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Episode 76. ADHD, Sleep Hygiene and the Recipe for a Good Night’s Sleep

Does ADHD cause sleeping problems? Should adults get recess like school kids? Did you know that 70% of people with ADHD have some type of sleep problem? This includes problems that are behavioral, medical, and neurological. In this episode of Refocused, we continue our discussion with two sleep experts, Dr. Stephen Lange and Dr. Sanford Auerbach. This week’s focus is on sleep problems, sleep architecture, sleep hygiene, and how they impact our ability to get restful sleep. We share tips on how to improve your sleep hygiene and manage your sleep-related issues. If you or someone you know is experiencing sleep problems, seek medical advice for diagnosis and treatment options.

Dr. Stephen Lange is a psychologist who focuses on sleep and ADHD and provides healthcare services to the U.S. Coast Guard as a Coast Guard Auxiliarist.

Dr. Sanford Auerbach is the director of Boston Medical Center’s Sleep Disorders Center and an associate professor of neurology, psychiatry, and behavioral neurosciences at Boston University Chobanian & Avedisian School of Medicine.

Learn more: Why Does White Noise Help People Sleep?

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Lindsay Guentzel (00:01):

Welcome back to Refocused. My name is Lindsay Guentzel and this is episode 76. ADHD, Sleep Hygiene and the Recipe for a Good Night’s Sleep. On today’s episode, we are continuing the conversation we started in episode 75. ADHD, the Science of Sleep and Why We Need It. I highly, highly recommend going back and listening to that one first before jumping into today’s episode. It will all make more sense, I promise.

(00:47):

Sleep hygiene is what we do to help us get great sleep. The lead-up, the prep, the practice, the routine we establish to give our brains and our bodies the best opportunity to sleep well. It’s something I talked with Dr. Stephen Lange and Dr. Sanford Auerbach at length about in the last episode, and it was also the focus of the follow-up conversation I had with Dr. Lange after we hosted the webinar last year with ADHD Online called, Is your ADHD making you count sheep to fall asleep? I mean, how many of us have been told to just stay in bed, stay in bed until sleep comes? The frustration that takes over when you just lie there and wait? It is beyond brutal.

Dr. Stephen Lange (01:31):

My parents knew all kinds of things. They were right about vegetables. They were right about wearing my coat when it’s cold. And wearing a hat, gloves. They were not right about what to do if you can’t sleep. They told me, “Lie there. Eventually you’ll fall asleep.” And, “Lie there and just relax.” And you don’t lie there and just relax. You lie there getting more and more frustrated, which makes it harder and harder to sleep. And I’ve actually had psychology patients who have told me that their primary care physicians said, “Eventually you’re going to sleep.” And all I could think of is my patient’s internal reaction to that aimed at the doctor and not very polite. And not very pretty. Because that just doesn’t work. So I’d say if you’re having trouble falling asleep, that’s intuitive and that should be pretty easy change to make. Sit up in a chair and do something restful, whether it’s reading, meditation, prayer, listening to quiet music. Do not listen to ACDC. Do not listen to Twisted Sister or Metallica. This is where you go for the Mozart effect. Listen to something quiet.

Lindsay Guentzel (02:36):

In a perfect world, we could just sleep well every night without much thought or concern going into it. And there are those people in life. I have a friend who averages close to four hours of deep sleep a night, which is a far cry from the 35 minutes of deep sleep I’ve been getting on average for the past six months. And if I weren’t outrageously jealous, I might be impressed. But shocker, I’m tired and that is a lot of energy to expend right now. I kid, of course. I’m happy for my friend. I just wish sleeping well came easier for me. One of the things that Dr. Lange stressed is that we’re all going to have inconsistencies from night to night. But once you lie down, you want to be asleep in about 20 minutes or less. If you’re not sleeping after 20 minutes, don’t get frustrated or worried about not falling asleep. Or being concerned that you’re not going to be alert enough in the morning for work or school.

(03:32):

Get up, do something quiet, and restful, and calming, and relaxing. And when you can’t keep your eyes open anymore, go back to bed. If 20 minutes later you’re not asleep, rinse and repeat. It reminds me a bit of Psych 101 with Pavlov and the dogs, that we’re conditioned to connect a bell with food. To us, a bed should mean sleep. If we see our beds as a frustrating and sleepless place, well then we’re barking up the wrong tree.

