Poor Sleep and ADHD and How to Improve it

biological clock

In this report, we take a look at ADHD and sleep and explore why we struggle with it and what we can do about it.

Poor sleep is common to children and adults with ADHD. It seems to come with the territory, so much so that some researchers have even explored the possibility that ADHD could in fact be a sleep disorder.[1]

This is not an unreasonable hypothesis when you consider that if someone who doesn't have ADHD has a few bad night's sleep, they will begin to appear very much like someone who suffers from ADHD. In fact, there are indeed some instances where people suffering from a sleep disorder, have appeared to have ADHD when they haven't.[2]

So imagine (or you may not need to, because you have it) what it is like when someone actually has ADHD and poor sleep? That's right. It's double-whammy. A recipe for disaster.

Conversely, getting a good night's sleep can have a profoundly positive impact on your symptoms of ADHD. In fact, when sleep is good, it can seem for some like ADHD is a thing of the past, or at least you're much better equipped to manage it with less tears and more patience.

biological clock

Resetting Your Biological Clock

Before we get into the sleep tips when you have ADHD, that you can begin practicing right away to improve you or your child's sleep, it's important to understand a key concept called the “Biological Clock”.

There is a part of the brain called the suprachiasmatic nucleus (SCN) inside the hypothalamus which controls your circadian rhythms. The circadian rhythm is like a set of internal Biological Clocks which help to control many neuronal and hormonal cycles during a 24-hour period.

Think of it this way: Your alarm clock is one dimensional. It makes a sound to wake you up. However, the Biological Clock is multi-dimensional.

In simple terms, light, warmth, noise, food and increased physical activity, signals the biological clock to cause the body and brain to be awake and active in the morning, whereas the opposite (low light, coolness, quiet, lack of food, and low activity) signal the body and brain to be relaxed or sleepy.

Interestingly, when your Circadian Rhythm is balanced and regular, not only will your sleep and ability to wake up improve, but so too will your energy levels, motivation, and ability to focus. Not least of all, is that when your Circadian Rhythm (Biological Clock) is regular, your sense of time improves, which is of course a key difficulty for people with ADHD and is related to poor Executive Functions (organisation).

It should be noted that research shows the majority of people with ADHD have poor sleep and issues with Circadian Rhythm, so correcting the circadian rhythm is a key not only to better sleep, but an improvement in most of our symptoms.

Is it a coincidence that more people with ADHD tend to miss meal times, vary the time they wake up or fall asleep, and also seem to wear watches less often. All of this affects our sense of time. Of course, these habits may be due to ADHD, but simultaneously they certainly make it worse! I didn't wear a watch for most of my life, for example, but noticed when I did that my sense of time was greatly improved.

The aim of this report, because we are aiming to improve your sleep, is to learn to program your biological clock in a way that means you find it easier to relax, fall asleep, and stay asleep, at bedtime.

That said, you should bear in mind, that what you do in the daytime, especially the morning, also has a big knock-on effect to your ability to sleep properly. The two – morning and evening – are to be considered inseparable from each other.

However, one step at a time. Let's focus on the evening side of the equation here, as your main interest is sleep, and then when that is beginning to “stick”, you can move on to correcting the morning side of the equation if you wish. That said, if you already experience good sleep, then you may want to go straight to “7 Tips to Help You Wake Up In the Morning When You Have ADHD” here.

women with insomnia

Why People With ADHD Suffer Poor Sleep

There are lots of reasons why children and adults may struggle with poor sleep, including a racing mind, evening hyperactivity, inability to relax, restless leg syndrome (RLS), and of course a disturbed circadian rhythm or Circadian Rhythm Disorder (CRD).

Of course, whilst this article and the practical suggestions to follow can help anyone with difficulty sleeping, nonetheless you may also want to go a step further in some instances, especially if for example there is a sleep disorder such as Sleep Apnea (disordered breathing). Working with an expert on sleep or attending a sleep lab may be required, in some instances.

