"Sleep hygiene." Is that a phrase you've come across lately? Chances are you may have, since a Google search for that unique two-word phrase turned up 645,000 hits!

"Hygiene" seems like an old fashioned word to me, something that reminds me of my elementary school days. It refers to practices that maintain good health and prevent disease – like washing your hands or brushing your teeth.

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In last Wednesday’s HINT, we looked at how the lack of good sleep exacerbates or even creates some ADHD challenges. We also looked at some ways in which sleep might be disturbed, such as sleep apnea. This week we’ll look at recommendations for supporting folks with ADHD in “getting the right amount and quality of sleep.”

For folks with ADHD, getting the right amount of sleep can be difficult because of challenges in any of several areas: going to sleep, staying asleep, sleeping soundly, waking up on time, getting up on time, and staying awake as needed throughout the day. 

Many of my clients have had a lot of trouble with the waking up/getting up component. It didn’t matter how many alarms or other aids were set up to wake them, they either would not wake up or would fall right back to sleep after waking up. When I invited these client to look at possible reasons for those difficulties, we found that most of them did not get to bed or go to sleep at a time that would allow them to sleep as long as their bodies needed. 

Many people with ADHD who experience sleep problems have a “delayed sleep phase syndrome, a disturbance of the circadian rhythm.”  Many of those folks stay up too late because their bodies won't let them fall asleep at a reasonable hour. Last week I was speaking with another ADHD coach who told me he starts his work day at 1pm because he can't get to sleep at a "normal" time. Fortunately, he is in a business that lends itself to a 1-9pm workday!

For some folks who can't get to sleep when they need to, one factor may be that their bodies produce the sleep hormone melatonin later in the day than is the case for most people. Melatonin is a hormone that helps your body know when it is time to sleep and to wake up. Check out this article for a more in-depth discussion of the function of melatonin. The doctor who wrote the article suggests that, if taken early enough in the day, melatonin supplements can help in establishing an earlier time of sleep onset. You'll want to check with your doctor to see if this is right for you.

Other measures that will stimulate sleep involve some routines and regimens that you might want to experiment with. The list below is compiled from several online and offline sources. I hope you find some of them helpful.

• Use earplugs or a white noise machine 
• Keep the room completely dark or use eye shades
• Lower the lights in your home an hour or so before you want to sleep
• Have a consistent schedule of going to bed and waking up every day, including weekends
• Don’t take a nap within four hours of your desired bedtime, and when you do nap, don’t sleep longer than 30 minutes
• Avoid stimulants such as tea, coffee, cola, nicotine, and chocolate within 4-6 hours of bedtime
• Time your eating so that you are neither hungry nor stuffed at bedtime
• Engage in vigorous exercise earlier in the day but not within a few hours of bedtime
• Avoid alcoholic beverages close to bedtime
• Don’t have electronic devices such as TV, computer, tablet, or  smart phone in your bedroom
• Have regular exposure to natural light during the day, especially late afternoon, and allow morning light into your room as the seasons allow
• Establish a bedtime routine that includes activities such as a warm shower, dimly lit rooms, reading something neutral, listening to calming music, etc., and that avoids activities that are physically, mentally, or emotionally stimulating
• Have a notebook by your bed for writing down thoughts that you are afraid you’ll forget; writing them down will help you let them go, because you've captured them on paper
• Keep your bedroom slightly cool, though you might be helped by keeping your hands and feet warm with gloves and socks
• Hide your clock so that you are not lying in bed watching the seconds pass
• If you don’t fall asleep in 20 minutes, get up and read or listen to music until you are tired and ready to sleep
• Drink enough in the evening that you don’t wake up thirsty, but not so much that you wake in the night for one more more trips to the bathroom

As we have discussed in other HINTS, start with small steps as you experiment with new strategies. You might find it helpful to keep a diary of what you’ve tried and the results and circumstances related to your experiments. This record might be of value to your doctor if you consult with him/her about your sleep challenges.

If you have another strategy that works well for you and you’d like me to share it with ADHD HINT subscribers, please let me know. This is a community of support and we can all learn from each other!