Dr. Stephen Lange (04:02):

If we wake up and we’re definitely not asleep and we’re not going back to sleep, you have to think about a couple of things. One is what are you doing when you’re lying there? Are you worried? Do you feel worried? Do you feel anxious? Is something on your mind? And there’s a great song. I think it was a Frank Sinatra song and I think maybe Carol King sang it too. So, “Where it’s 4:00 AM in the morning and the world’s fast asleep and I lie there awake thinking of you.” So if you are worried, if you’re thinking, then do you have an anxiety disorder? People with anxiety disorders have a lot of interrupted sleep. They wake up worried, even if they went to sleep easily. At that point you want to work with a psychologist or a counselor, maybe a psychiatrist with medication on dealing with excessive worry and anxiety.

Lindsay Guentzel (04:54):

We have a rule in our house. The last person downstairs locks the door. The last person to bed turns off all of the lights. A go-to sign that we’re winding down for the night. It took a while for us to fall into that routine and every once in a while we forget the rule. And it will shock no one that in a house with two people, one who is nearotypical and one who is neurodiverse, it tends to be me, the one with ADHD who is nice and comfy in bed that realizes the light above the kitchen sink is still on. And I have to get up to turn it off more than I’d like to admit. Now we have a new routine we’re trying to get in place. Who is turning on our new sound machine? The other night we were both lying in bed.

(05:36):

I was reading, my boyfriend’s doing a crossword, when we realized the sound machine wasn’t on. You know, the one that I had mentioned in the last episode? Well it’s also the one that’s all the way across the room. And I’d like to pat myself on the back here because I was offered the idea that the winner of rock paper scissors would go turn it on. But I took one for the team and got up. Did I mention I love the sound machine? I truly feel like it is helping me sleep through the night. And even John’s noticed an improvement in my sleep patterns. I used to sleep with a box fan running in the room and I’m not really sure when or why I stopped doing that. But when I was down in Austin for South by Southwest, there was construction happening next door, that somehow went on all night long. Trucks beeping and things being loaded and moved around and the first night it woke me up.

(06:27):

Second night I turned on a YouTube video, 10 hours of white noise to help your baby sleep through the night. And had the best night of sleep I’d had in a long time. It’s actually what prompted the text message to my partner to get me a white noise machine for my birthday.

Dr. Stephen Lange (06:41):

The sleep architecture is how we go through the five different parts of the sleep cycle. That’s the hardest thing to change. Duration of sleep is much easier to change. Delayed sleep onset is much easier to change. Our sleep architecture may be hardwired into us and it may very well be related to ADHD and that kind of dysregulation. And that may not be something that’s going to change.

Lindsay Guentzel (07:06):

For many people with ADHD, steady background noise can help improve concentration and fixation by blocking out distractions. And when you sleep, those distractions tend to be noises that wake you up. But when a noise wakes you up in the middle of the night, it’s not actually the noise that wakes you up, it’s the sudden change or inconsistency in noise that essentially startles you awake. That’s according to the popular science article, why does white noise help people sleep? Where reporter Colin Lecher explored what happens when a person sleeps in a room with white noise. In his article Colin spoke to Seth Horowitz, a neuroscientist and the author of The Universal Sense: How Hearing Shapes the Mind. Seth explained that white noise creates a masking effect that can block out those sudden changes that can wake up light sleepers. Or even prevent people from falling asleep. I’m going to link that in the show notes so you can read more, because it’s super interesting.

(08:00):

But one of the problems sleep experts run into when working with patients is, we sometimes don’t know if we are waking up in the middle of the night. It’s one of the things Dr. Auerbach mentioned in episode 75. That some people don’t even realize they wake up at night.

Dr. Sanford Auerbach (08:16):

You can have a little awakening here or there. In fact, most people do have short awakenings through the course of the night. They may not always remember them, but they go through the course of the night. And they’re just not always aware of them. Some people may be too obsessed by it and if they have a short awakening will stay up the rest of the night, worry about the fact that they woke up.

Lindsay Guentzel (08:36):

Noise pollution is no joke. And it’s not always things you think of, like living on a busy street and getting woken up by emergency sirens in the middle of the night. It can be little noises. Your house settling in the middle of winter. The furnace shifting to a different temperature. Your brain essentially gets distracted from the task at hand and you wake up. Oh, and dreams. Dreams bubble up at night when we’re resting so our brains can work out our experiences. They are related to all of the emotional content that we suppress during the day. And it’s a topic worth talking about. So maybe all the sleep dreams us ADHD’ers are having, are something we can learn more about in the future. And see how they weave into the five stages of sleep.

