ADHD and sleep problems

Many kids with ADHD have trouble with sleep. When kids can’t fall asleep or stay asleep, many families struggle with everybody getting a good night’s sleep. 

In this episode, hosts Amanda Morin and Gretchen Vierstra talk with guests who are “in it” when it comes to sleep challenges. First, they hear from Belinda, whose son has ADHD, autism, and trouble sleeping. Find out how she deals with sleep challenges, both as a parent and as someone who struggles with sleep herself.

Then, the hosts get expert advice from a clinical psychologist, Dr. Roberto Olivardia. Learn more about the connection between ADHD and sleep. And get ideas for better sleep from his toolbox of strategies.

Related resources

• How ADHD affects sleep — and what you can do to help

• Download: Bedtime checklists for kids 

• Follow Belinda on Instagram to see more about her advocacy for neurodivergent people. 

Episode transcript

Amanda: Hi, I'm Amanda Morin. I'm the director of thought leadership for Understood.org, and I'm a parent to kids who learn differently.

Gretchen: I'm Gretchen Vierstra, a former classroom teacher and an editor here at Understood, and this is "In It."

Amanda: "In It" is a podcast from the Understood Podcast Network. On this show, we talk to parents, teachers, experts, and sometimes even kids. We're here to offer perspectives, stories, and advice for and from people who have challenges with reading, math, focus, and other types of learning differences.

Gretchen: Today, we're looking at the very real connection between ADHD and sleep problems. And we'll be providing some excellent advice on how to help kids who just can't seem to get a good night's sleep.

Amanda: Later, we'll hear from Dr. Roberto Olivardia, a clinical psychologist who teaches at Harvard Medical School, and has a psychotherapy practice in Lexington, Massachusetts. He specializes in working with kids who have learning differences and with their families. He's also an Understood Expert.

Gretchen: First though, we're talking to Belinda, a mom in Florida who has definitely been in it when it comes to ADHD and sleep challenges. Belinda has a 12-year-old son, who she's calling Mr. B to protect his privacy, which is kind of funny. Because when I refer to my 12-year-old when I'm talking publicly about him and what makes him neurodiverse, I call him Mr. 12, and we had a really good laugh about that.

Gretchen: Mr. B has ADHD and is autistic, and he's gone through periods where sleep has been a major challenge. And Belinda has the same diagnoses, and has had the same struggles.

Amanda: And we are so grateful to her for sharing her experiences with us. We're talking today about how ADHD can affect sleep, something I know has been an issue for your family. But before we get into it, I'd really love to know a little bit about you and your son. What is he into and what does he like to do?

Belinda: Well, so Mr. B, he's my only son. So that lets you know right away he does tend to get a lot of extra presents on Christmas. But he's a bright kid. Let's see. He plays soccer. He loves Roblox, which he's playing actually right now. He likes Legos. He loves to read. He's got a good sense of humor for a young child. He's a little bit precocious. And he was diagnosed with ADHD fairly recently, in 2018. He also was diagnosed with anxiety at the time. And then 2020, we went back because even though he was on medication, we just were like, "Something's still a little off." And he was diagnosed with autism. Personally, I was also recently diagnosed on the spectrum as well, and I have ADHD and anxiety. So what drove me to get a diagnosis was I felt that a lot of his experiences, a lot of the ways that he was reacting, it was almost like I was looking in a mirror. And it brought back a lot of my past, a lot of my childhood. He's like a mini me. It's interesting.

Amanda: He sounds like a lot of fun. And I will tell you that Mr. 12 also has ADHD and he uses the phrase "autistic." So Mr. 12 is ADHD and is autistic, and is probably playing something like Roblox in the other room right now too.

Gretchen: Do you want to move on to sleep, Amanda?

Amanda: Yeah, I think we should. Well, I would love to move on to sleep. I don't sleep well, so I would love to move on to sleep. But we know that having ADHD can make going to sleep difficult, and I'd really like to know what that looked like for your son. But I'm really wondering if it's something you also have struggled with.

Belinda: So as a baby, in Spanish, we say "ojo duro," which means a hard eye, difficult to fall asleep. And 4 a.m. was his witching hour. So he'd put her in bed, and like clockwork at 4 a.m. my husband would go and tend to the baby. And he said his eyes would be like this in the darkness, like kind of looking around. And this is an infant. I mean, he was under 6 months old. Naps were, I mean, it was very difficult to get him to nap. I would literally drive around while he fell asleep. And what also made it a bit difficult as well is hearing from mom friends, "Oh, mine sleeps through the night. What an angel." And you're like, "Ugh."