For most people, however, following these suggestions can help. The trick with ADHD, though, is being able to put them into practice and stick to your new plan. That's where the possibility of a sleep or ADHD coach, or indeed ADHD Hypnotherapist, may come in helpful, to help you to make and stick to these all important changes.

night owl

Why We Stay Up Late

There are various reasons why we may stay up late or struggle to get to sleep. You, or your ADHD child, may have anxiety which becomes distracting on the evening, the mind may be racing with ideas/thoughts, or we may just struggle to wind down and relax.

Naturally, on the evening when there are less distractions, or because we are “Night Owl” chronotypes (versus Larks, early riser chronotypes), we feel more inclined to focus and get things done. We may be happy that we can finally get work done and take advantage of it. But it also means staying up late.

And herein is the dilemma: an unreasonable trade-off between activity and poor sleep and energy levels. When we wake up next day we will feel low in energy, struggle to get motivated, and often sleep in for longer. This causes worse sleep again the following night, and also exaggerates our natural tendencies as Night Owl chronotypes. We struggle to get up more, and struggle to sleep more.

Over time this gets worse, and we end up with severely damaged Circadian Rhythms (Circadian Rhythm Disorder, CRD, which is common in ADHD). Our biological clocks end up severely out of balance, and over time we just get worse.

sunrise

The Difference Between ADHD & Being a Night Owl

Yes, people with ADHD tend to be Night Owls and late riser chronotypes, but people with ADHD take this to extremes. You may be a night owl, but even 100% night owls gain no advantage by staying up any later than midnight. Past that point, it's not because you're a night owl, it's because you have ADHD which is exacerbating your pre-existing tendencies.

When I did the Morningness-Evening Questionnaire (MEQ) it confirmed that I am a Night Owl, surprise surprise! However, it also showed how my optimum bedtime was much earlier than my ADHD had led me to believe. It was even able to predict when the sleep hormone melatonin started to release in my brain by accurately predicting when I would first start to yawn. That was at 2130, which means even though I was not going to bed until midnight and gone, my body naturally wants to sleep by about 1030.

But what happens when you have ADHD, or indeed to anyone that doesn't listen to their natural bio-rhythms, is that you push your body past it's desired sleep-time, in this case 1030PM, and then you have a “second wind.” In other words, you push your body and brain to stay awake with an extra dose of cortisol or adrenalin. That's like having more coffee to keep yourself awake longer. Far from ideal...

Discovering the truth about my actual sleep time, helped me to realise that I was in fact staying up late due to my ADHD tendencies, and that this was in turn exacerbating my ADHD symptoms and leading to circadian rhythm disorder (CRD) which is common in people with ADHD. But by acknowledging that it wasn't because of being a Night Owl or because of ADHD, I was able to identify my poor Sleep Hygiene habits (or lack of Sleep Hygiene!) and make the necessary corrections to get myself to sleep at a more reasonable time.

When I work with ADHD clients as a hypnotherapist, my job is not about clicking my fingers and using hypnosis to make people sleep or wake up, but is very much about helping them to understand why they have poor sleep and how to correct it.

I invite you, as I invite my clients, to complete the Morningness-Evening Questionnaire (MEQ) which is research-based, and will help you realise that even extreme night owls with ADHD are designed to go to bed earlier https://www.cet-surveys.com/index.php?sid=61524&newtest=Y

if you stumble make it part of the dance

Old Habits Die Hard: Be Patient & Give It Time!

The good news is, this can be corrected. But it takes correct knowledge, and practice until you get there. Don't expect changes over night. Unlike a normal alarm clock which can be reset immediately, the Biological Alarm Clock takes a while to reset itself. You have to be as consistent as possible. Not one of our best traits, but it can be done.

Many parents have asked me “How do I get my teenager with ADHD to go to bed at a reasonable time?” I always reply that if they've been going to sleep at 3am, you asking them to go to sleep at a reasonable time, i.e. 10PM, is not a reasonable request.

