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ADHD, Sleep and Circadian Rhythms

Posted by Coach Kim Collins on January 14, 2013

Sleep is a huge problem for adults with ADHD. Recent studies estimate that up to 83% of patients suffer some type of sleep disturbance. But despite this close correlation, there’s a surprising lack of scientific research to explain exactly why ADHD patients are such bad sleepers.

One of the reasons for this gap in our knowledge is because the sleep/ADHD relationship raises a chicken and egg question: is ADHD (and its associated medication) the cause of sleep problems, or is it the other way round, i.e. do existing sleep problems cause ADHD?

Studying the rhythms

Most sleep/ADHD studies to date have focused on children with attention deficit disorders, so relatively little is known about the sleeping patterns of adults with ADHD. But new research published in 2012 is beginning to shed some light on this area, in particular about the circadian rhythms of adults with ADHD.

Circadian rhythms refer to the built in 24 hour internal clock which governs our sleep wake cycle. In normal healthy individuals, this clock is linked to the light/darkness cues of day and night. As darkness approaches, the hormone melatonin is secreted by the pineal gland inducing drowsiness. Similarly, the light of dawn signals other physiological responses to facilitate wakefulness.

To monitor these changes, the scientists fitted the participants with actigraphs to measure their movements during sleep, and took saliva samples at regular intervals to measure melatonin levels. They also took readings of two ‘clock’ genes, and another hormone, cortisol which also varies with circadian rhythm.

The measurements clearly demonstrated a wide range of sleep disturbances in the ADHD patients. Compared to the control group, night time activity levels were higher, sleep duration was shorter and over half of the adults with ADHD took an hour or longer to fall asleep,

But perhaps more intriguing were the discoveries regarding the circadian rhythms of the ADHD group. They showed a marked preference towards ‘eveningness’ or ‘owl’ behaviour, i.e. they slept and woke later. This tallied with their cortisol levels, which peaked 3 hours later than the control group.

The ADHD group also expressed a much weaker melatonin cycle, whilst their clock genes, compared to a steady pattern for the non-ADHD group, showed a complete breakdown i.e. no rhythm at all. The study concluded that: “adult ADHD is accompanied by significant changes in the circadian system, which in turn may lead to decreased sleep duration and quality in the condition

What are the implications?

Whilst this was a small-scale study, the findings raise some interesting questions. Do faulty circadian rhythms lead to ADHD? Can ADHD symptoms be treated in the same way as circadian rhythm disorders i.e. with melatonin or light therapy? Is there a link between the altered cortisol response (which is also a stress hormone) and the mood and anxiety disorders common in ADHD patients? If nothing else, the results of the study suggest an interesting direction for new research.

What practical steps can be taken?

The good news is that these days you don’t have to go to a sleep laboratory to find out what your sleep patterns look like. You can examine your own circadian rhythms just by downloading an app onto your smartphone. More advanced systems such as the Zeo Sleep Manager can track your sleep patterns and provide you with detailed graphs showing you exactly how much REM and deep sleep you’re getting. Alternatively, just use a pen and paper and start to make a log of your sleep habits, including sleep duration, wake time and when you feel drowsy during the day.

Gathering the data is just the first step. Once you have more information about your personal sleep patterns, consider talking with a health professional about how you can make a positive change to your life by tackling your sleep problems.

This is a guest post by Jeff Mann,  owner of Sleep Junkies, a website dedicated to bringing you the latest research, news and tips about sleep to make you healthier, happier and smarter.

 

Image courtesy of Ambro at http://www.freedigitalphotos.net

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Clever ADHD Products

Posted by Coach Kim Collins on January 12, 2012

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Listen to Your Body

Posted by Coach Kim Collins on September 6, 2011

Are you listening to your body? If you were to check in with your body right now, what would it tell you? Would it tell you that you are hungry, thirsty, tired, stressed, that you’ve been sitting at the computer too long, or that you have to go to the bathroom?

I tell my clients all the time that if you don’t listen to your body – eventually it will be heard!

Listening to your body is particularly difficult when you have ADHD. If you are constantly distracted by things or get easily caught in hyper-focus, it’s hard to remember to pay attention to what your body is telling you.

Ignoring messages of pain and discomfort can eventually have permanent repercussions. So, it’s important that you set up a system that reminds you to check in with yourself.

  1. Establish a timeframe to check in with yourself, like every 30, 60, or 90 minutes.
  2. Decide what you will ask yourself during your check in. For example, what do I need to start doing or stop doing to feel focused and energized right now?
  3. Choose a reminder tool to use like your computer, your cell phone or a habit changing device called MotivAider.

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How Are Your Weekends?

Posted by Coach Kim Collins on August 31, 2011

Are you spending the weekends the way you want to? Most of the time we are so focused on creating structure during the weekdays, we forget about planning how we will use our time on the weekend.

The weekend presents a challenge for many people with ADHD because the built in structure of work and school are not present.

The first thing you want to think about is, how exactly do you want to spend your weekend? Do you want to use your weekend to take care of household chores so that your weeknights are free? Or do you prefer to take care of your chores during the week so that your weekends are free for rest and recreation? Another option is to balance your chores between weeknights and weekends so that you will have time for finish up chores and get some recreation.

The important thing is that you think about how you want to spend your time and plan a loose structure so that you control your weekend instead of your weekend controlling you.