Dr. Stephen Lange (09:19):

There are five stages of sleep. The first stage is very light sleep. The last stage is REM sleep where we do most of our dreaming. And the third stage is deep restful sleep. So we’re always cycling through, and when we hit that first stage of sleep we can feel awake even if we’re asleep. So someone looking at us could say, “Oh, she’s asleep.” But it feels like we’re awake and we’re aware of noises and lights and things going on around us. When we hit that first stage of sleep, we’re also more likely to actually wake up. So that happens naturally to all of us. Most of us are unaware of it because we transition to the next stage of sleep, which is at the second stage, which is the transitional stage. Now we’re in deep sleep again and we’re not even conscious of it happen. Sleep is essential to health. Our brain actually repairs itself chemically. It kind of goes through a wash cycle while we’re asleep. And so do some of our other body systems.

(10:14):

We use sleep to consolidate memory and learning. And that’s important especially for children, but for all of us. If you study and then go to sleep, you do better the next day than if you sleep, wake up and study. Because we need that sleep time for our brains to kind of consolidate that.

Lindsay Guentzel (10:33):

Something just as intrusive as noise pollution is light pollution.

Dr. Stephen Lange (10:39):

In an evolutionary sense, we were not adapted to be sitting in office chairs in artificial light. Because in evolutionary time we didn’t have artificial light. We’ve only had artificial light for what, maybe a 120, 150 years. We have thousands of millions of years of evolution behind us without artificial light. One of the things that happened to schools and also businesses that really wrecked our sleep for all of us, not just people with ADHD, is they shrunk windows. And now we have these little slit windows in a lot of places that don’t really let in a lot of light. And if you look at a really old school building, maybe that’s been turned into something else. And so you’ll see these huge windows and that was perfect. I don’t know how they came up with that, or I don’t think it was sleep science, but they did back in the day.

Lindsay Guentzel (11:29):

We’ll talk more about light a little bit later. But for now let’s focus on how we can improve our sleep. If you know what it feels like to not get good sleep or to not sleep easily, you understand the frustration. The concept of sleep hygiene was introduced in the late 70s to help doctors better understand what was causing insomnia in their patients. One Refocused listener from Michigan sent us a voice memo sharing her sleep story. Haley’s been working the midnight shifts in a hospital while finishing up her program in school. And trying to find a balance with all of the stuff she has going on. And it’s unfortunately been affecting her sleep.

Haley (12:13):

So my current schedule is Wednesday through Saturday, but I pick up shifts for Sunday mornings too. So I do basically a whole 16 hours. So from 11:00 PM to like 3:30 PM. And I’m off the next night and day anyway, so I sleep all day. Or whenever I go to sleep. And then wake up at midnight or so depending if I go to sleep at like 7:00 is three, but still. And somehow I end up being sleepy around the nighttime. So as soon as, if it starts going back to Wednesday night when I have to sleep, I’m up all day. And then I’ll get maybe an hour of sleep. And then I feel to the dread throughout my whole body and then I’m sleepy.

Lindsay Guentzel (12:50):

First off, Haley, thank you for sharing that with us. I am so sorry for what you’ve been going through. I know every single one of us who has struggled with sleep felt it when you said, “I felt dread throughout my whole body.” Because it is a very distinct feeling and it’s not one you forget. The good news is we have some tried and true tips we want to share with you. But I do want to point out something that came up in Haley’s story that we haven’t addressed yet. Shift work. It’s estimated that 18% to 26% of the American population are shift workers. Meaning they work at times when the rest of the world is sleeping, and they sleep at times when the rest of the world is awake. And shift work can be brutal for our sleep routines. We’re legit asking our bodies and our brains to work against our natural cycle. Against evolution.

(13:41):

And one of the biggest concerns with shift work according to Dr. Lange is that it can lead to fragmented sleep, which is where you’re not getting an adequate amount of continuous sleep in one sitting. Maybe only two or four hours of sleep at a time. And so your body never gets into a full sleep cycle and that means you miss out on the good REM sleep. Our dreaming sleep. Fragmented sleep can lead to sleep deprivation and the crummy thing is, fixing sleep problems as a shift worker is incredibly difficult. Which I imagine is probably disappointing to hear, especially for someone like Haley. That there’s not a magic solution. But it doesn’t mean that you should stop trying to get solid sleep. Remember, progress over perfection. But how do you do that? And where do you start? We’ve got some ideas for you and it starts with the CDC. And its page on its website focused entirely on tips for better sleep.

