Monday, August 12, 2019
welcome to the leADDership brief
A weekly newsletter for creative and innovative people, like you, with ADHD who want timely, helpful, and interesting resources
for leading and living well with ADHD.
THE IMPORTANCE OF SLEEP HYGIENE
One of the most important self-care practices you can adopt is fostering a good night’s sleep. Sleep is important for your ability to focus, concentrate, to your mood, and to your general health and well-being.
Unfortunately, many people with ADHD do not get the sleep they need. Just like we don’t “out-grow” ADHD, it does not go away at night either. It is a part of our functioning life 24-7-365.
Adults with ADHD rarely fall asleep easily, stay asleep all night, and/or sleep soundly through the night. Waking up easily and feeling refreshed is often illusive. More often, our mental and physical restlessness disturbs our sleep patterns which has an effect on our overall sense of well being .
No matter how the medical and health professionals explains sleep problems, the remedy usually involves something called “sleep hygiene.”
According to the National Sleep Foundation sleep hygiene is a variety of different practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness.
The practices and habits are highly individualized, especially for folks with ADHD. Some people need absolute silence. Others need white noise, such as a fan or radio, to mask disturbances to sleep. Some people need a snack before bed, while others can’t eat anything right before bedtime. Some People need pitch black and some people don’t.
FOUR COMMON BLOCKS TO QUALITY SLEEP
DIFFICULTY FALLING ASLEEP
Many of my clients with ADHD report an inability to shut off their mind so they can fall asleep at night. No matter how tired they are as soon as their head hits the pillow their mind clicks on and the thought spiral begins as they replay their day and every conversation. Many describe themselves as “night owls” whose most productive time is after 10:00 p.m. One study found that by age 30, more than 70 percent of adults with ADHD report that they spend more than one hour trying to fall asleep at night.
RESTLESS SLEEP
When you finally fall asleep, your sleep is restless, you toss and turn and awaken at any noise in the house. You often awake to find the bed torn apart and covers kicked onto the floor. Sleep is not refreshing and you awaken as tired as when you went to bed. I am a restless sleeper and I also have restless leg, another symptom many of my clients report having. Restless leg is defined by the National Institute of Neurological Disorders as:
“Restless legs syndrome (RLS) causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms commonly occur in the late afternoon or evening hours, and are often most severe at night when a person is resting, such as sitting or lying in bed. They also may occur when someone is inactive and sitting for extended periods (for example, when taking a trip by plane or watching a movie). Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up.
RLS is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance, and personal relationships. Many people with RLS report they are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks. Untreated moderate to severe RLS can lead to about a 20 percent decrease in work productivity and can contribute to depression and anxiety. It also can make traveling difficult.”
INTRUSIVE SLEEP
This is drowsiness or sleep that intrudes on our day. ADHD is commonly referred to as interest based syndrome. As long as we are interested in or challenged by what we’re doing, we can focus, even hyper-focus on a task or activity. When we lose interest in the task or activity, our nervous system disengages, in search of something more interesting. Sometimes this disengagement is so abrupt as to induce sudden extreme drowsiness, even to the point of falling asleep.
This was a hugely helpful and liberating for me as I spent years letting my inner critic yell at me for zoning out to the point of overwhelming sleepiness during a boring meeting or class, or NEED, like NEED, a nap in the middle of the day because sitting in an office by myself all day has lacked stimulation and interest. This scientific insight has allowed me to hold compassionate space for myself when I feel the drowsiness descend and take appropriate measures to address it.
DIFFICULTY WAKING UP
One study showed that 80 percent of adults with ADHD report multiple awakenings until about 4 a.m. Then they fall into “the sleep of the dead,” from which they have extreme difficulty waking up.
They sleep through two or three alarms, as well as the attempts of family members to get them out of bed. ADHD sleepers are commonly irritable, even combative, when roused before they are ready. Many say they are not fully alert until noon.
WHY IS QUALITY SLEEP SO ILLUSIVE?
According to Thomas Brown, Ph.D., longtime researcher in ADHD, the simplest explanation is that sleep disturbances are a direct manifestations of ADHD itself. At least 75 percent of adults report difficulty with getting restful and refreshing sleep.
