Sleep Hygiene

Research is just starting to shed light on whether the severity of ADD symptoms could be improved by better sleep hygiene, which is defined as “the variety of different practices that are necessary to have normal, quality nighttime sleep and full daytime alertness.” A study published in early 2015 found that a brief sleep intervention “modestly improve[d] the severity of ADD symptoms” among children with ADD, most of whom were treated with stimulant medications. The intervention “also improved the children’s sleep, behavior, quality of life, and functioning” for as long as six months after the intervention ended. Still, much more research is needed to understand the effects of ADD treatment on sleep as well as the connection between ADD and sleep disorders in the physical brain.

If you are taking stimulant medication and experience insomnia (difficulty falling and staying asleep), this may be a side effect of the stimulant medication used to treat adult ADD. Insomnia can actually worsen ADD symptoms, so it is important to discuss this with your healthcare provider as you work to manage and treat your ADD.

The NIH’s publication, Your Guide to Healthy Sleep, recommends:

  • Sticking to a sleep schedule. Go to bed and wake up at the same time each day.
  • Exercising, but not too late in the day. Try to exercise at least 30 minutes on most days but not later than 2–3 hours before your bedtime.
  • Avoiding caffeine and nicotine. Coffee, colas, certain teas, and chocolate contain the stimulant caffeine, and its effects can take as long as 8 hours to wear off fully.
  • Avoiding alcoholic drinks before bed. Having an alcoholic beverage before sleep may help you relax, but heavy use robs you of deep sleep and REM sleep, keeping you in the lighter stages of sleep.
  • Avoiding large meals and beverages late at night. A light snack is okay, but a large meal can cause indigestion that interferes with sleep. Drinking too many fluids at night can cause frequent awakenings to urinate.
  • If possible, avoiding medicines that delay or disrupt your sleep.  If you have trouble sleeping, talk to your doctor or pharmacist to see whether any drugs you’re taking might be contributing to your insomnia and ask whether they can be taken at other times during the day or early in the evening.
  • Not taking naps after 3 p.m. Naps can help make up for lost sleep, but late afternoon naps can make it harder to fall asleep at night.
  • Relaxing before bed. Don’t over-schedule your day so that no time is left for unwinding. A relaxing activity, such as reading or listening to music, should be part of your bedtime ritual.
  • Having a good sleeping environment. Get rid of anything in your bedroom that might distract you from sleep, such as noises, bright lights, electronic devices, an uncomfortable bed, or warm temperatures. Turn the clock’s face out of view so you don’t worry about the time while trying to fall asleep.
  • Having the right sunlight exposure. Daylight is key to regulating daily sleep patterns.  If possible, wake up with the sun or use very bright lights in the morning.
  • Not lying in bed awake. If you find yourself still awake after staying in bed for more than 20 minutes or if you are starting to feel anxious or worried, get up and do some relaxing activity until you feel sleepy.