Getting a Good Night’s Sleep with ADHD

Sleep disturbance is a very common problem among people with ADHD and seems to become more severe with age. Adults with ADHD can struggle with a variety of sleep problems, however, the most common sleep issue is what can be described as “night-owl syndrome” (officially termed Delayed Sleep-Phase Syndrome) in which individuals tend to get a “second wind” no matter how tired they may have felt during the day and early evening, and have difficulty falling asleep at night.

Delayed Sleep Phase Syndrome seems to have an almost addictive appeal to many adults with ADHD. “These are the only hours I have to myself,” a busy mother with ADHD might say. Or, “These are the only hours when my head feels clear and I can think.” Some with ADHD actually use these hours to do productive work, but more often they are spent in escapist activities such as watching television or surfing the net. Despite chronic fatigue, some with ADHD are strongly resistant to changing their sleep habits. Their night-owl hours are almost a secret addiction — a time when the demands of the world go away and they can do as they please without interruption.

Few of these night-owls fully recognize the damage they are doing to their health and to their ability to focus and function. Inadequate or interrupted sleep has a significant impact on the frontal lobes of the brain — essentially giving adults a double-dose of ADHD! Being a night-owl is no laughing matter. Many adults put their employment at risk through chronic late arrival after too little sleep. Others put their health at risk, and stumble through their days over-dosing on caffeine which further contributes to their difficulty falling asleep the following night.

Getting adequate, regular sleep each night should be a primary goal of therapy for ADHD. You may need to try a variety of approaches before you find the magic equation that works for you. Consistency is the key. So don’t try to get by on little sleep all week and think you can “catch up” on the week-end. You’re only giving yourself a big dose of jet-lag that exacerbates your sleep problems. Try the following guidelines consistently for two weeks and chart your hours of sleeping and waking. If your sleep difficulties persist, you may need to add additional approaches.

Discuss this with your therapist.

Set a lights-out time that is a full 7 (or 8) hours before you need to get up.
Get in bed at least 45 minutes before your lights-out time. If you want to fall asleep by 11 (to get up at 6 or 6:30 p.m.), then you need to be in bed by 10:15 p.m..
No TV or internet for 45 minutes to an hour before getting in bed. (In this case, no TV or internet after 9:30 p.m.).
Don’t eat in the hour before bedtime — digestion can interfere with sleep.
Take a hot bath or shower before getting into bed. Body temperature naturally drops as one goes to sleep. By warming yourself up in the shower, your body temperature will naturally drop after you get in bed, promoting sleepiness.
Read magazines, catalogs, or books (no exciting page-turners that will tempt you to keep the light on).
If reading is not your thing, try listening to books on tape or relaxing music.
If you still can’t fall asleep, try
benadryl (a safe, over-the-counter decongestant that can be sleep-inducing),
drinking SleepyTime tea, or
drinking a glass of warm milk flavored with real vanilla and a teaspoon of sugar.
Meditation tapes can also be sleep inducing. Try the “Brain Train” tape at mindworkspress.com
If sleep continues to evade you, don’t get up and become active, watch TV or get on the internet — more stimulation will only make the problem worse. Stay in bed and read quietly using a book light so that your room remains darkened.
If you’ve tried all this and you’re still not sleeping, consider your caffeine intake (coffee, tea, sodas, chocolate). Caffeine can stay in the system a long time. Try no caffeine after lunch and if that doesn’t work, limit caffeine to breakfast each day.
Still not sleeping? Another non-medication sleep aid is the Alpha-Stim device which sends mild electrical stimulation to the brain via ear clips, producing relaxing Alpha brain waves. Talk to your therapist about purchasing an Alpha-Stim device through the clinic.
Regular daily exercise is an important and healthful way to promote good sleep. But be sure not to exercise right before bed. Exercise either in the morning, at noon, or early evening after work.
Get up on time, at the same time, each morning, even if you haven’t had enough sleep. Sleeping late will only continue your night-owl pattern. A brief nap later in the day is OK if you’re very tired, but not after 4 p.m.
If waking up is hard, try setting your alarm 45 minutes before get-up time. Take your stimulant medication then and go back to sleep. By the time that your alarm rings at 6:30 a.m. the medication will be in your system and you’ll feel more energetic and alert.
If you’ve tried all of these consistently for a period of three weeks and sleep still evades you, it’s time for a medical consultation.