(14:34):

Here’s what they offer up. Five tips for you to consider when addressing your own sleep hygiene. One, be consistent. Go to bed at the same time each night and get up at the same time each morning. Including on the weekends. Two, make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature. Three, remove electronic devices such as TVs, computers, and smartphones from the bedroom. Four, avoid large meals, caffeine and alcohol before bedtime. And five, get some exercise. Being physically active during the day can help you fall asleep more easily at night.

(15:13):

What does the list look like for you? Here’s what it looks like for me. Am I consistent with my bedtimes and morning alarms? I’m much better now than I was, but I know I definitely struggle on the weekends. And I’m at the point in life where the consistency issue is very much isolated to going to bed. I’m waking up at the same time regardless of what time I go to bed, which makes my issue with bedtime consistency all the more apparent. But I’m guessing this one is fairly common because even sleep psychologist Dr. Lange… Yeah, he struggles with this one too.

Dr. Stephen Lange (15:46):

This is hard. I want to sleep in on weekends. I often do sleep in on weekends. If I were having difficulty sleeping and having a bout of insomnia, I would want to discipline myself to go to bed and wake up the same time, seven days a week.

Lindsay Guentzel (16:03):

I do, however, have number two figured out. Our bedroom is a great place to sleep.

Dr. Stephen Lange (16:08):

You want your sleep environment to be welcoming and calming. You do not want to have a sleeping environment that’s overly stimulating.

Lindsay Guentzel (16:17):

Our bedroom is dark, the walls are a deep green and we have blackout curtains. Which were a request from my significant other that are something I very much enjoy now too. We have a ceiling fan that keeps us cool and makes you want to snuggle under the covers. Now, the CDC’s third tip, removing electronic devices. We actually did away with the bedroom TV a few years ago. Besides our new sound machine, there’s nothing in our room that makes noise. Except for our cell phones. And I’m trying to be better about not mindlessly scrolling through my phone in bed, because it’s not like I’m not on it enough throughout the day. I hope you sense the sarcasm there, because it is a tough habit to break.

Dr. Stephen Lange (16:55):

You use beds for sleep and sex only. So no laptop computers in bed, no phones in bed, no doing homework in bed, no talking on the phone in bed. You want to condition yourself so that your brain associates your bed with sleep and sex. And nothing else.

Lindsay Guentzel (17:14):

When it comes to avoiding large meals and caffeine before bed, I think I’m pretty consistent. I used to have such a hard time with big meals before bed, especially when I was working as a server in a restaurant. And we’d get off of my shift around 10:00 or 11:00 at night, and would be of course starving. And outside of my morning coffee, I don’t really drink beverages with caffeine. I’m this really boring plain water gal, but even that brings with it sleep issues.

Dr. Stephen Lange (17:38):

If you drink too many liquids right before bed, you can have interrupted sleep just because you have to go to the bathroom. A lot of people have taken a drink of alcohol to go to sleep. You know, a shot of whiskey, a glass of wine. That will put you to sleep, but your sleep quality suffers. And you can wake up too early and have a rebound. Chronic use of alcohol will wreck your sleep for a very long time.

Lindsay Guentzel (18:01):

Alcohol before bed is something I have struggled with, honestly probably, throughout my entire adult life. It’s that mindless end of the day drinking. And of course it really amped up during the pandemic. But I’ve been alcohol-free for the last few months, thanks to my lovely medical mystery situation. And I do know that it’s played a factor in the fact that I feel like I’ve been sleeping better. The fifth and final tip is regular exercise. I’ve been moving a little less lately thanks to that mystery illness. But I do understand how movement matters when it comes to sleep. Movement is as much of a workout for our brains as it is for our muscles. Which by the way is one of the topics we’re going to dive into in May for mental health awareness month. But while exercise and movement is good, there is one thing you have to keep in mind when adding it to your routine.