Gretchen: Oh, geez.

Belinda: So yeah, and I was the same way. Sleep is still a struggle to this day for me. My husband's the opposite. He can lie down, go to sleep. No problem.

Amanda: That's our house too. There's something about that that makes you want to be like, "I'm so happy for you and also wake up, because we're awake right now too."

Belinda: Yeah.

Gretchen: I wondered if you just could tell us a little bit about when your son was a baby. I know you said you drove him around. What were some of the other things you did that worked? Because I know that can be a struggle for lots of families.

Belinda: Yes. So some things were typically used with babies, the rocking chairs, the swaddling. We made sure the temperature was just right for sleep. How he slept, what he was wearing. Music was soothing. We tried also white noise. There was a lot of laying him on my chest, a lot of having him feel like snuggled, a lot of rocking, a lot of late nights.

Amanda: My goodness. Mr. 12 was so much the same way. I was actually writing a book when he was a baby, and I would swaddle him. And I was typing. And I say today that I'm still brushing crumbs off the top of his head from when I was eating over him.

Belinda: Yes.

Amanda: What's his sleep like now?

Belinda: Well, so he started sixth grade. And when COVID hit in our state, we had lockdown. And then we had to do homeschooling. That really affected his anxiety levels. So when he was beforehand sleeping through the night, post quarantine lockdown to now, he cannot fall asleep alone. It's been a real struggle. He will not fall asleep unless someone is there with him. He will wake up in the middle of the night, come to my bedroom, unable to sleep. And we did go through a sleep psychologist. We tried medication.

Now, I will say when he was a baby, we lived by the beach and we lived by forests, kind of a cool situation we have. The beach would tire him out. We'd go there and he'd play in the waves and the sand and make sand castles. And he would fall asleep on the way home. And when you're talking about crumbs, there would be sand all over his pillow. So that's one thing that I could suggest, is when they are younger, definitely tucker them out. I think nature really has a great way to tire kids out and they get that nice fresh air in their lungs. But then, I mean, the pandemic really has made a difference. So he has a Spotify playlist, weighted blankets, night-light. We tried teas. I mean, I think you name it, we probably tried it.

Amanda: Does he worry about going to sleep?

Belinda: Well, honestly, what happens sometimes is he comes alive at night and he'll want to have conversations. And the thing I will say is these are the conversations that are important. This is when he tells me if something is bothering him, what's on his heart. He'll just start having these questions, like these deep philosophical conversations at bedtime. And that's OK, but I'm like, "It's 11. You got to go to bed. We got to be up at 6 for school." So I try to curb him by answering quick and saying, "Hey, let's talk about this in the morning."

Gretchen: My daughter is... I mean, she unpacks everything right before.

Belinda: How old is she?

Gretchen: She is 13. So everything gets unpacked right before then. And like you said, it's a struggle, because these are important conversations that you want to have, but not at 10:00 at night. But I wonder what's on your Spotify playlist. What kinds of things are on there that are helping?

Belinda: We've actually looked at ADHD and sleep. So we'll put those keywords in, and these lists come up. There's one that's classical guitar and the classical piano, but I need to make sure they play for at least eight hours. That's the key. Because if they stop, it could be great music, but if it stops in an hour or three hours, he'll be up.

Amanda: Interesting.

Belinda: So my best tip would be, make sure it's long and play it on loop.

Gretchen: I have a question around that though.

Belinda: Yes.

Gretchen: Because I know lots of times families worry about putting phones in the bed with their kids. Does your son ever get distracted by anything else or does he...?

Belinda: Well, it's an old phone.

Gretchen: OK.

Belinda: It has Wi-Fi, but no calling out. So I put in parentals controls and I put the timer. So it's fixed to the only thing he can access overnight would be Spotify and go to flashlight. And that might be it.

Gretchen: No, that's helpful.

Amanda: That's such a good tip.

Gretchen: That's a good tip. That's such a good tip.

Belinda: Yeah. Now, he does need someone there with him. So these are some tips. We have night-lights, we have music, but he still needs that comfort of having someone there. You have the weighted blanket. I mean, I feel like I've tried and done pretty much everything. And the way I look at it is, I'm an '80s kid. So diagnoses, all these things, plus being from South American culture, my mom was like, "OK, you can't sleep? OK. That's fine. Go to my room. Maybe leave a light on," or whatever, but it wasn't how we are now when we have this technology and we have more information and we know what we can try. My father, he's the same way, difficult to sleep. Night owls, we just tend to come alive at night like vampires.

