Did you get by on just a few hours of sleep last night, or do you tend to have difficulties staying asleep once you finally doze off? The Centers for Disease Control and Prevention notes that 1 in 3 Americans aren’t getting adequate sleep, which can increase the risk for health problems such as diabetes and stroke. Having attention deficit hyperactivity disorder contributes to this statistic. Studies presented at a September conference in Paris highlighted that about 75 percent of children and adults with the disorder have sleep difficulties.
[See: 8 Things You Didn’t Know About Counseling.]
First Things First: It’s Not About Willpower
“There are neurobiological reasons as well as behavioral reasons why people with ADHD experience sleep challenges,” says Roberto Olivardia, a lecturer in the department of psychology at Harvard Medical School, who runs a private psychotherapy practice in Lexington, Massachusetts. The one thing it’s definitely not about, he says, is lack of willpower. “It’s not an issue of will,” he explains, noting that people without the disorder should refrain from asking “why don’t you just go to bed early?” or “everyone else just gets in bed and falls asleep, so why can’t you?”
“The ADHD brain is wired in a way that makes sleep difficult,” says Olivardia, who sits on the Scientific Advisory Board for ADDitudemag.com and serves on the Professional Advisory Board for Children and Adults with Attention-Deficit/Hyperactivity Disorder. “There are biological underpinnings. For these people, sleep difficulties or not wanting to go to bed isn’t about being obstinate or oppositional.”
He explains that it’s difficult for the ADHD brain to “surrender to slumber,” in which people may wake up throughout the night frequently, have sleep disorders like sleep apnea or have delayed sleep phase syndrome — a circadian rhythm imbalance which leads to later bedtimes and longer wake-up times.
ADHD Behavior and Lack of Sleep
Behaviorally, Olivardia says that people with ADHD often want to work in the evening, enticed by the fact that there are fewer distractions than during the daytime. Because friends and family are less likely to call at midnight and children are sleeping, the thought is that there will be more of an opportunity to find and maintain focus. The problem, according to Olivardia, is that this “hyperfocus of productivity can be hard to shut off and get to sleep.” He says it’s not unusual for people with ADHD to engage in high-stimulation activities at the end of the day, from online interactions and watching television to reading a highly-engaging book. These people may feel as though they’re “on a roll” and not want to stop whatever it is that’s piqued their interest.
Ultimately, all of this potentially spells trouble for someone with ADHD. Over time, lack of sleep can “exacerbate all ADHD symptoms,” Olivardia says.
Addiction to Stimulating Activities
Sue West, a productivity and ADHD coach based in New Hampshire, says that it’s usually a struggle for people with ADHD to get through the day. Executive functioning skills, which pertain mostly to setting priorities and organizing, often wear out for these people by the end of the day, West explains. However, she says it’s typical for a second wind to come along, many times bringing with it an addictive behavioral component that’s common among people with ADHD. She notes that technology is one such addition that can disrupt the body’s circadian rhythm and create a double whammy. When this second wind is coupled with feeling more stimulated because of electronic devices, (specifically, the light emitted from them — which Olivardia says “hits the brain like strobe lights,” especially when looked at in a dark room) it can create a never-ending cycle that makes a person less interested in falling asleep.
[See: Hoarding, ADHD, Narcissism: Inside the Minds of History’s Great Personalities.]
Manage Time During the Day
To get a better night’s sleep, West says it’s “not about just getting to sleep, but how well you manage time and tasks during day.” For example, she suggests setting a reminder about an hour or so before the end of your workday that allows you to finish tasks (instead of running out of time) and leave at an appropriate time. “Update the to-do list,” she says, and “literally think about closing a door on the day” so work-related activities don’t linger in your head and keep you up at night.
Develop ‘Anchor Points’
West also suggests setting a bedtime which provides “anchor points” for people with ADHD who often struggle with a sense of time. She says to set specific times such as regular wake-up and supper times, as well as breaks throughout the day or times when electronic devices will be turned off or left elsewhere in the house. This helps instill a sense of time so tasks can be completed in a productive manner that negates the urge to stay up late and in turn, go to bed at a reasonable time. “Accountability partners” can help with this, West says, adding that people with ADHD may want to have a spouse or partner provide reminders about things like task duration or leaving an electronic device downstairs instead of on the nightstand after a certain time.
Prepare the Body for Bed
“Create an external environment that tells the internal environment — the body — that it’s time to go to bed,” Olivardia says. About an hour to an hour and a half before bedtime, he says someone with ADHD should avoid stimulating activities and instead, develop routines that ready the body for sleep. Brightly lit rooms don’t send signals to the body that it’s time to sleep, so one option is to dim lights in the house before bedtime. He also adds that people should consider changing into pajamas about two hours before bedtime. Doing these things helps “ease the body into this transition” of sleep and provides a sense of relaxation.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
Heavy Comforters, Dark Rooms
Olivardia also suggests sleeping in a cool room with a heavy comforter, noting that the weight and warmth of the comforter can be enticing, especially amid the cooler surrounding bedroom environment. At the same time, a heavy comforter acts as a “literal and figurative symbol of grounding,” which can be soothing for someone with ADHD.
Covering up bright digital clock numbers and putting up room-darkening curtains in the room can also help promote sleep, shutting out simulating sights that can disrupt the process. “The ADHD brain is vulnerable to any level of stimulation, so if you give it an inch it will want a mile,” Olivardia says. All of these ideas, he says, “tell the brain that there’s nothing to do here but close our eyes and sleep.”
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How to Ensure a Good Night’s Sleep for Those With ADHD originally appeared on usnews.com