Dr. Stephen Lange (18:49):

Any movement counts and that’s where you begin. Do anything. And if all you do is walk to the mailbox, if you walk to the end of your driveway, if you’re in an apartment complex and you walk to the street, it all counts. When it comes to exercise, I think part of the problem is expectations. It’s our expectations and expectations people place on us. So if you’re going to go from zero physical activity to CrossFit, that’s a lot. Anything you do, which is physical movement out in sunlight, is good. It doesn’t matter if you’re walking from your front door to your mailbox at the street. That counts. Everything counts. You have to give yourself credit for any movement that you do, especially outdoors. And not expect that I’m going to go and suddenly run a 5K tomorrow. Do not use exercise machines right before bedtime. You will be wide awake and alert.

(19:43):

You know that idea of like a runner’s high. You get a runner’s high because physical activity stimulates norepinephrine, which is an antidepressant. And it is also associated with alertness. So if you exercise too close to bedtime, you will not want to go to sleep. You will want to be wide awake.

Lindsay Guentzel (20:04):

So looking at these CDCs sleep hygiene guidelines I score a rocky 2.5 out of 5 on my best day. One thing I’d like everyone to keep in mind with a list like this is, while they often offer up great information, they can also push us to focus on perfection. I’m even guilty of it. I mean, look, I even gave myself a score. So please, as you’re going through that list, go easy on yourself.

(20:36):

If you’re still laughing from my suggestion that we, people who have ADHD, go easy on ourselves. Trust me, I get the humor in that one as well. It’s not our strong suit, is it? But at the end of the day, what it all comes down to is ADHD is a disorder of self-regulation. According to Dr. Lange, the fact that we struggle to manage our impulses and regulate our attention and avoid distractions, also means that our level of arousal versus relaxation is also very difficult to regulate. What does that mean? Well, it means it’s more difficult for us to wind down at night, which is a huge part of our sleep hygiene.

Dr. Stephen Lange (21:16):

The more diagnoses you have, the more trouble you’re going to have with sleeping. So people who have a second diagnosis like generalized anxiety disorder or a child with oppositional defiant disorder, bipolar disorder, depression. Those individuals will have more trouble sleeping than those who only have ADHD. But it also is important to realize that few people only have ADHD. ADHD is a very comorbid disorder, meaning that most people with ADHD have one or more other disorders.

Lindsay Guentzel (21:49):

And if you’re feeling like we just opened up Pandora’s box, you’re not wrong. Because having ADHD does open up a whole other area of concern regarding sleep comorbidities. It’s all just a big basket of fun, you guys. According to Dr. Lange, people with ADHD are more likely to suffer from obstructive sleep apnea, restless leg syndrome, and periodic limb movement disorder. What are those? Well, sleep apnea is likely something you’ve heard about before. Sleep apnea is a common condition in which your breathing stops and restarts many times while you’re asleep. And it can be serious, preventing your body from getting enough oxygen. The connection between ADHD and sleep apnea is strong enough that we are working on exploring this topic in a full episode that we want to bring to you soon. But if you, or likely your partner, notice that your breathing starts and stops during sleep, that you have frequent loud snoring, that you’re grasping for air during sleep, I highly recommend speaking to your medical provider about it.

(22:50):

Because as I said, and Dr. Lange emphasized more than once, the connection is there and it’s strong. Restless leg syndrome is a neurological condition that has two parts. One, a person will experience unpleasant or uncomfortable sensations in their legs. And two, they will have an irresistible urge to move them. Making sleep difficult. And finally, periodic limb movement disorder is the repetitive cramping or jerking of a person’s limbs while they’re trying to sleep, which again doesn’t make it easy to stay comfortable or relaxed. And then of course there are the things we’ve just chalked up to being human. Nightmares, sleepwalking, maybe sleep eating. According to Dr. Lange, those can be extra difficult to treat, but worth having a conversation with your medical provider about.

Dr. Stephen Lange (23:38):

ADHD is really related to sleep problems. 70% of people with ADHD have some type of sleep problem and that includes problems that are more or less behavioral, those that are more or less medical. Some that are neurological. If you have ADHD combined type, you’re going to have more problems sleeping than most other people with ADHD. If you have inattentive type, you’re more likely to have daytime drowsiness, even if you sleep well.

