7 Steps to Get Better Sleep When You Have ADHD

sleeping women

How is it possible to get better sleep when you have ADHD? In this blog, we take a look at seven key steps that you can implement right away to help you or your child get better sleep when you have ADHD.

Please note that the third strategy onward is based in our 5 step model of correcting your circadian rhythm for better sleep when you have ADHD, which includes, Light, Sound, Temperature, Food and Activity.

There are so many things that may need to be corrected if you want better sleep when you have ADHD, that it can get overwhelming, which is why this simple 5 step model is an easy way to make sure you're getting to the core of the problem.

sleeping women

1).Think Quality Sleep versus Quantity.

Less is more. 6-8 hours quality sleep is better than longer but lesser quality sleep. If you need to catch up with sleep, then do not sleep longer in the morning but go to bed earlier instead.

If sleep quality is good, then most of us do not need more than 8 hours per night, and more is not necessarily better. That said, of course, everyone is different, and it depends on many factors such as age.

In fact, do not assume "I need to get 8 hours sleep" because, believe it or not, you may in fact function better on less.  If in doubt here is a table of suggested sleep hours by age: https://www.newscientist.com/article/mg23030750-300-how-much-shuteye-do-i-need/ 

Please note that we sleep in 90 minute cycles, so when you wake up at the end of the cycle you feel refreshed and alert, and yet if you wake up in the middle of a cycle you can wake up groggy.

You may find that by waking up at the end of a cycle, even if it's less sleep, you feel more refreshed and alert than if you woke up during a cycle of a longer sleep. There are apps like Sleep Cycle which you can use that measure your sleep cycles and wake you up at the end of a cycle to make sure you wake up refreshed. I have used this in the past and it really works. However, be careful to make sure your phone is in airplane mode (all WIFI, bluetooth and phone signal switched off) as this may interfere with your sleep quality. https://www.sleepcycle.com/

routine

2). Be as Regular and Consistent in Your Sleep Routine as Possible.

When you become a teenager or leave home it seems cool and adult to stay up till the wee hours, and sleep in the day. But the reality is that it does your ADHD brain no good. I know it's not cool, but when it comes to having a bedtime routine, sorry, your parents were on the money!

Stay consistent with sleep and wake cycles.  The key is to always wake up at the same time, and make sure your bedtime is roughly the same time (within an hour). The time you wake up is the number one factor in your circadian rhythm, and surprisingly you'll find that if that can be kept constant, even when you have a bad night's sleep, you will feel much better waking up at the same time than trying to catch up. At least in the long run...

Many parents have asked me where to start with an ADHD teenager who goes to bed at 3am. The answer?

“Don't ask them to go to bed at a reasonable hour like 10PM, because for them that's not reasonable. Instead, aim to go to bed 10 mins earlier the first night. That's believable and easily achievable; and, once achieved, 20 and then 30 mins won't seem so difficult because they'll enjoy success from the outset.”

The circadian rhythm or biological clock can be reset, but it's not instant like an alarm clock! Give it time. Think: “less is more.”

To help my clients figure out the best time to actually aim for sleep, I recommend using the Horne-Ostberg Morningness/Eveningness Questionnaire (MEQ) to discover the best rhythms for your biological clock: http://www.cet-surveys.com/index.php?sid=61524

You may be surprised. Like many with ADHD, I assumed I am a “Night Owl” because I have always tended to stay up excessively late. However, it turns out that I am “intermediate” or average in my scores. Therefore, many of us just assume we are “Night Owls” because of our bad sleep habits, and even then – if you are a night owl – and have ADHD, the combination could be lethal!

Because of the ADHD you end up exaggerating how much of a Night Owl you actually are. So do the MEQ Questionnaire and find out what is optimal for you, and adjust accordingly, not to what you think, or what you are used to, but to what is truly natural for your chronotype.

sleeping naturally

3). Light: Turn the Lights Down Low & Sleep In Darkness

It may seem an obvious thing to say, that our brain requires darkness for sleep, but in our modern “24-7 always on” world, full of artificial lighting, and a recent trend towards lighting which tends towards the blue end of the spectrum, blue light is a major factor in poor sleep and circadian rhythm disorder (CRD).