Amanda: Thank you so much for joining us today.

Belinda: Thank you for having me.

Gretchen: Thank you so much.

Belinda: Amanda and Gretchen, it's been a pleasure. Thank you.

Amanda: You can keep up with Belinda and her advocacy work on behalf of folks who are neurodivergent on Instagram or Twitter. Check the show notes for her handle.

Gretchen: Like Belinda and Mr. B, Roberto Olivardia has had sleep challenges for most of his life.

Amanda: Now, as a psychotherapist and researcher, he has a greater understanding of why ADHD makes sleep so hard for him and for many others. And he's got a toolbox full of strategies to make it easier.

Gretchen: We're so happy to have him here with us today to share what he's learned.

Amanda: Thank you for joining us, first of all.

Dr. Olivardia: Sure. My pleasure.

Gretchen: We're so excited to talk to you about this hot topic of sleep.

Dr. Olivardia: Oh yeah.

Amanda: It's something that does come up a lot in conversations with families who are what we call "in it," and we're hoping you can help us better understand it.

Dr. Olivardia: Definitely. Well, I have ADHD myself. And I mean, I'm a sleep disorder poster child. And then I have two kids with both have ADHD. And even as infants were, I mean, my poor wife would be at mothers' support groups. And they'd be like, "Oh, finally, my kid's sleeping through the night at 5 months old." And my kids were like 16 months old when they slept through the night. So I know from a personal experience. But even today, I mean, sleep is still, it's an issue for me. It's a full-time job for me to get to bed every night.

Amanda: That's so relatable to me. It is in our house too. And I'm curious how often concerns about sleep come up in your work with patients who have ADHD.

Dr. Olivardia: Right now, sleep problems are not in the DSM, the Diagnostic Statistical Manual criteria for ADHD. I suspect, at some point, it will be. Because frankly, I don't know anyone with ADHD that hasn't had an issue with sleep. So whether that's trouble falling asleep, staying asleep, waking up in the morning despite getting ample amounts of sleep, sleep disorders, like sleep apnea, narcolepsy, night terrors, circadian rhythm abnormalities, bedwetting. I mean, and the research is quite significant in showing that people with ADHD are significantly a higher prevalence of having a whole host of sleep issues. So with young people I work with, that is, I would say, in the top three issues, if not the number one sometimes, that parents will bring up is, "My kid doesn't want to go to sleep. Suddenly, at 10:00 at night, they get this rush of energy and they want to go to bed at 1 in the morning. And then it's waking up the dead in the morning when they got to get to school that they sleep through their alarm clocks." It's very, very common.

Amanda: I'm wondering about the biology at play here. Is there something in that ADHD brain, for example, that gets in the way of sleep?

Dr. Olivardia: Absolutely. And I'm glad you started off with that question, because what I always try to do in my practice is first validate the experience of understanding this is biology and wiring at play. And then there's behaviors and psychology that come along with that. But to your question, absolutely. The studies show that, first, that people with ADHD, it's more prevalent for them to have circadian rhythm abnormality. So one of them is there's a term called the delayed sleep phase syndrome, which basically refers to that at about 9, 10:00 at night, our bodies should be getting tired, or earlier if the person is younger, a child. And then kind of lull itself and get itself ready for bed. And for a lot of people with ADHD, there's almost a shift where, at that time, sometimes they get an increase in energy or parents will call it the "second wind."

It's almost like they're physically not tired. And I can attest to this personally that I would always say, I mean, certainly through high school and college, 10:00 was where I started doing my best work, and writing papers and everything. And it would be about 2 a.m. That I would start to feel tired. And it was validating to me, because I got a sleep study in my early 30s, because I have a whole host of sleep issues throughout my life. And when I heard that phrase for the first time — delayed sleep phase syndrome — they said, "You weren't even entering into the deeper levels of sleep until about 2 in the morning."

And I thought, "Oh, that was so validating," because it's like, "Oh, OK, this isn't just me here. There is something else operating." So we know that can happen. We also know that people with ADHD have a harder time kind of grounding themselves. As ADHD individuals, we're always seeking stimulation. There's a funny quote I heard many years ago at an ADHD conference that said, "For people with ADHD, going to sleep is lying in a dark room waiting for nothing to happen."