  1. Make a list of things that must be done on the weekend and post it where you will see it.
  2. Plan weekend activities as a family and put things on the calendar.
  3. Make a habit of getting the kids to prepare for the week (doing homework , chores, and getting clothes ready) Friday night or Saturday morning to avoid the last minute Sunday night  chaos.
  4. Alternate weekends with other parents to shuttle kids around for weekend activities.
  5. Choose at least one fun or relaxing thing to do every weekend.
  6. Try to establish one weekend a month where you don’t do anything you don’t what to do.

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Jump Start Your Brain And Get Tasks Done!

Posted by Coach Kim Collins on May 5, 2011

  1. Do something physical. Every time you exercise you are helping your brain’s executive functioning abilities. I usually recommend doing some jumping jacks, running up and down the stairs a few times or taking a quick walk.
  2. Meditate before you jump into a difficult or boring task. Just take 5 minutes (set a timer) and focus on your breathing, take a quick power nap or visualize yourself successfully completing your task.
  3. Drink some water. Dehydration can impact your ability to stay focused and can impair your short-term memory and the recall of long-term memory.
  4. Take a Green Break. According to Kathleen Nadeau, PhD “Taking breaks to refresh your energy and concentration is an effective way to increase your chances of completing your task.” Because the color green has a calming quality, Nadeau suggests facing something green (particularly something in nature) and focusing on it while taking deep breaths.
  5. Get motivated with music. Music has to power to change your state of mind. So, pump up to music to get you in the mood to work.
  6. Be accountable. Tell someone else what you plan to do and when you will be finished. Then arrange to check back in with them when you are done.
  7. Try the 5 minute method. Set a timer and just start the task for 5 minutes. Once the timer goes off you can decide whether you want to continue or transition to something else.
  8. Create a Benefits & Consequences Card. The ADD brain rarely remembers the pain of the past and the goal of the future. So it may be helpful to write on an index card what the benefits are for getting the task done and what the consequences are for putting it off. Post the card in front of you so that you are reminded of these things in the moment.
  9. Talk through your task with someone else. Sometimes you just need to talk about a task with someone to clear your mind and organize your thoughts. Set a 5 – 10 minute timer and call someone you can use as a sounding board. A brief conversation may be all you need to get started.
  10. Create an endpoint. Write out what your goal is for a single work session, define how long the work session will be and plan a reward for when your are done .

Posted in ADHD, Productivity | 1 Comment »

Hyper-focus

Posted by Coach Kim Collins on January 12, 2011

Are you tired of getting caught in hyper-focus at the wrong times?

The ability to hyper-focus or concentrate intently on one task for a long period of time can be a gift when it’s not standing in the way of accomplishing other things that are important. Here are some strategies that may help you rein in your hyper-focus so that you can use it when you need it.

  • Pay attention to what types of activities or tasks you tend to hyper-focus on and plan to do those types of tasks when you are not in danger of missing an appointment or deadline.
  • Practice stopping. Set a timer across the room (out of reach) to go off every 30 – 60 minutes and no matter what you are doing  – stop, stand up and go turn off and reset the timer. By practicing this you are conditioning yourself to work in 30 or 60 minute blocks and to react to the alarm when it goes off.
  • You can also place a post-it note on your timer to remind you why it’s important to stop and move on to the next task.
  • It may be easier to break away from a task when you make it small enough to do quickly. So, break your tasks into bite-sized action steps that take 5 – 15 minutes.
  • Plan time to hyper-focus. Clear the decks of other essential projects and then allow yourself to work on a task for a large chunk of time. You might want to have someone call or come and get you so that you won’t work too long without taking a bathroom or food break.
  • Afraid of interrupting the flow of creativity that hyper-focus brings? Learn to bookmark your spot so that you will be able to come back to where you left off. Practice this by using the last 5 minutes of a task to tie up loose ends and note what you were thinking and what your next step should be.

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Adult ADHD is Real: But How to Convince the Unconvinced?

Posted by Coach Kim Collins on August 23, 2010

Do you know or love someone with ADHD? Do you struggle to understand the difficulties and inconsistencies  of ADHD? This is book you should read.

Gina Pera, author of the book “Is it You, Me, or Adult A.D.D.?” has asked the questions that many Non-ADDers are asking:

  • Why does my partner have lots of attention—for some things?
  • Why does my partner get the fun, and I get the drudgery?
  • Why is my partner consistent—at being inconsistent?
  • Why can’t my partner “Try Harder” to pay attention?
  • Why can’t my partner just grow up?


Click the link below to read more about this book!

Adult ADHD is Real: But How to Convince the Unconvinced?.

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Describing ADHD

Posted by Coach Kim Collins on June 23, 2010

I was recently given an interesting assignment in an ADD coach training that I’m in. I was asked to write 2 sentences: one describing how I would explain ADHD to an everyday person and another describing how I would explain it to an employer.

I posed these two questions to a small group that I run and here are the sentences I crafted from their response.

  1. As  a person with ADHD I can focus intently on things that are engaging, but at the same time, am easily distracted when doing routine tasks; consistency in any endeavor is extremely challenging.
  2. I can be an extremely creative, flexible, and energetic employee when my job responsibilities are clearly defined, when I am given deadlines, feedback, and can maintain frequent communication with my boss.

How would you describe ADHD (in positive terms) to someone in one sentence? Please send me your response by commenting on this post.

Posted in ADHD | Tagged: | 1 Comment »

 
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