Too much blue light will confuse your brain by stimulating it and lead it to think that it's daytime. It will suppress the release of the sleep hormone melatonin.

The number of times I've had a client who reports bad sleep and when asked about their sleep routine tell me they “scroll on my phone in bed”! And it's not just in my practice. Researchers have found a link between late night device use and insomnia, because blue light from your device can block melatonin up to 99%.

To combat this, make sure to to turn the lights down low at least one hour before your intended sleep time. You may even want to have bulbs for the evening time which are amber in colour.

However, due to light sensitivity, some people with ADHD may need to begin this process 2 hours before sleep.

Switch all your devices into Night Mode and/or use free apps like Twilight or f.lux to block blue light. Better still why not give chronotherapeutics a go. This means wearing a pair of blue-light blocking glasses before bedtime, which have been shown to improve sleep latency (how fast you fall asleep), reduce insomnia, and reduce anxiety in those with ADHD. They are also highly effective at helping you to adapt to an earlier sleeptime. [1, 2]

sleep saviour blue light blocking glasses

The particular glasses which I personally use and recommend to my clients, which also block out green light, are called Sleep Saviours. I noticed myself becoming drowsy within 20 minutes of wearing them, and found that within 2 weeks of wearing them they were as effective as taking melatonin, giving me 8 hours of refreshing sleep. https://safetyblueblockers.com/

When you go to sleep, make your room as dark as possible. Use black out blinds and/or eyemask. Switch off any lights in the room. Even one LED from a device in your room may be enough to interfere with the quality of your sleep. Only use red light as a night light.

Finally, there is research to indicate that the brain may respond to EMFs from WIFI enabled devices and confuse radio-waves for light.[3] Many of my clients have reported sleeping with their mobile phone next to or even underneath their pillow! When asked to move their phone away from their bed they have noticed improved sleep.

So make sure that your WIFI is switched off at bedtime and that there are no WIFI enabled devices running in your bedroom. In most phone settings this is merely a case of switching to airplane mode, but some phones, especially Apple, will also need the WIFI and bluetooth to be switched off separately.
If in doubt, just place the phone as far from the bed as possible. If you have children, it may be best to remove devices from the bedroom entirely until the morning.

quietness

4). Sound: Quietness helps you to sleep.

Your bedroom should be as quiet as possible. If too loud, use a pink noise/white noise machine, fan, or the app lightning bug to play soothing nature sounds which can mask distracting sounds. https://play.google.com/store/apps/details?id=com.media1908.lightningbug&hl=en_GB&gl=US

Just as the lights should be lowered and artificial light needs to be avoided 1-2 hours before bed, you similarly need to lower the volume of sound 1-2 hours on the evening, and then aim for silence at bedtime or use soothing sounds. The sound of ocean waves or rain can be particularly effective at inducing sleep.

women in cold

5). Temperature: Cooler temperatures help trigger and deepen sleep.

Research shows that a slightly cooler temperature at bedtime (approx 15c) creates a strong signal to the brain to sleep (increasing the release of sleep hormone melatonin), whereas a warmer temperature in the morning can signal the brain to wake up. Each individual will be different in this regard, but certainly nighttime temperatures always need to be somewhat cooler to facilitate sleep. Less than one degree may be enough to stop you from falling asleep or wake you up.

It may seem paradoxical, but also having a hot bath, shower, or sauna, followed by cooling down rapidly, can signal the brain to sleep. This should be done approximately 90-120 minutes before sleep and can speed up the sleeping process significantly.

man wearing cryohelmet for better sleep

Finally, if you or your child really struggle with insomnia, you may want to consider the use of a night-time cooling cap. Research shows that wearing a headcap which cools the brain (chryotherapy) has been found to calm the mind and facilitate deeper sleep. [4] A company called Catalyst offer cryohelmets at a resonable price. https://www.cryohelmet.com/store

empty menu as fasting

6). Food: Avoid stimulating food on the evening and fast to improve your sleep.

The eating of food signals the body to wake up, and conversely lack of food facilitates sleep.

