ADHD: Daylight Savings Time
The Effect on Our Adult ‘Circadian Rhythm’
Now that we have “fallen back” to daylight savings time, many adults with ADHD are experiencing a disruption in their ‘circadian rhythm.’ “Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism’s environment. They are found in most living things, including animals, plants and many tiny microbes. The most common connotation to ‘circadian rhythm’ is something we all need more of: ‘sleep’.”
For many adults with ADHD, disrupted sleep patterns are a common part of their daily lives. “Up to 83% of adults with ADHD report sleep problems, and children with ADHD also show differences in sleep patterns.” “Many adults with ADHD report inability to “shut off my mind so I can fall asleep at night.” Many describe themselves as “night owls” who get a burst of energy when the sun goes down. Others report that they feel tired throughout the day, but as soon as the head hits the pillow, the mind clicks on. Their thoughts jump or bounce from one worry to another. Unfortunately, many of these adults describe their thoughts as “racing,” prompting a misdiagnosis of bipolar mood disorder, when this is nothing more than the mental restlessness of ADHD.”
Much research has been done to see if there is “an association between two brain “systems””: attention, and circadian clock and results show there is a connection between ADHD and sleep.
In one such study, “the authors recruited people with ADHD (13 of them), and controls (19 of them). They had them wear actigraphs (actigraph is the device used to measure continuous activity or movement) to look at when they were active and awake, and took samples of their saliva and mouth mucosa, to look at the expression of clock related genes and hormones associated with circadian rhythm, in this case cortisol and melatonin.
They found that ADHD patients were overall more active than controls, but they also showed differences in rhythm. ADHD people tended to be much more active at night (they call this a shift toward “eveningness”), and they also had much more trouble falling asleep, on average taking an hour after going to bed to get some z’s, while no controls complained of this.
They also saw something particularly interesting: The control group showed a nice circadian rhythm, with a peak in the middle of the day and lower at night. In contrast, the ADHD patients showed no discernible rhythm. Not a shift in rhythm, but no rhythm at all. The study showed an association between ADHD and a disregulated circadian rhythm.”
Baltimore-based psychiatrist Myron Brenner, M.D., notes: “One hypothesis is that the lack of an accurate circadian clock may also account for the difficulty that many with ADHD have in judging the passage of time. Their internal clocks are not “set.” Consequently, they experience only two times: “now” and “not now.” Many of my adult patients do not wear watches. They experience time as an abstract concept, important to other people, but one which they don’t understand. It will take many more studies to establish the links between circadian rhythms and ADHD.”
Tips for ADHD Adults
How to get to sleep
“No matter how a doctor explains sleep problems, the remedy usually involves something called “sleep hygiene,” which considers all the things that foster the initiation and maintenance of sleep. This set of conditions is highly individualized. Some people need absolute silence. Others need white noise, such as a fan or radio, to mask disturbances to sleep. Some people need a snack before bed, while others can’t eat anything right before bedtime. A few rules of sleep hygiene are universal:
- Use the bed only for sleep or sex, not as a place to confront problems or argue.
- Have a set bedtime and a bedtime routine and stick to it – rigorously.
- Avoid naps during the day.
- Avoid caffeine late at night.”
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 Baird AL, Coogan AN, Siddiqui A, Donev RM, & Thome J (2012). Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioral, endocrine and molecular levels. Molecular psychiatry, 17 (10), 988-95.