Submitted by MelissaOrlov on 10/24/2023.
Sleep can be elusive. Use this science-based checklist to find out what you should definitely be doing to ensure the best sleep, and other things you might choose to do if they make sense for you.
The Bedroom Environment
Definitely do:
- Cool temperature
- Comfortable bedding – for some who are restless, this might included a weighted blanket
- Very dark room (or use comfortable eye shades) – minimize charger, computer, electronic lights. No blue or green lights (cover light indicator with black electrical tape if on a charger, etc.)
- No reading with electronic blue light (computers, tablets, etc.- use a blue light filter such as comes on your device or the app Twilight if you must use them)
Consider:
- Allergy reduction (particularly dust mites)
- White noise machine or calming noise
- Noise masking sleep buds, such as Bose to block out snoring, traffic, etc.
Calming Your Mind and Body
Definitely do:
- Set a ‘window’ for getting to bed 85% of time (ex: 10:00-10:30pm)* Be as consistent as possible so your body learns the rhythm.
- Understand your transition. How long does it take you from the time you decide to go to bed before you actually get into it? Leave enough time for this routine.
- Take 2 minutes slow, deep breathing (focus on breath going in and out of your body) with feet on floor, eyes closed before getting into bed. This helps move your body into “rest and digest’ mode.
- Exercise, but not in the evening close to bedtime. (Rigorous daytime exercise aids sleep.)
- Make sure ADHD medications aren’t keeping you up (move latest dose earlier in day if they are)
- Keep a notepad and pen on your nightstand to capture ideas so anxiety about what needs to be done doesn’t keep you up
- Limit stimulating TV shows right before bed (also, light of TV suppresses melatonin)…turn TV off completely at least 45 minutes before lights out
Consider:
- Developing a short mindfulness meditation practice
- Listening to calming music or noises
- Doing a progressive muscle relaxation exercise (moving from toes to top of head, visualize relaxing one muscle at a time – eyes closed.)
- Visualizing a place you find relaxing.
- Taking 20 minutes before you start your going to bed routine to plan out the next day and lessen anxiety about it.
- If you take magnesium supplements, consider taking them before bed, as they can aid in sleep
*One way to determine what window is optimal for sleep is to track the quality of your sleep with an app or Fitbit over several weeks. It will likely show you a timeframe within which you get good quality sleep and the most of it. It will also likely show you the benefits of exercise for sleep if you are also tracking that. I have found this useful in learning that I sleep better if I have lights out by 10:15pm than if I turn them out after 11pm. With the former I tend to get more REM and deep sleep minutes
Falling Asleep / Staying Asleep
Definitely do:
- Drink less alcohol, and not after 8pm (digests as sugar and wakes you up)
- Eat lighter dinners, and not after 8pm
- A few minutes of whatever slows your mind down (soft music, crosswords, reading a few pages – NOT online media – something non-anxiety producing and non-stimulating!)
- Use the power of cuddling and relaxing in your partner’s arms – touch can be a good soother.
- If you wake up in the middle of the night it may be a circadian rhythm issue (rather than really needing a bathroom break). Deep breathing before bed might help with this. Deep breathing when you wake up can also be helpful. In addition, one reason people can’t get back to sleep if they wake up in the middle of the night is anxiety about falling back to sleep. Instead of worrying about “oh, no, I might not be able to get back to sleep again!”, just relax into it and think, “this will pass.”
- Address a partner’s snoring. Ask your partner to try to lessen it (ex: sleep on side instead of back; drink less; get an evaluation for sleep apnea; use snore strips; get a formed pillow that holds the neck in a better position) and consider ear plugs, white noise machines or even moving to another room during snore fests.
- If you are moving your bedtime earlier, do it in increments of 10-15 minutes at a time. More than that and your body may have trouble successfully adjusting to the change.
- If you or your partner thinks you might have a diagnosable sleep issue, such as sleep apnea, go get a sleep evaluation. If you do have sleep apnea (which many with ADHD do have) you will find that the current machines are not only less intrusive but can make a huge difference in diminishing ADHD type symptoms and in your daily life
Consider:
- Taking 3-5 mg of Melatonin (or up to 10. Talk with your doctor on this)
- Limiting afternoon caffeine (definitely do this if you think it’s keeping you awake!)
- Managing stimulant medications so that they don’t interfere with sleep – time your latest dose in the day so it wears off before 8:30pm
- Avoiding afternoon naps
- A stress management program if the level of stress in your life is keeping you awake at night
Making Your Body Healthier for Sleep
Definitely do:
- Eat a healthy, veggie/lean protein diet with lots of fiber and probiotics to support good gut health (connected to good sleep)
- Lower your stress levels overall – stress hormones interrupt sleep
- Choose a bedtime that allows you to wake up without an alarm. If you can’t do that, you should seek an earlier bedtime.
- MelissaOrlov's blog
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Comments
Medication and sleep
Submitted by Mozzie on
I'm in my fifties and I've had problems with falling asleep for as long as I can remember. I couldn't get comfortable. I would fidget. I would get in and out of bed multiple times to do random things I'd forgotten to do before bed but suddenly remember with laser like clarity when lying in the dark. The slightest noise, sliver of light or a crumple in the bed sheets would distract me. My mind would not be quiet - songs, To Do lists, what species of owls live in the local area, when did I last go to the dentist, I better take that frozen chicken out now because I'll probably forget in the morning etc. I did everything I could to improve my sleep. All the good doctor recommendations, gold standard sleep hygiene stuff. Did it work? A little. Sometimes. Not enough. It wasn't just me that was affected. I often kept my husband awake with my restlessness or I'd rudely wake him with one of my sudden departures from bed to put the water bill somewhere I would see it in the morning. Eventually I just resigned myself to being tired because 'I'm a bad sleeper'. I wasn't diagnosed with ADHD formally until late in life. So now I understand why I have struggled to sleep and why standard sleep hygiene hasn't 'fixed' the problem. But over time, I have found some things that have helped me - knowing I have ADHD and not being as anxious about not sleeping; at the end of the day, I send myself emails to remind myself of the things I need to do the next day; I walk my dogs for 40-60 minutes EVERY afternoon unless I have gastro or a broken leg; I like the bedroom to be cold and totally dark; my husband agrees to patiently wait for me to finish getting in/out of bed multiple times and diffuses his frustration by making fun of my bed time 'jack in the box' routine; to reduce distraction from random noise (like his CPAP machine), I run the ceiling fan most nights (even in winter) or, I listen to brown noise; when we go to bed, my husband and I have a cuddle as Melissa suggests - but not in summer because he is like a human radiator; I use a single weighted blanket to help keep me still (but only in winter); if I can't sleep and I'm anxious about keeping my husband awake, I get up and try to go to sleep in another room (he knows I have ADHD, so he doesn't take it personally); if I have trouble falling asleep before midnight, 3 nights in a row, I will take a short course of melatonin to get back on track. These strategies help but they don't always work. I try to figure out what's getting in the way and problem solving. One example is pain. I figured out that bursitis in the hip was not helping the Sandman come to visit so I got focused on addressing the pain problem. My next mission is to figure out if stimulant medication is friend or foe to catching consistent Zzzzz. My husband thinks medication has a negative impact on my sleep. But I'm not convinced. Medication has helped me a lot with the self-regulation shuffle and by the time I go to bed, the medication [theoretically] is no longer active. So I was wondering if others have experienced this conundrum? Could this be the 'rebound effect'?