Lindsay Guentzel (24:07):

So you might be wondering, how does your actual diagnosis play a role in what you might encounter when it comes to sleep problems? Well, the DSM currently drops people with ADHD into three buckets, hyperactive, inattentive, and combined type. And it’s something I threw to Dr. Lange after we hosted the webinar together. And he went out to try and find the answer. And the one thing I’m learning from my time hosting this podcast is even though ADHD feels like such a big part of my world. Where we are at with research, it’s not really that in-depth yet. And unfortunately Dr. Lange couldn’t find any research that even looked at the topic, but his experience as a sleep psychologist led him to this educated guess.

Dr. Stephen Lange (24:53):

ADHD is a disorder regulation. We’re dysregulated. And if you have ADHD inattentive type, what’s dysregulated is attention, motivation, sustained mental effort, planning, organization decision-making. If you have hyperactive type, what’s dysregulated is self-regulation of a activity level and kind of purposeful activity. If those two are combined, then your level of dysregulation is just greater. And I think that level of dysregulation means that, because you have greater dysregulation, you’re going to also have greater dysregulation of sleep. Also, people with ADHD hyperactive impulsive type, have a hard time settling and relaxing their bodies to sleep. People with inattentive type are more likely to have anxiety disorders or depression along with their ADHD, so they’re more likely to be worriers. So I think having that combination may also feed into that as well. So it may not just be that people with combined type are more dysregulated. Maybe that they have co-occurring conditions that predispose them to have difficulty sleeping.

Lindsay Guentzel (26:05):

It’s just another reminder that there is so much more affecting our sleep. It’s really the way our culture views it. And I want to share something that Dr. Lange shared with me that really made me stop and think.

Dr. Stephen Lange (26:17):

In US culture, we tend to think of sleep as wasted time. If you’re a napper or if you’re a long sleeper, obviously you’re just not a hard worker, and you’re not with the program. So that just makes it even worse.

Lindsay Guentzel (26:30):

We tend to think of sleep as wasted time. So even if we know we can be doing better and put in some work to get better sleep, we’re programmed to think it’s not worth it. Because it doesn’t matter.

Dr. Stephen Lange (26:42):

The problem with sleep hygiene is we all know it works and we all know it’s good for us. And we don’t do it. Anything in the list of good sleep hygiene, people resist. For example, no caffeine after 2:00 PM. It’s relatively easy to do, except people don’t want to do it. Actually, it might not be easy to do. People can be hooked on caffeine. You can be hooked on caffeine. No nicotine after 2:00 PM. Very difficult if you’re a smoker. Getting sun on your face I think is pretty easy. If I were working in a place that was very negative about taking breaks and stepping away from your desk, I would make a point of talking to my supervisor about a need for that. And maybe get a doctor’s note as a disability accommodation, especially if having ADHD. If I were running a company with employees, I would insist that people take your lunch away from the office, don’t eat lunch at their desk.

(27:35):

That’s not a sign of being a especially hardworking. It’s just a sign that you’re not doing self-care. And take a break and go outside. Smokers do it. Why can’t everybody? Go outside, get sunlight on your face.

Lindsay Guentzel (27:49):

Dr. Lange threw in a few other sleep hygiene things to consider if sleep is giving you a hard time. But there are also sleep hygiene things to consider once you get into bed and turn off the lights. And this might be one of the most important parts of our conversation. Because we are working on breaking down years and years of misinformation.

Dr. Stephen Lange (28:08):

If adults could get sunlight and movement during the day, they would be more productive employees. And all the call centers where people are… Call centers have high rates of just quitting. People leaving those jobs. Give them adult recess, they might stick around longer and they might do better. And by the same token, if you were going to design buildings, we’ve made windows smaller so we get less sun. I went to a school that was built in the 1930s. We had huge windows and high ceilings, and that was for ventilation because we didn’t have AC. And also for sunlight, and that is far better than having these little narrow slick windows. Adults need movement and sunlight just like kids do. And it’s kind of sad that there are schools that are getting away from recess. Because if you want kids to do well in the afternoon, they have to have sun and movement.

(29:03):

It’s also part of health maintenance. Controlling body weight, controlling metabolism. If you want kids to be awake and alert and learning efficiently in the afternoon, they need physical activity. They need sunlight on their faces. And the same is true of adults. Before, I would suggest to someone that they take melatonin with their doctor’s permission. I suggest to them, is there a way for them to get natural sunlight on their faces early in the day. And to get moderate physical movement, moderate physical exercise. You don’t have to work up a sweat, you don’t have to be out of breath, but you have to move. And that’s what we were adapted to and that would be my first solution before suggesting a supplement. From my understanding of the research, and this again, not as a physician. My last gasp effort at helping someone sleep, would be to suggest to them that they talk to their doctor about sleep medication. The research does not show that sleep medication is better than behavior change.

