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  • Writer's pictureAviva Nirenberg

Back to basics Part 1: Sleep

Why search far and wide for the newest most exciting and exotic ADHD treatment when some of the most effective but overlooked ways to manage ADHD are simple, free, and easy to implement?

Today we'll begin to explore the foundational pieces of ADHD management. Even if our overall ADHD treatment plan includes many components, it is critical that we start with these building blocks: sleep, exercise, and nutrition.

In addition, when we notice an exacerbation of ADHD symptoms, our first step should always be to recheck and evaluate how we're doing with these three basic necessities.

Quality sleep is an essential part of ADHD management. Restful sleep has a positive impact on many of ADHD's core symptoms. For example, a good night's sleep improves the ability to focus and sustain attention. It also can lessen hyperactivity. In addition, good sleep enhances impulse control, emotional regulation, and overall mood.

However, getting a good night's sleep, unfortunately, is not as simple as it may seem. The ADHD brain wiring often makes sleep a challenge. In fact, more than 50% of ADHD children and 70% of adults affected by ADHD reported sleep disturbances. (, 2017)

One explanation is the difficulty that those with ADHD have with neurotransmitter regulation, since the neurotransmitter, serotonin plays a prominent role in sleep cycles. Also, people with ADHD may experience abnormalities in their sleep patterns or circadian rhythms.(, 2017) There is also scientific evidence that ADHD individuals may have trouble entering and sustaining REM sleep, the deepest phase of the sleep cycle.(, 2008) Consequently, they don't feel refreshed in the morning.

Other factors also contribute to the prevalence of sleep problems among the ADHD population. ADHD stimulant medications such as Ritalin, Adderall, or Vyvanse may still be in the body and make sleep difficult. Also, for the ADHD brain, that thrives on interest, sleep may seem too boring an activity. Additionally, cognitive hyperactivity or a constant bombardment of thoughts may make it difficult for the ADHD brain to shut down and prepare for sleep.

Don't get discouraged, though. While it may seem that ADHD and restful sleep are an unlikely pair, implementing good sleep habits can reap enormous dividends.

Daily exercise, although not too close to bedtime has a tremendous effect on the ability to fall asleep and sleep more deeply. A consistent bedtime including weekends is also very important. A pleasant sleep environment also promotes more restful sleep. That can include a comfortable bed, blanket, pajamas, and a pleasant room temperature.

It's also a good idea to avoid activities that may hinder restful sleep. From late afternoon, it's a best to avoid drinking caffeinated beverages. Also, from 1 to 1 1/2 hours before bedtime it's recommended to stop using a cellular phone or computer because the blue light they emit affects melatonin production and sleep quality. (, 2017) Another tip is to refrain from any activities that are very engaging for you, like reading the latest suspense novel. Finally, try to avoid eating within two hours of bed time. If you are very hungry, make it a light snack that's high in protein and will help induce sleep such as an egg, almonds, cottage cheese or turkey. Other snacks for good sleep include cherries, bananas, oatmeal, an apple or plain crackers.

Finally, it's vital to introduce and maintain a good bedtime routine. In other words, the hour prior to your designated bedtime should be devoted to winding down. The most important thing is that this time should be relaxing for the individual. Some possibilities are quiet reading or storytime for a child, listening to calming music, or a warm bath or shower. To relieve stress and anxiety accumulated during the day, some may benefit from breathing exercises, progressive muscle relaxation, thinking positive thoughts, or envisioning a favorite place. So, while sleep may certainly pose challenges for ADHD individuals investing the effort to implement good sleep habits will have tremendous rewards.

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