A reasonable request, employing the philosophy of “less is more”, is to suggest going to bed 20 minutes earlier. That's believable and achievable rather than self-defeating. And when that occurs, then they can move on to 40 minutes earlier. Doing it this way, they may not be going to bed at 10PM, but they will be able to make significant progress within just a week, leading to the possibility of further progress...

sensitivity

Why Sensitivity Can Keep You Awake At Night

We also need to bear in mind that people with ADHD, as one of their cardinal traits, tend to be sensitive. This can include emotional and social sensitivity, and also sensory sensitivity, such as to light and sound. The latter is interesting to consider in the context of sleep, because we know that people with ADHD often have some level of “light sensitivity” or more likely to suffer from Seasonal Affective Disorder (SAD).[3]

Why is this important? Well, it seems that this sensitivity may exacerbate issues with the circadian rhythm. To get decent sleep you may need to be more careful than neurotypicals. For example, when wanting to sleep on the evening, we generally need at least 1 hour of low light before sleep, including the avoidance of blue light exposure which tends to come via screens. (Blue light will signal the Biological Clock that it is daytime, and suppress the release of the much needed sleep hormone melatonin).

That said, people with ADHD and/or light sensitivity may need to observe a longer “wind down” period, such as 2 hours minimum before sleep, because their brain may over-react to light. This also applies to engaging in anything stressful, emotionally arousing, exciting, and other sensory elements such as sound.You'll learn more about sensory control in the next section.

good sleep hygiene

How To Improve Your Sleep Hygiene

The trick to improving your sleep, is to improve what is called “Sleep Hygiene” which will help reset the brain's Biological Clock.

There are many aspects to this, and to make it easier to follow I will break them down into the categories we used earlier for the Circadian Rhythm, including:

  • Light – Keep it dark on the evening, 1-2 hours before intended sleep time.
  • Sound – Keep it quiet or soothing, 1-2 hours before intended sleep time.
  • Temperature – A cooler bedroom temperature will encourage sleep.
  • Activity – Learn to slow down and relax, to wind down 1-2 hours before sleep.
  • Food – Avoid anything stimulating such as caffeine or spicy food and if possible avoid any calories 3-4 hours before sleep-time for optimal sleep and energy.

These are the main 5 that we will focus on. But don't get overwhelmed by trying to do all of these at once! Otherwise you will struggle and possibly give up on the process.

simple

Practice the Philosophy of “Less Is More”

Instead, remember to apply the philosophy “less is more”, which is so helpful when we have ADHD. In this instance, we focus on identifying the number one area of Sleep Hygiene that needs improving.

We focus on getting one new habit into place at a time. Give it a week. Think of it more in terms of what I call a “rolling contract.” You commit to just one week, which seems possible compared to “permanent.” When you complete the first week, you then feel more likely to give a second week a go because you're motivated by your initial success. And remember, if you fall off the horse, just get back on! “Slip up but don't give up.”

Once you're managing this new habit most nights, move on to the next habit. Also, correcting your circadian rhythm and getting a good night's sleep doesn't mean you have to do all of these. You may only need to target the “weakest link” or “links.”

If, for example, just making your bedroom darker at bedtime and avoiding blue-light 1 hour before sleep works for you, then that may be enough.

If you found this article helpful, why not check out the next article, where we dive deeper into the practicalities of how to get a good night's sleep when you or your child has ADHD - “7 Steps to Get Better Sleep When you Have ADHD” will take you in depth into all the key strategies and tools you need to get a good night's rest...

 

References

[1] Which Came First: ADHD or the Sleeping Problems? https://www.healthline.com/health/ahd/sleep-problems 

[2] ADHD & Sleep Disorders: Are Kids Getting Misdiagnosed? https://childmind.org/article/adhd-sleep-disorders-misdiagnosed/ 

[3] ADHD & Seasonal Affective Disorder https://www.psy-ed.com/wpblog/adhd-and-sad/#:~:text=%2D%20Those%20with%20ADHD%20are%20more,poor%20concentration%2C%20among%20others.)

 

Leave a Comment