So for good sleep avoid heavy meals before bedtime. It is best to stop eating 3-4 hours before sleep and only drink water or herbal tea after that point.

This triggers autophagy which not only improves sleep but also increases the cellular repair process in the body, meaning that sleep will be more efficient and refreshing, and you'll be more likely to wake up early in the morning, refreshed and energised and alert.

If you must have something on the evening, or have a child with ADHD, then opt for a liquid drink such as warm milk with some banana which can help them fall asleep due to the tryptophan content.

Be careful with consumption of certain foods on the evening, such as spicy foods, or anything containing caffeine. Depending on individual tolerance, even a small piece of chocolate can be enough to spoil sleep as it contains caffeine, and it can take up to 10 hours for the effects of caffeine to wear off. This means that in some particularly sensitive individuals that caffeine may need to be prevented after midday.

Conversely, we also know that some individuals with ADHD actually find it easier to sleep by taking medication (including stimulant based) at bedtime. We are all different. The key is to experiment and find out what works for you. In the case of taking medication at bedtime, however, you may want to consult your medical health professional for further advice.

7). Activity: Learn to relax and wind down at bedtime.

This may sound obvious, but we all need reminding of this, especially when you have ADHD. How many times have you started playing exciting music late at night, had a late night workout, or started doing lots of work at a computer?

You might “feel like it” but doing so signals the brain to wake up even more and will program your circadian rhythm to make you even more active at night in future. The trick is to learn to calm down and relax at bedtime and program your internal biological clock for rest.

Whilst this isn't an article about waking up, nonetheless having a good morning routine will help improve your sleep. For example, make sure to get out in the natural light as early as possible in the AM (preferably within 30 minutes of waking up) as this will improve your circadian rhythm and also the serotonin from natural light will convert to higher levels of melatonin at bedtime.

Research suggests that exercise is generally optimum for sleep when performed at 5pm, although exercise should never be performed as late as 20:00-21:00 as it can leave you over-stimulated before sleep, and even if you do sleep it may be fitful, not as deep, or as efficient.

As a rule of thumb do not exercise 3-4 hours before your usual bedtime. That said, some people with ADHD may respond differently to evening exercise, so experiment to find out.

If you really struggle to relax on the evening, then learning relaxation techniques such as deep breathing, meditation, or hypnosis can really help.

If you use a hypnosis track, however, be careful to avoid one which tells you to wake up at the end. What tends to happen is that you'll be drifting off during the hypnosis, but the suggestion to wake up at the end is taken literally by your subconscious and then you wake up again feeling super alert! Opt, instead, for a specific sleep hypnosis track designed to be listened to directly before sleep, or practice self hypnosis.

Conclusion: One Step At A Time

So there you have it. 7 key strategies to not only help you get better sleep when you have ADHD, but also your ability to wake up energised in the morning.

Remember to go easy on yourself. Resetting poor sleep and wake habits can take a while. But once you've done it, it will become more natural to you.

If at any point things slip, as they often will (especially when you have ADHD) remember that at least you now know how to get a good night's sleep. “Slip up but don't give up.”

You're now armed with all the knowledge you need to get that sleep you've been longing for. It's just a case of making these changes. You may find the help of a sleep coach, ADHD coach, or ADHD hypnotherapist, helpful in implementing and sticking to these changes.

REFERENCES

[1] Blue Blocking Glasses Developed to Improve Sleep in ADHD, John Carrol University, 2007, in Science Daily https://www.sciencedaily.com/releases/2007/11/071112143308.htm
[2] Treatment of Attention Deficit Hyperactivity Disorder Insomnia With Blue Wave-Length Blocking Glasses, University of Alabama, 2012 https://www.lightforfitness.com/wp-content/uploads/2019/11/HIGH-LIGHTED-Treatment-of-ADHD-insomnia-with-blue.pdf
[3] Technology and Our Healthy Sleep, Environmental Health Trust https://ehtrust.org/key-issues/cell-phoneswireless/screens-and-sleep/
[4] Putting Insomnia on Ice: Cooling Down Our Brains May Help Us Sleep Better, Scientific American, November 2011 https://www.scientificamerican.com/article/putting-insomnia-on-ice/

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