And I thought, "Yes, it is so boring." It's like, "OK, I'm lying in bed. I'm just waiting for this moment that I'm supposed to be asleep." It's so like, "What am I doing?" And that's actually really hard. And I think that's what's so... It's almost baffling to people who don't have ADHD to be like, "What are you talking about? Just you go to bed and you go to sleep." Honestly, that's a weird concept. It still is a weird concept for me to just surrender and just end the day. And like, "OK, I'm not supposed to be thinking of all of these things?" Because to people with ADHD, you're in this dark room, you're not being stimulated. And so your head starts imagining, and it's sometimes things I could be anxious about. Sometimes, the things I'm excited about. Sometimes I'm like, "Ooh, that meal I had today was so good. How can I make that meal again?"

And all those things are activating an individual. There are research also looking at serotonin levels, that serotonin is a neurochemical in our brain that is implicated in sleep and arousal. And that can be dysregulated for people with ADHD. So when we're supposed to be hypoaroused, so having a lower level of arousal, we're almost having a hyperarousal, because again, if an environment doesn't provide enough stimulation to someone with ADHD, the ADHD brain will create and try to seek it.

So we're always in this negotiation with our environment of, "OK, I need enough stimulation that grounds me, but not too much that keeps me awake, but not too little." I mean, I remember in third grade, and this is so diagnostic, my wonderful third-grade teacher, Ms. Wade, who I adored, she had us write a paragraph of a fictional character that we related to. And all the boys wrote like the Hulk and Superman. And I'm like, "Really? You relate to the Hulk? Maybe you want to be the Hulk, but I don't think you can relate to the Hulk."

Amanda: And if you do, maybe there's something else we need to talk about.

Dr. Olivardia: Yeah. We need talk about some anger management skills. But I wrote Goldilocks from the Three Bears. And my teacher was like, "Goldilocks?" And I said, "Yeah, because for Goldilocks, this bed was too hard, and this bed was too soft, but this was just right. And this porridge was too hot. This porridge was too cold." And to people with ADHD, there is this sort of specificity that we need to shape our environment so it's just right. And it can almost feel or seem like almost obsessive compulsive. And sometimes, people with ADHD have OCD traits, but that's a little different. That's more of, "This is what I need to ground myself." And so when I tell you today, I have to sleep a certain way with my wedge pillow, with the temperature of the room a certain way, with a comforter that's weighted enough. That's what's going to get me to sleep.

Amanda: I'm grinning. I am grinning, because my 12-year-old who has ADHD, his room, we have room-darkening curtains. We have the fan, we have the noise machine. We have the weighted blanket. All of those things need to be in place before he can sleep.

Dr. Olivardia: Yes. So I mean, that's awesome that he already is working on that and understands all that. Because I think for a lot of people with ADHD, if they don't understand the context of it, they might... Unfortunately, I think one of the greatest obstacles to ADHD is shame. And this idea that a lot of people would be like, "Oh, well, why can't I just be one of those people that just like go to sleep? I shouldn't need all of these things." Or they don't always know that they need all of these things, but absolutely. I don't know how people sleep with a sheet on them. I have to have a comforter that's thick, that literally is almost, I think of it as literally holding me into my bed. Like, "You are now going to sleep," because I feel like I'm going to levitate if I don't have it.

Amanda: So relatable.

Gretchen: We're also wondering about ADHD medications, if and how they impact sleep.

Dr. Olivardia: So one of the treatments of ADHD is medication, and it's either stimulant medication or non-stimulant medication. But particularly with stimulant medication, it's tricky, because for some individuals, if they take a dose, let's say later in the day, it could impact their sleep and keep them up. And at the same time, I've had patients of all ages who have a dose of medication actually in the early evening, which actually helps them go to sleep. Because they're better able to ground themselves to get done what they need to get done, to actually focus, strange as it sounds, focus on going to sleep. And anecdotally, I mean, I didn't start drinking coffee until I was in my early 30s. And the birth of my first child that got me to.

Amanda: Yeah. That's when we start drinking coffee. When you have kids, that's it.

Dr. Olivardia: You have kids, that'll just get you into coffee. And I would notice that, just anecdotally, I would drink sometimes like a cup of coffee, like a half hour, 45 minutes before bed. And I would sleep better.

Gretchen: That would keep me up all night if I had it that late.

