By Dr Dalida Duvnjak, Clinical Director for Psychiatry
Do you struggle with sleep?
How many times have you heard “I have always been a bad sleeper”? But what if you or someone you care about is that “bad sleeper”? The sleepless nights, restless hours and frustration of staring at the clock. For people with ADHD, sleep issues are all too common.
Sleep is a basic human need.
We all need sleep to function – it’s a basic human need. Sleep should be a time of rest and recovery, yet for many people, it becomes a source of irritation and anxiety. Lack of sleep can affect our ability to work, maintain relationships and regulate our mood. While short periods of poor sleep can be manageable, long-standing sleep difficulties can create more anxiety around going to bed and a sense of defeat when something that appears effortless for others is a struggle for you.
Sleep and sleep problems are shaped by many factors; life circumstances, demanding or stressful jobs, relationship difficulties, loneliness, parenthood and culture. Many people with ADHD experience persistent sleep issues, sometimes from a young age. Sleep problems are not always linked to stress or worry, for those with ADHD they can also be connected to excitement, overstimulation or anticipation.
Sleep problems and research
Our scientific understanding of sleep has evolved over the last few decades. Research shows that sleep problems, including insomnia and ADHD-related sleep disruption, are common across all age groups and many difficulties go unreported.
Studies suggest that sleep may not arise from a single centre in the brain but instead emerges from a coordinated network of brain regions. For example, the hypothalamus regulates our circadian rhythm – responsible for sleep wake cycles, our brain stem controls transitions between sleep and wakefulness and our pineal gland secretes melatonin, a hormone which helps regulate our sleep pattern.
We know that sleep is vital for rest, recovery and repair. People with prolonged sleep difficulties often report more bouts of illness, pain and feeling unwell. During sleep, certain glands release growth hormones, important for bone maintenance and muscle development. The body also produces cytokines, proteins involved in fighting infection. Prolonged poor sleep leads to a reduction in hormone and cytokine release, impacting how fit and well that person then feels.
What can we do when sleep becomes a problem?
Sleep difficulties are something that happen to us and do not define who we are. For those with ADHD-related sleep issues, positive change is usually achievable, but it is important to find what works for you.
- Physical activity
Walking, running, Pilates and yoga can support better sleep. We know finding motivation for exercise can be tough (especially for ADHD) so find something you like and start to gradually introduce it to your daily routine – even if this is a gentle walk around the block a couple of times a week.
- Reduce evening screen use
Turning off laptops TV and phones an hour before bed reduces stimulation and allows your brain to start to settle down, particularly helpful for ADHD overstimulation at night.
- Use familiar audio
Listening to a familiar podcast or audio book can help the brain wind down and switch off – try to pick something that isn’t too engaging so that your brain doesn’t want to stay awake to listen!
- Consider foods that support sleep
Cherries, walnuts and olives all contain natural melatonin, and foods such as almonds or pumpkin seeds, contain magnesium can support settling down to sleep. Reducing caffeine in the evening can also help winding down before bed.
- Optimise bedroom temperature
Keep your bedroom temperature between 15 and 19 degrees Celsius – this helps our body to lower the temperature needed to start and maintain sleep.
- Find your ideal background noise
Try different levels of noise to see what works for you. Try a silent environment, white or brown noise or calming instrumental music and see which one helps you settle the best. Ambient noise can help to reduce nighttime restlessness for people with ADHD.
- Consider tactile sensations
Choose fabrics for bedding and pyjamas that you can tolerate against your skin, a mattress that is the right firmness for you and pillows that are the right height and softness to support you to sleep. You can also try soft socks to keep your feet warm.
- Manage light levels
Low or warm-glow lighting in the evening can help our brains start to settle before we try to go to sleep. Try a warm-glow night light, or fairy lights in your bedroom or blackout curtains or eye masks to help maintain sleep.
- Calming scents
Body butters, moisturisers and pillow sprays containing lavender and magnesium used before bed can help promote a sense of calm before bed.
- Start with morning consistency
Settling to sleep at the same time each night can be tricky for people with ADHD, try getting up at the same time each morning to start to create a routine. This may feel challenging in the beginning but over time your brain and your body will adapt to the routine and naturally start to feel more ready for sleep. ‘Sunrise’ lamps can help with this as they light up the room slowly before waking.
Over time, our body and brain begin to recognise these changes, and our kindness to ourselves will be rewarded with the good night’s sleep we all deserve.