage tasks, and regulate emotions. This can then lead to increased stress and anxiety, further disrupting sleep patterns.

Poor Cognitive Function Due to ADHD and Lack of Sleep

Both adult ADHD and daytime sleepiness have adverse effects on cognitive function, impacting memory, attention, and processing speed. Individuals with these conditions may experience:

• Difficulty remembering information learned recently (working memory)
• Slower processing speed, impacting reaction times and the ability to complete tasks efficiently
• Executive function impairments further limit planning, organisation, and problem-solving abilities

The challenges don’t end there. Daytime sleepiness resulting from poor sleep can worsen ADHD symptoms by also creating a frustrating cycle. These include:

• Poor Sleep Leads to Daytime Sleepiness: Disrupted sleep leaves you feeling sluggish and tired during the day, making it difficult to concentrate and participate in activities fully.
• Daytime Sleepiness Worsens ADHD Symptoms: The inability to focus and stay on task can lead to frustration, a feeling of falling behind, and reduced motivation to engage in activities, including healthy sleep hygiene practices.
• Reduced Motivation for Sleep Hygiene: Feeling tired during the day can ironically make it harder to fall asleep at night. You might spend more time in bed lying awake, further disrupting sleep patterns.
• Insomnia: Difficulty falling asleep or staying asleep.
• Restless Legs Syndrome (RLS): An uncomfortable urge to move the legs, often accompanied by tingling or crawling sensations.
• Sleep Apnea: Interruptions in breathing during sleep.
• Delayed Sleep Phase Syndrome (DSPS): A delayed circadian rhythm causing late sleep onset and difficulty waking up in the morning.

This cycle can significantly impact an adult’s daily life, affecting work performance, relationships, and overall well-being. Not only can this cause cognitive dysfunction and poor memory, but it also affects their self-esteem, causing frustration over not being able to function like a ‘normal’ or neurotypical person.

Cognitive Deficits Associated with ADHD

Adults with ADHD may struggle with the mental skills needed for everyday tasks. These skills, called executive functions, are like the “managers” of the brain, responsible for things like planning, organising, focusing, and managing time. 

Because of weaknesses in these areas, adults with ADHD might have trouble getting started on tasks, staying on track, or meeting deadlines. Executive functions are higher-level cognitive processes that include:

• Working Memory: The ability to hold and manipulate information over short periods.
• Cognitive Flexibility: The capacity to switch between tasks or thoughts.
• Inhibitory Control: The ability to suppress irrelevant or distracting information and impulses.

Deficits in these areas can lead to:

• Disorganisation: Difficulty managing time and tasks.
• Forgetfulness: Problems with remembering appointments, deadlines, and important details.
• Difficulty in Decision-Making: Struggling to weigh options and make informed choices.

Daytime Sleepiness in Adult ADHD

Many adults with ADHD report feeling excessively tired during the day, even after a full night’s sleep. This isn’t simply laziness; it’s a symptom known as hypersomnia of childhood-onset (type II). Research suggests that several factors might contribute to this daytime sleepiness:

• Disrupted Sleep Patterns: Individuals with ADHD often struggle with falling asleep or staying asleep due to racing thoughts, hyperactivity, or difficulty quieting their minds. This sleep fragmentation leads to inadequate sleep quality, resulting in daytime fatigue.
• Circadian Rhythm Issues: The body’s natural sleep-wake cycle, regulated by the circadian rhythm, may be disrupted in adults with ADHD. This can lead to difficulty falling asleep at night and excessive daytime sleepiness.

What Are the Solutions to Tackle Daytime Sleepiness for ADHD Individuals

While the relationship between adult ADHD, daytime sleepiness, and cognitive function presents challenges, there is hope. Understanding the connection, adopting healthy sleep habits, and seeking professional support can help break the cycle and improve your overall well-being. 

Here are some strategies specifically for adults with ADHD to improve sleep and break this cycle:

• The Key Is Routine: Even on the weekends, go to bed and wake up at the same time every day. This helps in maintaining the normal sleep-wake cycle of your body.
• Wind Down: Establish a calming nighttime ritual that tells your brain when to stop. This can be doing some gentle stretching, reading a book, or having a warm bath. Don’t use phones or TVs with screens for at least an hour before bed.
• Exercise Often: Frequent exercise can enhance the quality of your sleep, but stay away from strenuous exercise right before bed.
• Manage Your Stress levels: Stress aggravates symptoms of ADHD and impairs sleep. Prior to going to bed, methods including deep breathing exercises such as 3-7-8, yoga, and mindfulness meditation can help reduce stress and promote relaxation.
• Talk to Your Doctor: If you suspect a sleep disorder like restless leg syndrome or sleep apnea, consult your doctor. They might recommend treatment options that can significantly improve your sleep quality.
• Light Therapy: If light exposure disrupts your sleep, discuss light therapy with your doctor. Regular exposure to bright light in the morning can help regulate your sleep-wake cycle.
• Cognitive Behavioural Therapy for Insomnia (CBT-I): CBT-I can help address underlying thoughts and behaviours that contribute to sleep problems. This therapy teaches relaxation techniques and strategies for managing negative thoughts around sleep.
• Tomatis® Method as a Different Approach: The Tomatis® Method is another approach that is non-invasive and rewires your brain in a holistic way. It involves listening to music through special headphones.

Since ADHD individuals are more prone to having low self-esteem, here are some additional points to consider:

• Self-Compassion: Remember, you are not alone. Many adults with ADHD experience sleep difficulties. Practice self-compassion and avoid getting discouraged.
• Celebrate Small Wins: Focus on celebrating small improvements in your sleep and cognitive function. Each positive step is a victory on your journey towards better health.
• Advocacy: Educate yourself and others about ADHD and its associated challenges. Advocate for yourself when seeking healthcare and support.

The Tomatis® Method for ADHD and Daytime Sleepiness

The Tomatis® Method might help improve sleep and focus for people with ADHD. Here’s the idea:

• It influences the brain’s sleep regulation through a nerve called the vagus nerve.
• This method might bypass the amygdala, a part that can trigger stress and hinder sleep.
• By calming the nervous system and promoting better sleep, the Tomatis Method could also help with daytime energy levels.
• Additionally, it uses high frequencies to potentially energise the brain, reducing daytime sluggishness in people with ADHD.

This, combined with good sleep habits, could lead to better overall sleep quality, increased focus, and improved performance at work or school for people with ADHD.

It takes time and effort to establish good sleep habits. Be patient, celebrate small wins, and don’t get discouraged if you have setbacks. With consistent effort and the right approach, you can improve your sleep quality and experience the many benefits it offers for managing your ADHD.For more information on managing adult ADHD and improving sleep and cognitive function, visit our website or contact our team of experts at the Tomatis® Method, Australia. Let us help you achieve a balanced and fulfilling life.