Dr. Olivardia: Yes. So if my wife had coffee past 3 p.m., that impacts her sleep. I am a half hour to 45 minutes. Now, why is that? Because caffeine obviously is a stimulant. And what's happening is that it's enough of a stimulant, but not too much, that it's enabling me to focus on going to sleep and going to bed. Managing the impulsivity of all of the things that might get in the way between point A of, "I should go to bed," to point B, which is actually getting to bed. So I always tell people with medication, I mean, what we know about stimulant medication is it's truly a unique individual experience.

Because you can have two people who both take the same dose, let's say, of Adderall, who respond totally differently to it because of just the nature of their ADHD and their own chemistry. Because ADHD is interacting with your environment. So I always tell people, "It's not necessarily that, oh, you take stimulants, it's going to create a problem with sleep." To that individual, it might help them reduce their impulsivity to focus and regulate their attention so that it enables them to go to sleep indirectly. So I'm not saying that a stimulant is a sleep aid, but that it enables in managing one's ADHD, which then becomes the thing that could make it problematic.

Amanda: That's such a good clarification. I think parents and listeners will really appreciate hearing that, because I think there are a lot of myths around that. So I think clearing that up is super important.

Gretchen: That leads me to another, I don't know if it's a myth or not, Roberto, I'm going to ask you this. So as parents, we get a lot of warnings about how much sleep kids should be getting. Is it really true across the board that all kids need this certain amount of sleep? And when do parents really need to be worrying about their child not getting enough sleep?

Dr. Olivardia: So in general, there are these guidelines that the National Sleep Foundation will set at certain ages that we need a certain amount of sleep to really do the work that sleep is really meant to do. Which is it's meant to repair our brains and our bodies, give us some rest. Our brain is actually quite active when we're sleeping. It's consolidating our information from the day before, it's boosting our immune system, it's regulating our metabolism.

So I always tell people that sleep deprivation is not just about losing sleep. It affects our metabolic cycle, and that's why sleep deprivation and weight issues can go hand in hand. It certainly can affect our concentration, but not just our concentration because we're tired, but because our brain hasn't properly done that work on consolidating that information, so it might be harder to access information.

And I could tell you in my experience with ADHD, it was really much later in my adult life where I really came to terms with understanding. Because when I was in my 20s, definitely, I saw sleep as very disposable. I honestly was like, "Well, sleep is what happens when there's no more fun to be had, or there's no more work to be done." And I'm somebody, I can find fun very easily. And I love my work. I truly love what I do. So to me, it was like, I did not respect sleep in the ways that I should have. So that's one of those things I'm almost having this newer relationship with.

So to your question, there are these guidelines that, let's say, for a pre-adolescent or adolescent especially where they're growing, it could be anywhere from like eight to ten and a half hours of sleep a night. Now, are most teenagers getting that amount of sleep a night? Absolutely not. We really are in a sleep debt. And at the same time, to also know that not everybody needs that amount. I can honestly tell you, the only times I've ever slept more than eight hours was when times I was sick, like with the flu, or I was massively sleep deprived and just making up. I've never been an eight-hour sleeper.

So it really comes down to, how I always tell people, because a lot of adults, especially that I work with will be like, "No, I'm good on four hours of sleep." I'm like, "Well, maybe, but let's look at that. How much caffeine are you ingesting?" And some of them like, "Oh, I only have like four five-shot lattes." Four.

Amanda: Every two hours.

Dr. Olivardia: That doesn't work. Or if it's the kind of thing, because especially with ADHD, and I had to understand this myself, is I'm never bored at what I do like at my work. And so I can be really tired, but once I'm in the office and I'm talking with people, I'm activated. I'm turned on. So the question isn't always like, "Do you fall asleep at work?" It could be, "Well, what happens in the moment that you're not stimulated?" We always want to look at that because if it's the moment you're not stimulated, you're falling asleep, you're not getting enough sleep. What's your mood like? Because the other thing is, lots of people can get by. I got by on two, three hours of sleep in graduate school all the time. Was I optimal? No, I wasn't optimally functioning. I mean, in so many different ways. So it's looking at our mood state. So it's, if you were to go to sleep and just not have your alarm wake you up, how many hours would you need to really feel refreshed in that way?

Gretchen: You actually have opened my mind to how many sleep challenges there actually are out there. And so now, with all these challenges out there, especially for kids with ADHD, what are your top recommendations for how to help kids sleep?