Lindsay Guentzel (30:09):

That’s where we’re going to wrap it up for today. I know we have barely scratched the surface on where we can go having these conversations about sleep and ADHD. And I hope you’ve enjoyed the start of them. And that today’s episode offered you some ideas on how you can make your own sleep hygiene a better fit for your life and your needs. Maybe a noise machine is the magic ticket. The thing is, you won’t know until you try. And that part of the equation, the trial and error, it’s an incredibly important yet equally frustrating part of figuring out your sleep hygiene. But remember, like I encouraged Haley, it’s progress over perfection with everything in life. Also, can we all just send a bunch of love to Haley for sending in her story? I basically begged and groveled on my knees and she did it. And by sharing her story, she gave us the opportunity to talk about shift work and the stress it puts on sleep.

(31:02):

So big high-fives go out to you, Haley. Your email and your voice memo really made my whole week. Before we go though, I have to start by thanking my managing editor, Sarah Platanitis, who came in at the 11th hour when I was losing my mind over this episode. And somehow she patched work this baby together like a beautiful quilt we would all love to snuggle up under and take a nap with. And to have someone on my team who can, one, sense my meltdown is coming. And two, look at my work and know what I’m trying to do and then do it better. It is such a gift. Sarah, I’m so lucky to work with you and I truly, truly love having you on our team. All of these little snippets you heard throughout these two episodes on sleep, they all had to be cut and cataloged by our tremendous coordinating producer, Phil Rodemann, who has been learning all of these new skills on the fly.

(31:55):

I throw a lot of different tasks at him throughout the day. Heck, sometimes throughout the hour. And he always answers by telling me he’ll figure it out. And so far, I’ve yet to stump him. A big shout-out to Al Chaplin, who as I was losing it over the weekend when I realized I was physically, mentally, and emotionally unable to finish this episode by Monday, they jumped in to help me spread the word on social media. The work Al creates for our Refocused social media channels is smart and on brand. And a little fun and sassy, which I guess is also on brand. And I hope you all go check out their awesome work on our Instagram at Refocused Pod. I feel very blessed to have this team of people working with me right now. The last few months would have been very different without their commitment to this podcast and their hard work shines through in every episode.

(32:47):

Refocused is a collaboration between me, Lindsay Guentzel and ADHD Online. A telemedicine mental healthcare company that provides affordable and accessible ADHD assessments and treatment plans, including medication management and teletherapy. To find out how they can help you on your journey, head to adhdonline.com. I’ve already gushed about my managing editor, Sarah Platanitis, my coordinating producer, Phil Rodemann, and my social media superstar, Al Chaplin. But obviously I’ll always take the opportunity to tout their talents again. And there are more people to thank like Mason Nelle over at Deksia in Grand Rapids, Michigan for all of his help in getting our videos ready to share with you guys. Refocused also couldn’t happen without my partners turned friends at ADHD Online. High-fives to the ones I bug the most. Keith Boswell, Claudia Gotti, Melanie Mile, Suzanne Spruit, Tricia Merchant Dunny, and the entire team at ADHD Online and Mentavi Health

(33:43):

Portions of today’s episode were engineered by the incredible duo over at EXR Sounds and Vision, Amanda and Eric Romani. Our show art was created by Sissy Yee of Berlin Gray. And our music was created by Louis Inglis, a singer-songwriter from Perth, Australia, who was diagnosed with ADHD in 2020 at the age of 39. Links to all of the partners we work with are available in the show notes. To connect with the show or with me, you can find us online at Refocused Pod as well as @lindsayguentzel. And you can email the show directly, [email protected]. That’s [email protected].

(34:18):

Next week we’re moving on to one of our favorite ADHD quirks to talk and commiserate about object permanence. Or should I say object constancy. The jury is still out on what to call it. You likely know it as the lovely ADHD day-to-day challenge of out of sight, out of mind. And we have a great conversation lined up that you won’t want to miss. In the meantime, take care of yourself and please, in an effort to reduce the unbelievable amount of stress we all carry around with us, unnecessarily, be a little kinder to yourself this week.

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