Sleep Disorders in ADHD & Autism

Jillian Enright

Sleep Disorders in ADHD & Autism

March 14–20 is Sleep Awareness Week

Sleep Awareness

March 14–20, 2022 is Sleep Awareness Week. Sleep disorders are extremely common in neurodiverse individuals, so I want to share specific information related to sleep issues in autism and ADHD. I am fortunate that I usually sleep well nowadays, but this comes after decades of insomnia and sleep issues.

The only reason I sleep well now is that I have a very active job which keeps me outdoors a lot and because I stick to a fairly strict sleeping schedule at least 6 days of the week. If I deviate from this too much, I very quickly regress.

At one point during the pandemic when I wasn’t working, I started staying up a bit later each night. One night I didn’t go to bed until 4 am and then slept until about 11 am the next day.

I knew I had to get back on track immediately, or I would be in for some serious issues. In the past when I had really bad insomnia, it led to severe depression and anxiety, which are common consequences of prolonged sleep loss.

Even short-term sleep deprivation can cause increased reward-seeking behaviors, reduced social skills, and a reduced ability to accurately interpret social cues — things I already struggle with due to being Autistic and having ADHD.

Long-term sleep deprivation can lead to increased mortality, increased accidents and injuries, lower quality of life, decreased family well-being, and poor overall health.

…Yeah. That’ll help with the anxiety.

Sleep Disorders

Not only are sleep disorders common in Autistics and people with ADHD, but sleep disorders are also worsened by sensory modulation issues. Issues with sensory modulation make it difficult for neurodiverse people to tune out or desensitize themselves to unpleasant or overwhelming sensory stimuli.

An interesting study found that 30% of children with ADHD but no sensory processing issues had sleep disorders, whereas 85% of children who had both ADHD and SPD also had disordered sleep.

I couldn’t find any study comparing Autistic people with SPD to Autistics without SPD, but that would be a very small group, considering so many Autistics (as many as 95%) process our senses differently from neurotypicals (NTs).

Interestingly though, neurotypical people with sensory hypersensitivities are also more likely to have sleep issues when compared to NTs without hypersensitivities. Sleep disorders are thought to affect approximately 30% of the general population, whereas at least 80% of Autistics have sleep difficulties.

Insomnia

The most common sleep disorder is insomnia, which makes it hard to fall asleep, hard to stay asleep, or causes people to wake up too early and not be able to get back to sleep.

Insomnia affects approximately 6–15% of the general adult population, but insomnia affects over 44% of adults with ADHD, and anywhere from 50–80% of Autistics.

This isn’t entirely surprising because the reticular activating system (RAS) is implicated in ADHD and autism, a region of the brain that plays a role in regulating our sleep cycles.

Strategies to combat insomnia

The most effective strategy for drastically improving my insomnia has been what doctors call “sleep hygiene”, which essentially refers to lifestyle habits that help set us up for better sleep.

Some of those habits can include:

  • Maintain a consistent sleep schedule.
  • Reduce caffeine consumption (yeah right!), or at least reduce caffeine intake after a set time of day (okay, that I can do).
  • Drink less alcohol: booze may help you fall asleep, but it won’t help you get a restful sleep.
  • Avoid napping.
  • Get regular exercise and fresh air (exposure to sunlight helps regulate our circadian rhythm, making it easier to fall asleep at night).
  • Allow time to wind down before bed — the sleep foundation recommends 30–60 minutes. I find I need at least an hour, usually two.
  • This includes unplugging and avoiding electronics. I charge my phone on a bookshelf a few feet from my bed, so that I can’t easily grab it, but it’s still close by in case of emergency.

For my fellow ADHDers who take stimulant medication, make sure you take it early in the morning! I set an alarm to remind me and keep my medication right by my coffee maker so that I remember to take them first thing.

Stimulant medications can make it difficult to fall asleep at night, especially if taken too late in the day.

Disclaimer: this is not intended as medical advice, simply tips I’ve learned through personal experience, as well as academic research.

If you feel you have good sleep hygiene, and still really struggle to fall asleep or stay asleep at night, you may want to speak to a medical professional for more personalized advice and support.

A bedtime routine

Having a regular bedtime routine also helps signal to your body that it’s time to prepare for sleep.

This may involve dimming the lights in your home, changing into comfortable pyjamas, or listening to quiet and relaxing music. Practicing meditation, deep breathing, mindfulness exercises, or other relaxation techniques may help.

For me, I absolutely have to read before bed. I nearly read all day long, but I have to switch from reading academic material to something enjoyable that doesn’t require as much concentration, such as an entertaining fiction novel.

Sleep experts also recommend keeping your bedroom for sleep only, but they kindly allow sex as an exception, so there’s that. Sweet dreams!

© Jillian Enright, Neurodiversity MB

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References

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Crasta, J. E., Salzinger, E., Lin, M. H., Gavin, W. J., & Davies, P. L. (2020). Sensory Processing and Attention Profiles Among Children With Sensory Processing Disorders and Autism Spectrum Disorders. Frontiers in integrative neuroscience, 14, 22. https://doi.org/10.3389/fnint.2020.00022

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Fadeuilhe, C., Daigre, C., Richarte, V., Grau-López, L., Palma-Álvarez, R. F., Corrales, M., & Ramos-Quiroga, J. A. (2021). Insomnia Disorder in Adult Attention-Deficit/Hyperactivity Disorder Patients: Clinical, Comorbidity, and Treatment Correlates. Frontiers in psychiatry, 12, 663889. https://doi.org/10.3389/fpsyt.2021.663889

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Neurodivergent. 20+ years social work and psychology experience. I write about mental health, neurodiversity, advocacy, education, and parenting. Founder of Neurodiversity MB. CYW, BA Psychology.

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