Dr. Olivardia: Yeah. So one is, I always want to involve kids too, and one just validating to them. Well, first it could be hard for a lot of people, whether you have ADHD or not, to get to sleep, to have a bedtime routine. However, it is definitely something that's very common. And part of having ADHD is the difficulty with that. And almost trying to approach it in a fun kind of way of like, "OK, what are the things that we can do to sort of make it happen?" And it won't just be one thing. It'll often be all the darkening shades and the this, and the this, and this. And for them not to look at that as, "This is like so high maintenance," but to look at as like, "Oh my gosh," because when you do find those proper toolbox and you get a good night's sleep, it's amazing.

It's like, I don't care if I have to do 10 cartwheels before I have to go to... If that's what's going to get me. So you first lay that out and then it's really trying different things like in trying to understand, what is the thing that's difficult? Is it that when you get to sleep, just your mind is thinking and thinking and thinking, and then you're activated? So that could then be having some stimulation in the room. So again, it's like Goldilocks where it can't be too much. So sometimes, when I just know I have a lot on my mind, I'll have on my phone, I'll put Enya, who for those of you who don't know, Enya's Gaelic, amazing, "Sail Away," amazing, brilliant artist who has the most ethereal lush music. So I'll put an Enya song on repeat, the same song, at a low volume that I'm not super stimulated but it's loud enough that I can hear it. And why that, again, that Goldilocks zone is it's enough that my mind is paying attention to that and not attending to maybe the sounds outside. And I say the same song on repeat, because if it's different songs, your brain's like, "Ooh, novelty, novelty, novelty."

Now, for other kids, it could be either a fan in terms of the wind on them. It could be the lighting in the room. If there's a digital clock, maybe we need to get rid of that clock. Any amount of light. Now, there are other kids that might say, if it's too dark, they might get a little scared and they start thinking of things. So then they might need a night-light. And a night-light could be almost like they're north star that they're sort of looking at. And then that enables them to fall asleep.

So it's always about trying to understand the function of what gets in the way. Now, for some kids, it could be the actual bed and the sensory experience of sleep. And I know this for myself, like I sleep with a wedge pillow because I sleep at an angle, basically. And this was even when I was a kid, I couldn't explain it except to say, if I was lying flat, I felt as if my head was angled down, like in a dentist chair.

Amanda: Yep. I have sensory issues and that's so relatable to me. The, you feel like you're falling backwards even though you're not.

Dr. Olivardia: Yes. So it could be the pillow. Because again, ADHD, individuals are very sensory defensive. We're sensitive by nature. I mean, emotionally, physically. So even the sheets, it could also be being aware of what you're doing before bedtime. And for parents of kids with ADHD to know it's not always going to be what you think it is. So to give you an example, I work out. When I go to the gym, I go to a 24-hour gym. Tuesdays and Thursday nights, I see patients until 9 and I work out after that. And on the nights I work out, I sleep so much better.

Now, most people would be like, "What? How does that not activate you to wake up?" It's the same thing with the coffee 45 minutes before. ADHD, we're a little out of the box. And so sometimes, even the things that parents understandably, because they want the best for their child, will be like, "Oh, that definitely is not going to be good for them." I would say, just like we're teaching kids to be curious, and we want parents to also be involved in that process of knowing what might totally not work for them could very much work for their ADHD child.

Amanda: So one of the things I think I'm hearing is involve your child in picking out sheets and comforters to some degree, right? Bring them to the store and have them choose them. Try out things that you as a parent may not think would work for you, like running around the block or something like that. Although in the middle of the night, that's probably a bad idea. But you know what I mean.

Dr. Olivardia: Well, I mean, it's funny you mentioned that, Amanda, that precise example. Because when my son was like 5 years old, I live in a cul-de-sac. And it would be to get him to bed 9:00, we would run around the cul-de-sac. And my neighbors thought I was a little crazy.

Amanda: We do that in our cul-de-sac, which is why that example may have come out of my mouth, because we're doing that. Gretchen, did you have a couple of other things you wanted to hit on, too?

Gretchen: Well, I'm looking at our list of wonders for what might work. And I think we also wondered about diet, because families are always hearing things about how diet affects their kids throughout the day, including sleep. And so is there any truth to that with the diet?

