Better Sleep for ADHD and ADD

For people with ADHD or ADD, sleep can be elusive. Here's how to catch some Zzzs.

For people with attention-deficit hyperactivity disorder (ADHD) or attention-deficit disorder (ADD), sleep can be elusive.

“People with ADD tend to have very busy, cluttered minds,” says Sanford Silverman, a psychologist and director of the Center for Attention Deficit and Learning Disorders in Scottsdale, Arizona. “It's not that one has ADD during the day and it's gone at night. It’s there pervasively.”

As a result, he says, “It's hard to just all of a sudden say, well, OK, I’m going to go to bed.”

Silverman has counseled adults and children with ADHD and ADD for three decades. He says people with ADD or ADHD may feel more alert at night than during the day, or wake up during the night and be unable to fall back asleep. Emotional instability and over-excitability, common in ADD and ADHD, can also affect sleep, making it hard to settle down.

Yet getting more, and better, sleep can have a significant impact on overall energy levels and mood. Silverman suggests several ways to catch more Zzzs for both children and adults:

Practice good sleep hygiene. Following a regular routine of getting to sleep at the same time every night can help the body get “into the rhythm of sleeping,” he says. Keep your bedroom cool — between 65 to 70 degrees — and as dark as possible: consider blackout curtains, and hide artificial lights such as from your bedside clock, which can be stimulating to the brain. Then, make your bed cozy and comfortable with a favorite quilt or even an electric blanket in winter — it will become a place you want to retire to.

Incorporate exercise into your routine. Physical fatigue is a sure-fire way to promote deep, restful sleep. Just don’t exercise strenuously within 2 hours of bedtime, since this will stimulate energy rather than decrease it. (If you really feel the urge to move, try a few restful, restorative yoga poses.)

Wind down before bed. Take a bath or shower at night, listen to soft music, or have a cup of tea. It doesn’t matter what works for you, Silverman says, as long as it relaxes rather than stimulates.

Turn off the phone and computer. Email and texts are “arousing, adrenaline-boosting activities,” Silverman points out — think of the rush of excitement you feel when you hear that familiar chime announcing an incoming text or message. Try to eliminate such sources of stimulation well before sleep.

The tablet and e-reader, too. A study from Brigham and Women’s Hospital in Boston compared the effects of reading on an iPad with reading a printed book before sleep. People reading on the iPad before sleep experienced less deep sleep during the night, produced less melatonin (a natural sleep-inducing hormone), and felt less alert the next morning. The study’s authors suggest the light emitted by the device is to blame.

Try reading a printed book instead — “as long as it's not something that's getting your brain stirred up,” Silverman says. Avoid thrillers or page turners, which can pump up adrenaline. As an added benefit, many people say reading before bed makes them sleepy.

Write down what needs to be done tomorrow. People with ADD and ADHD “tend to worry,” Silverman explains. “So you might have a child or adult who’s … attempting to go to sleep, and they may look on the outside as if they're not necessarily perturbed or bothered by anything. But they may be worried about what they have to do tomorrow in school or work.”

Take the time to talk with a child or adult and write down what needs to be done the next day, which will help them relax and organize their thoughts. Since people with ADD and ADHD tend to have problems with short-term memory and accessing knowledge they already know, Silverman says, doing so can alleviate the stress of trying to remember everything.

Try slow, regular breathing. At his clinic, Silverman trains people to sync their breathing with their heart rate in a process called heart rate coherence. Doing so, he says, trains the “nervous system to go into more of what we call parasympathetic activity, or a calmer state.” You can seek out similar training. In the meantime, simply focusing on the breath will calm the nervous system, too.

Put these tips into practice, and you or your child should soon be well on the way to a good night’s sleep.