Eva was a thirty-eight-year-old government employee who had significant problems getting up in the morning. When she first came to see me she had just been put on probation for being chronically late to work. She was very frustrated because she loved her job, but felt so sleepy in the mornings that she slept through four alarms. She was so scared that she actually went out and bought a siren to get her up in the morning. Even though that helped her, she had made all of her neighbors mad at her, and now she was threatened with eviction from her condominium.
Getting up in the morning and going to sleep at night are frequently significant problems for people with ADD. Sleep-cycle problems can interfere with relationships, work, school, and overall energy level. Chronic sleep deprivation makes ADD worse.
Mornings are difficult for many people with ADD. Here are some common statements people with ADD say as they’re trying to get out of bed:
“Later . . .”
“Just a few more minutes.”
“I’ll get up in a little bit.”
“Leave me alone.”
“My alarm is set” (even though it already went off).
“I’m too tired to get up.”
“Okay, I’m up” (only to lie back down for several hours).
Many people with ADD feel very groggy or fuzzy-headed in the morning. The harder they try to get out of bed, the worse it gets. One teenager I know had such a hard time getting out of bed that she almost got fired from her summer job. Her boss told her if she was late one more time she was gone. She had three alarm clocks and she had two of her friends call her in the morning. Many high school students are frequently late for school because of the trouble getting up. Adults with ADD also have this problem. Have you ever heard of adults who say that they have to have a couple of cups of coffee in the morning to get going? Coffee contains the stimulant caffeine. (Stimulants are common treatment for ADD.)
Parents complain that they have to wake up ADD children and teenagers three, four, five, six, even ten times before they get out of bed. This can cause a lot of family turmoil in the morning. When parents have to tell a child over and over to get out of bed, they can get pretty irritable. They may start yelling, threatening, or using force to get the child moving. Some parents we know use water or ice to help the child or teen get up. The morning grogginess causes many people with ADD to be chronically late, which stresses out everyone in the morning, especially if the parent has to get to work or has other children to get to school.
The child or teen who wakes up to parent hostility starts the day off in a bad mood. It’s hard to concentrate in class when you have just been yelled at, threatened, or grounded because you couldn’t get out of bed on time. This also leads to other problems. For example, if you can’t get up on time, you may miss the bus, get a speeding ticket, end up in the tardy tank, or just cut class so that you’re not late again. Starting the day off on the wrong foot can affect your mood and attitude for the whole day.
Many ADD people say that when they get up on their own, they tend to do better than if someone is screaming at them to get out of bed. It often becomes a battle of wills. Both people end up feeling terrible.
Without parents hassling kids, some children and teenagers don’t get out of bed until noon, 1:00, 2:00, or even 3:00 P.M.. This can cause serious problems. When kids get up late, they will have trouble going to sleep at night. Getting up late causes a large part of the day to go by without participating in it. Many parents complain that their kids are wasting the day.
Many people with ADD have sleep problems. Some “go and go” all day until they drop from exhaustion. Others have difficulty getting asleep, or they wake up frequently throughout the night. Some are even hyper in their sleep and constantly on the move. Getting a restful night’s sleep helps you feel calmer in the morning. After a poor night’s sleep, the ADD person has even more trouble awakening.
Here are some of the things people with ADD have said about their sleep problems:
“I have to count sheep to get to sleep, but the stupid sheep are always talking to me.”
“When I try to get to sleep, all kinds of different thoughts come into my mind. It feels like my mind spins when I try to calm it down.”
“I feel so restless at night. It’s hard to settle down, even though I’m tired.”
“The worries from the day go over and over in my head. I just can’t shut my brain down.”
“I have to sleep with a fan to drown out my thoughts. I need noise to calm down.”
Sleep disturbances can cause many other problems, in addition to the obvious problems of difficulty waking up and morning grogginess. If it is hard to settle down at night, it might make parents angry, because they know too well about the morning problems. Not getting enough sleep continues the cycle of feeling tired and wanting to sleep during the day.
One teenager I know had such trouble sleeping that he could never go to bed before three o’clock in the morning. This caused terrible problems: He couldn’t get up in the morning and had to drop out of school. This caused him to feel isolated from other people his age. He even went to the Stanford University Sleep Center for help with his problem. In the end, medication was needed to help his sleep cycle.
Doctors aren’t sure why people with ADD have more sleep problems. Some doctors think it has to do with serotonin, the neurotransmitter most closely tied to types 3 and 6 ADD. However, we all depend on serotonin to fall asleep, and when there is not enough of it, getting to sleep can be an awful chore.
Here are thirteen ways to make it easier to go to sleep. No one suggestion will work for everyone, but keep trying new tactics until you find what works for your situation:
1. Don’t watch television one to two hours before bedtime, especially any program that may be overstimulating (i.e., the shows you most like). This includes news programs, as people with ADD tend to ruminate on the bad things that happened that day in their own world and the world at large.
2. Stimulating, active play such as wrestling, tickling, teasing, etc., should be eliminated for one to two hours before bedtime. Quiet activities such as reading, drawing, or writing are more helpful in the hours before bedtime.
3. Some people try to read themselves to sleep. This can be helpful. But read boring books. If you read action-packed thrillers or horror stories you are not likely to drift off into peaceful never-never land.
4. Try a warm, quiet bath.
5. A bedtime back rub in bed may be soothing. Starting from the neck and working down in slow, rhythmic strokes can be very relaxing. Some children and teens say that a foot massage is particularly helpful (although it may be hard to find someone to give a teen a foot massage if they haven’t showered or taken a bath before bed).
6. Soft, slow music often helps people drift off to sleep. Instrumental music, as opposed to vocal, seems to be the most helpful. Some people with ADD say that they need fast music in order to block out their thoughts. Use what works.
7. Nature-sounds tapes (rain, thunder, ocean, rivers) can be very helpful. Others like the sound of fans.
8. Some people with ADD say that restrictive bedding is helpful, such as a sleeping bag or being wrapped tightly in blankets.
9. A mixture of warm milk, a teaspoon of vanilla (not imitation vanilla, the real stuff), and a teaspoon of sugar can be very helpful. This increases serotonin to your brain and helps you sleep.
10. We make hypnosis and guided imagery audios to help. These can be so powerful.
11. Learn self-hypnosis. Self-hypnosis can be a powerful tool for many different reasons, including sleep. Here’s a quick self-hypnosis course:
Focus your eyes on a spot and count slowly to twenty. . . . Let your eyes feel heavy as you count, and close them when you get to twenty.
Take three or four very slow, deep breaths.
Tighten the muscles in your arms and legs and then let them relax.
Imagine yourself walking down a staircase while you count backwards from ten. (This will give you the feeling of “going down” or becoming sleepy.)
With all of your senses (sight, touch, hearing, taste, smell) imagine a very sleepy scene, such as by a fire in a mountain cabin or in a sleeping bag at the beach.
12. Seek sleep control therapy. Here are the tips many sleep experts give to chronic insomniacs to help them get to sleep on a regular basis.
Go to bed only when sleepy.
Use the bed and bedroom only for sleep.
Get out of bed and go into another room when you are unable to fall asleep or return to sleep easily, and return to bed only when sleepy.
Maintain a regular rise time in the morning regardless of sleep duration the previous night.
Avoid daytime naps.
13. I often use our Restful Sleep formula (with regular and slow release melatonin, magnesium, valerian, and GABA) to help quiet the ADD busy mind.
Getting up and going to sleep can hinder the success of a person with ADD. Use the techniques in this chapter to help. Be persistent. If one technique doesn’t work for you, don’t give up: Try others.