Dr. Olivardia: So eating, definitely. That could be a whole other podcast because I do a lot of work in the eating and eating. I work with boys and men with eating disorders as a whole other specialty in the world that I'm in. But particularly, this intersection of ADHD and whether it's impulsive eating or not enough nutrition in eating. With ADHD individuals, we love sugar. I mean, we do. We crave sugar. We love those simple carbs because they're dopamine producing, that neurochemical that's implicated in reward. So it is definitely very important, especially for parents to know in terms of regulating eating.

And a lot of times too, I mean, even what nutritionists will tell you is sometimes, it's not so much what we're eating that's as much as the issue as what we're not eating. And so sugar, of course, is not great if you're having it in large amounts. But what really isn't great about it is because it's satiating us. We're not eating maybe enough vegetables or we're not eating enough protein. And that's the real source that gives us that executive energy is high protein. So absolutely, that would be another thing to think about is, why it might be difficult. Oh, maybe you didn't have enough protein.

Amanda: So what I'm hearing is chocolate-covered broccoli.

Gretchen: Yeah. And I like that you're saying that it may not be what they're eating, but what they're not eating. And I'm going to use that in my house, because I've got a lack of protein with one of my children who also has sleep challenges. And so I think we'll be talking about more protein. Maybe we'll notice which nights are the better nights of sleep.

Dr. Olivardia: Yeah. Because sometimes, I mean, the reason that we might not be sleeping, too, is we're primitive. When it comes down to it, we need to eat, we need to sleep, and we need to drink water to survive. So those are the three most basic things. So if one of those is not... If any of those, rather, are threatened, it really disrupts the other. And so to know all of these systems are intertwined with each other.

Amanda: I'm thinking about parents. And I'm wondering, so when you have kids in the house who have ADHD who are having difficulty sleeping, it can sometimes be really hard on the entire family in some ways, because you're trying to manage that sleep thing. Do you have suggestions for parents, perhaps like me, where they can't do it? They can't stay awake when their child's awake? What do you do?

Dr. Olivardia: So that's a really good point, because it's so important for caregivers to get their sleep because we know, I mean, studies show this, that parents of children with ADHD can struggle with sleep issues because they're up trying to get their kids to sleep and it can be very frustrating. And it's important that A, parents have support and know that it's not a failure on their part. Their kid isn't meaning to be oppositional around bedtime and things like that. And to know that some of the things, again, that some parents maybe of non-ADHD children might suggest might not work for their ADHD kid. And to not feel judged if your kid is the one running around the cul-de-sac and other people are like, "What? Why are you doing that?" But just like the old adage of, you got to put the oxygen mask on yourself first, there are times that we just have to pick our battles.

And I gave the suggestion to a parent recently where she said, "I know that if I go to bed before my son, he's going to be playing video games until like 2 in the morning. And I have to make sure or he's asleep because that's my job as a parent." But she was burnt out and just really needed sleep. And I said, "Look, having him be up until 2 in the morning on a school night isn't going to be the end of the world for him. I mean, he'll have a crappy day the next day, but you need sleep." So I said, "Just go to bed. He may up until 2 in the morning, but you can deal with that after, because if you are in a stronger place and feeling just more grounded, you can then be there and teaching him the skills to be more grounded. And it's not selfish."

She felt selfish. She felt it was a self-centered to do that. I said, "No, no, no." I said, "Ultimately, when we take care of ourselves as parents, we are taking care of our children." So also to get support, negotiate with other caregivers in the household to say, "You know what? I need my eight hours of tonight. So if that means you might have to do that battle solely." And sometimes, in two-parent households, they might feel like they both have to go in. And sometimes it's like, "You know what? Even if it's going to take a little bit more for you, I need my night's sleep," or vice versa. Like, "You need to get your good night's sleep." And other times it's, "OK, this is not a battle worth fighting today."

Dr. Olivardia: Obviously, if he was up every night at 2 a.m., It becomes a problem. So it is very important for parents to also make sure that they're looking at themselves and their own health as well.

Amanda: I think it's a perfect ending point to say it's not the end of the world today.

Dr. Olivardia: Exactly.

Amanda: That's so perfect. I mean, we have so much good information. You taught us so much. Thank you so much for being here today.

Gretchen: Yes. Thank you so much.

Dr. Olivardia: Oh, my pleasure.

Gretchen: I really learned a lot. Thank you.

Dr. Olivardia: Wonderful.

Amanda: Roberto is a therapist in Lexington, Massachusetts, and the co-author of "The Adonis Complex."

You've been listening to "In It," part of the Understood Podcast Network.

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Gretchen: Thanks for listening. Everyone. And thanks for always being in it with us.