Studies point to a new way to treat ADHD symptoms by addressing biorhythms.
It has long been known that individuals with ADHD tend to suffer from dysfunctional sleep. It’s unclear whether this is inherent to the disorder itself or if it results from ADHD symptoms, for example from feeling stressed all the time.
Either way, non-restorative sleep creates a vicious cycle—poor sleep begets an exhausted child (or adult), whose nervous system goes into overdrive (fight or flight reaction) to stay alert the next day (affecting attention and memory), and this prevents restorative sleep from occurring the following night. Furthermore, insomnia may be compounded by stimulant medication commonly used to treat the disorder. Add to this the nature of today’s ubiquitous high-stimulation environment and sleep quality worsens still.
A common aspect of sleep disturbance seen in those with ADHD is delayed circadian preference, aka delayed sleep/activity rhythm or delayed sleep phase disorder, which simply means the body clock is delayed and out of sync with natural night/day cycles. This type of circadian preference has been associated strongly with ADHD symptoms in adults, and studies have demonstrated that ADHD children with initial onset insomnia (trouble falling asleep) probably have delayed sleep phase disorder.
While not everyone with ADHD has sleep issues, those that do might very well benefit from targeting this area by resyncing the body clock. Two interventions have been suggested to advance the sleep phase: bright light therapy administered in the morning, and melatonin administration at bedtime. One promising study (mentioned above) showed that light therapy given to adults with ADHD over a three-week period resulted in decreased subjective (self-reported) and objective (neuropsychological testing) attentional symptoms, improved mood, and phase advance in circadian preference (i.e. subjects felt like going to sleep earlier, and did so).
Melatonin trials in ADHD children have shown improved sleep scores but not necessarily ADHD symptoms. (Melatonin tends to be suppressed and delayed in ADHD.) However one long term follow up study on melatonin safety in children in which parents were surveyed three to four years later showed that of the parents who had continued regular use of melatonin, ninety percent felt it continued to be effective for earlier sleep onset, and about two thirds reported it improved mood and behavior.
Another interesting eight-week trial compared the combination of melatonin and Ritalin to Ritalin alone—since stunted or delayed growth has been attributed to stimulants in children—and found that those treated with the combination grew more in height and weight, despite no difference in calorie intake. The authors suggested that the growth might be attributed to increased growth hormone, which is released during deep sleep, since the growth did not correlate with increased food intake. This highlights the intricacies of the body clock on hormone regulation.
This area is promising, and since out of sync circadian rhythms are associated with a myriad of health problems, resyncing may improve sleep quality, attention and executive functioning, hormone regulation, and mental/physical health in general. Light therapy in particular may be helpful in rapidly improving sleep and attention.
Life becomes shockingly bearable once you stop fighting your body and listening to its natural rhythms and patterns.
I was diagnosed with delayed sleep phase syndrome at 18. I didn’t know what to do with the label then, and it meant little to my medical team. We live in a world the upholds the 9 to 5 as the norm; anything outside of that is strange and a show of poor character. I’d already been through the process of drugging myself into resting and propping myself up with stimulants since age 8, so that just continued with highly mixed success.
However, I was forced off of the medication dictating an artificial sleep schedule earlier this year. Trying to uphold an early start time was destroying me. I was delirious from lack of sleep, my mental health was an active danger to me, the side effects of the medication were harming my body, and I was functioning, as a whole, worse and worse before 4pm.
While a bedtime of 8am initially made me feel guilty, the difference it’s made in my wellbeing is astounding. People really do need to sleep, and not everybody can sleep at the same times. Myself included! I’ve since embraced being nocturnal, and I now enjoy working late at night while the rest of the world is quiet.
It’s nice to finally not punish myself for needing something.
one of the most enlightening realizations ive had was finding out that non-24 hour circadian rhythm people were a pretty large group and most of us have oddly similar cycles of usually around 28hr internal “days” and this masquerades as “insomnia” but if allowed to sleep and wake naturally we will just advance forward through time an extra 2-4 hours a day at a relatively stable pace. we can’t go to school or jobs or even run errands on normal schedules without massive pharmacological and behavioral intervention. most of the people who have been diagnosed or figured it out themselves will report horrific, life-ruining disruption in their professional lives and terrible health from accrued lack of sleep. this disorder is most common in vision-impaired people which seems to suggest it’s related to light cues. anyway just thinking about this as extremely loud yard work woke me up at 8am for the second day in a row
lot of people reblogging this identifying themselves in it so i wanted to give you a link to a more detailed desription of Non-24-Hour Sleep-Wake Disorder, and mention theres a similar disorder called Delayed Sleep Phase disorder where you are on a regular 24 hour cycle but you naturally get sleepy around 3-4am every day and wake up around 10am-12pm (roughly). as far as i can tell, despite the widespread nature of both these disorders, its basically impossible to get diagnosed bvecause sleep medicine is probably the single most useless specialty and if you dont have sleep apnea they dont want to hear about it.
I"m fascinated by the implication that our internal biological circadian clock is 28 hours.. is is possible that in the earth’s rotation/orbit used to be longer or slower???
