This is a Global Player original podcast. Hi, it's Katie and Sam, and welcome to this bi-sized episode of You're Wrong About ADHD. Advice today from Dr. Sophie Postock, talking about ADHD and sleep.
An incredible conversation for me, because she actually gave me permission to look at my phone at night. Well worth a listen. Let's get into it. It's one of the hardest things I find to regulate as part of my ADHD, and I also know that it's one of the things that makes my ADHD much better.
So I want to talk to you today about what is the connection, what is going on in our heads which makes it so hard for us to sleep, but then how can we fix this, how can we fix this? I am your typical night owl, and I cannot get to sleep at night. What is going on? And I know that's fairly typical of ADHD is.
What is going on in my head that makes it so hard? Okay, so I guess the first thing to say is everyone's different. There's not going to be one answer that's going to be, you know, the key for you. I often find it helpful to think about the three systems which influence the timing and quality of sleep, and we can talk about how ADHD might influence each one of those, if that's okay.
It'll give us a framework, I think, to work with. So basically, when and how well you sleep is controlled by these three different systems, and they're all independent. So if one of them's a bit skew, the good news is that we can focus on the other two. So we'll start with circadian rhythms, your internal body clock.
And this is really the instructions that are written into your DNA that tell you to be active during daylight hours and to rest and recover at night. And as you've quite rightly pointed out, very often in ADHD, people have a delayed circadian rhythm. So they are natural night owls. They really struggle to get going first thing in the morning, and yet they're naturally more alert late at night.
And, you know, for you going to bed at 11 probably feels a bit like me going to bed at 8 o'clock in the evening. It just doesn't feel quite natural. So right. Right, so we can come back to, right, what are we going to do to shift these circadian rhythms?
But there's no doubt that that's a bit of a challenge for a lot of ADHDers. And I think the other thing around circadian rhythms is that we all thrive on routine. Now, this is the same for everyone. But we also know that in ADHD, sometimes it's very hard to stick through a structure in a routine.
Or allergic, it's not as hard. We actually remain really angry by routine. And sleep thrives on routine. Because when you do the same things at the same time every day, so if you get out of bed at the same time every day, it anchors all of these little circadian rhythms.
And you have these rhythms in every single cell in your body. It's not just sleep and wake. This is what controls your focus, your mood, your immune function, your metabolism, your appetite. Everything is running on these 24-hour rhythms.
So if you can get them in sync, then it means your brain can anticipate what's going to happen next. Everything works very efficiently. So it's really good for everyone. So we'll come back to it.
So that's circadian rhythms. The second one is sleep pressure. And that builds up during the day. It's almost like an elastic band.
The longer you've been awake, the more you feel this kind of pressure to sleep. And when you get to a certain point, you will sleep, which is a good thing. But you can mess with that sleep pressure by using stimulants. And the most popular is caffeine.
And what caffeine does is it actually blocks the receptors in the brain that receive the message that it's time to be grousey. And I think if you are used to having an ADHD brain and sometimes using caffeine to try and help you focus, sometimes we go too far. And actually, a recent review last year suggested that if we're drinking coffee, we really need to stop drinking at 8.8 hours before we want to go to sleep if we're going to have uninterrupted sleep. So that is also definitely a factor.
And then the third system, so we've got a cadence of sleep pressure, and then perhaps the big one, which really totally screws with the other two, is the stress system. So all of our automatic processes, like heart rate, breathing rate, blood pressure, are constantly kind of in flux. We're controlled by these two arms of our automatic or autonomic nervous system. And there's fight or flight, which is all about action and movement.
And then we've also got rest or digest. And what we really want for sleep, obviously, is for our rest or digest, our parasympathetic nervous system, to be dominant. But in ADHD, we know that there's a tendency to kind of lean into the fight or flight system. We've got a brain which is a bit more aroused.
That's one of the kind of key characteristics. And it's incredibly difficult to switch that off sometimes. So we've got to rehearse it. We can't just rely on getting into bed, switching out the light, and expecting our brain to switch off.
We've got to train it to wind down and perhaps using intervals throughout the day to practice that process of relaxation, which is then also going to help us at night. So that's a little kind of overview, I guess, of some of the ways that ADHD can influence sleep. And I think for a lot of people, so if you're taking medication, that can have stimulant effects. And certainly, if you've noticed that changing your medication or starting medication can influence your sleep, it's obviously really worth talking to your medical professional about could you take it a bit earlier so that it's not going to have that impact.
Such a good chat. I've heard so much from our conversation with Dr. Sophie. If you enjoyed listening to this bite-sized episode and want more, you can find the full episode linked in the show notes or many more episodes like this one on the podcast feed.
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This is a Global Player original podcast.