One hypothesis is that the lack of an accurate circadian clock may also account for the difficulty that many of us with ADHD have in judging the passage of time. Our internal clocks are not set and we have short time horizons so we experience only two times: “now” and “not now” making sound, lasting sleep difficult. In simple terms we are either NOW asleep or we are NOT NOW asleep.
One interesting article I read suggests that people who sleep outdoors for even a short period of time experience better sleep. In one phase of the study researchers had 14 people either spend a weekend at home or camping. They found that for the seven who camped even a weekend outdoors caused people to shift their biological clock and to experience better sleep. The seven who spent the weekend at home showed no discernible shift to their biological clock.
Saliva samples showed that levels of melatonin, our sleep hormone, shifted compared with a typical week at home. Melatonin levels started to rise around sunset, and the study participant’s "biological night" kicked in about two hours earlier than the those sleeping at home.
The researchers also found that while camping is helpful, it isn’t necessary to better sleep. Spending time in natural sunlight every day and minimizing artificial light at night helps us wind down and get better sleep.
Here’s a fun fact for you:
As dawn breaks morning light is a cool blue/green signaling energy and wakefulness to the natural environment and humans.
As dusk settles in evening light shifts to a warm red/orange glow signaling that it’s time to slow down and prepare for rest to the natural environment and humans.
Smartphone, tablets, and computer screens are blue/green and mimic morning light to our brains. Some studies show that looking at the blue/green screens on our tablets and phones at night can be sleep prohibitive. Most tablets have a warm reading screen option you can set for nighttime viewing.
THE BENEFITS OF GOOD SLEEP HYGIENE
MEMORY AND LEARNING: research suggests that sleep has a role in the consolidation of memory, which is essential for learning new information. Sleeping is the most important time to shape memories and make the connections between events, feelings and experiences and is a requirement for forming new learning and memory pathways in the brain.
IMMUNE HEALTH: Sleep is your body’s mechanism to ward off infection. Lack of quality sleep can weaken your immune system, making you more susceptible to illness.
FOCUS AND ATTENTION: Sleep helps you think more clearly, have quicker reflexes, focus better, and can help with a longer attention span.
MOOD: Starting your day feeling refreshed can give you more energy, gratitude, and overall pleasantness. This can translate to how you feel during the day and how you go about interacting with other people.
MAINTENANCE: While you sleep, your body works to support healthy brain function and maintain your physical health.
EIGHT SLEEP HYGIENE
ROUTINES AND PRACTICES
TO TRY
SUNLIGHT: Get outside. Research shows that even 15 minutes of natural sunlight during the day supports better sleep.
CREATE A WIND-DOWN ROUTINE: Find one that works for you.
A word about medication: if you have a doctor recommended prescription for sleep aids, then please use them. I have absolutely no judgement about this. I’m not a doctor so will never make recommendations other than to follow your doctor’s orders when it comes to medication. We are all unique and our brains respond differently to things. What’s important is that you create and adopt a routine that works for you. Not what works for others or what others say about what works for you.
Here are few practices and options to consider:
TAKE A WARM BATH OR SHOWER: the lowering of your body temperature post shower or bath has sleep inducing qualities. Try using a lavender scented shower gel or soap.
Lavender is the most popularly recommended essential oil for sleep and relaxation. Lavender is a soothing scent that’s long been associated with relaxation and sleep, and used as a natural remedy for anxiety. Lavender is probably the most rigorously studied essential oil. Research shows lavender has anxiety reducing and sedative effects meaning it can work directly to help you fall asleep, improve sleep quality, and help you sleep longer.
Your sense of smell is directly wired to your brain’s center of memory and emotion. Cells inside your nose detect smells in your environment and send information to your brain, via the olfactory nerve. The information about smell goes immediately to the limbic system of your brain, which includes regions like the amygdala that control emotional reactions and memory.
This makes smell unique among your senses. Information you take in from your other senses travels first to the the thalamus which acts as a relay station, passing along sensory data to the other parts of the brain that produce your sensory perceptions. Only smell moves directly to youf brain’s emotion and memory center. This is why the smell of baking cookies can send you directly back in time to your grandma’s kitchen and warm memories.
