1. Do Your Own Sleep Study Good solutions depend on good data. Don't depend on your memory when analyzing your sleep habits and patterns.
Remember Jake? In an effort to prove his wife wrong (that he indeed was coming to bed regularly by 10 p.m.), he gathered data. He downloaded a sleep-tracking app to his smartphone. (Two popular choices are the SleepBot Tracker Log and Sleep Cycle.) Jake was able to track when he puts his head on the pillow at night and when he gets out of bed in the morning. "My wife was right," Jake admits. "I wasn't getting to bed when I thought I was."
Jake also gained a tool for monitoring improvement: "I can track the effect of changing variables on my sleep, such as when I watch the news at night or read a book. I also learned that getting exercise first thing in the morning helped me feel sleepier in the evening, so, instead of ignoring the alarm that tells me, 'Time to get ready for bed,' I go to bed." In the past, without such data, Jake would have not been able to connect cause and effect, much less accurately remember whether he’d gotten exercise that morning.
Jake places the phone under one corner of the fitted sheet (to keep it from moving around), and tracks nighttime movements through the phone's built-in sensors (accelerometer and orientation). Note: This can provide information for your physician to determine whether a formal sleep study might be advised. If you don't have a smartphone, a pen-and-paper sleep log will do. The important thing is that you're gathering hard data instead of relying upon your memory or perceptions.
All in all, Christine and Jake rest easier, now that she no longer feels the need to nag him to sleep.
2. Organize Your Brain If, despite your best efforts at gathering data, you can't improve your "sleep hygiene," try to get organized -- organize your brain, that is.
"A disorganized brain cannot go to sleep," Quinn explains. By contrast, an organized brain can focus on the task at hand, while tuning out distracting stimuli, whether it is focusing on paperwork or sleep.
Stimulant medications help many people with ADHD "organize their brains" during the day. They can also help at night. For some, stimulants cause nighttime disturbances, especially in those with co-existing anxiety or depression. But several studies show that taking a low dose of stimulant about 45 minutes before bedtime can promote the onset of sleep as well as improve its quality and duration for some children and adults with ADHD.
Initially skeptical, Mari was impressed when she tried taking stimulants a couple of hours before bed. Not only did she move through evening chores more efficiently, she also had better judgment about when to "turn off" the distractions. Moreover, she fell asleep within 20 minutes of going to bed and awoke refreshed.
Taking a stimulant at bedtime is not the only way to organize your brain, however, nor should it be the first option. You can try the following strategies:
> A WHITE NOISE MACHINE, which blocks out intermittently intrusive noises, so you focus better on sleep.
> MINDFULNESS MEDITATION, which may promote sleep by lowering anxiety and physical tension, says Lidia Zylowska, author of The Mindfulness Prescription for Adult ADHD.
3. Synchronize Your Internal Clock Research supports the long-held observation that adults with ADHD underestimate and overestimate the passage of time. Many factors contribute to this, including distractibility and hyperfocusing. But now we are learning that a "dysregulated" internal clock can contribute to the problem. This internal clock is the so-called circadian rhythm in the brain, which regulates periods of rest and alertness. For most of us, the circadian cycle is mostly constant and in sync with the environment. When its rhythm is stable, we feel sleepy at roughly the same time each evening and awaken naturally at the same time each morning. Circadian rhythm is influenced by external stimuli, including exposure to light and the timing of exercise, bedtime, and naps, and hormones, such as melatonin, which is released in response to darkness.
If you suspect your body clock is out of sync (perhaps you fall asleep later and sleep longer than most people, but mostly experience good sleep), try resetting it by tweaking external stimuli.
> GET A DOSE OF LIGHT first thing in the morning and dim household lights in the evening.
> USE A LIGHT BOX, such as the type recommended for Seasonal Affective Disorder (SAD). Use the lights for about 30 minutes each morning, with the bright light shining indirectly -- never directly -- toward your eyes.
If, after steady practice for two weeks, these light-therapy methods don't help, talk with your physician about over-the-counter melatonin, which is used to help shift workers and long-distance travelers adjust their circadian rhythm.
Remember: No amount of light therapy or melatonin will help if you are not having problems with circadian rhythm. The strategy that works for you is the one that addresses your problem.
This article appears in the Fall issue of ADDitude.
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