BEDTIME SNACKS OR DRINKS: sip a warm drink like decaf herbal tea or golden milk on it’s own or with a light protein snack. Check out the recipes in Foodie Corner or sign up to receive early access to recipes and live streams for my forthcoming cookbook
ELIMINATE CAFFEINE: in the late afternoon or early evening. (It is also true that for some adults with ADHD a caffeinated drink is necessary to fall asleep as it helps the brain to calm down. It all depends on your brain wiring)
QUIET TIME: many people find that even five minutes of meditation, gratitude practices, writing in a journal, or focused breathing helps the brain to calm down and get ready for sleep.
READING: I’ve read to fall asleep for as long as I can remember. As a gadget geek I got an e-reader when they first came out and love it! If you use an e-reader set it to the warm background light so your not staring at a blue screen.
LIGHT BULBS: Red Bulbs mimic the naturally occurring red refracted colors of dusk. Switch out your reading lamp and nightlights to a red bulb. I’ve also read good things about the Nite Nite bulbs*. They’re advertised as a sleep aid for infants and children but I’ve read good reviews from adults who use them. At $22 ($18 for prime members) it’s pricey but lasts for 2 years.
FOCUSED MUSCLE RELAXATION: relaxing your body from toe to head can be a helpful practice, especially if you have restless leg or anxiety.
While lying on your back place your hands on your belly and breath in and out for four deep breaths. Feel your breath move in and out. Starting with your toes curl them in tight and hold them for a count of four breaths. Relax for a count of two breaths. Flex your foot for a count of four. Relax for a count of two. Point your toes for a count of four. Relax for two. Clench your thigh muscles for four. Relax for two. Continue all the way up your frame until you get to the top of your head. Pay attention to your breath and your body. Speak kind thoughts to yourself and your body.
WHITE NOISE: fans, apps, and sound machines are all great options. I’ve also found some great podcasts like Slow Radio and Sleep Meditation Podcast to be helpful.
SELF-COMPASSION: use empathic touch and soothing self-talk to calm your parasympathetic nervous system and to help calm your mind and body. (Check out exercise 1 from July 15, 2019)
SLEEP APPS: I like this one from Calm: a meditation, sleep and relaxation app, available in both the App Store and Google Play store. Calm also contains some 100 sleep stories, sleep music, meditation lessons, nature sounds, and Calm Masterclasses delivered by world experts. Calm offers both free and paid subscription options.
KEEP YOUR BEDROOM DARK AND COOL
In general the best temperature for falling asleep is between 60-70 degrees Fahrenheit. If you want to go down an interesting rabbit hole on this topic google articles about sleep and thermoregulation.
Keeping your bedroom dark also keeps it cool by blocking out the sun and the darkness convinces your body it’s “sleep time.” If you live in a light-polluted area get an eye mask and blackout curtains to help your body and mind settle into a rested state.
Many of my clients need a dark room to fall asleep in. I’m a weirdo in that I sleep best in natural “moon lit” and “sun rise” room. My internal clock naturally goes off around 5:30 am at home. Hotel rooms that block out all the light are a guarantee that I will oversleep if I don’t set an alarm.
If you’re a “hot” sleeper like me, then a cool gel pillow is a life saver. I’ve found them on sale at Khols for under $30. You can also buy one here *
DEDICATE YOUR BED TO SLEEPING, SEX, AND NAPPING: Your body and mind should recognize your bedroom as a place of rest and intimacy. By subtracting simple things like devices, outside noise, and adding good hygiene, using your bed for the sole purpose of sleep and sex, can truly improve and benefit your well-being. We’ve never had a TV in our bedroom (absolutely no judgment for those who do!!), early on it was a budget constraint (we were too poor to have more than one small TV) and then it became habit. In retrospect it has been an accidental positive choice since my brain seems to only associate the bedroom for sleep and intimacy.
Articles referenced in the newsletter:
http://www.sleepreviewmag.com/2015/05/light-therapy-better-sleep/
https://www.webmd.com/sleep-disorders/news/20170202/time-outdoors-may-deliver-better-sleep#2
https://www.ncbi.nlm.nih.gov/pubmed/23524167
https://www.sciencedaily.com/releases/2018/07/180723155726.htm
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What Else Do You Need To Know?
Coach Pam