Ok after reading a chunk of this the correlation is pretty wild. Having the data it’s quite striking. Sleep intervention as a form of ADHD treatment has always seemed reasonable to me but this gives a lot more clarity to the approach and mechanisms.
For me, the seasonal aspect of it aligns with their blue light findings (both driving symptoms and aligning with improvement under the intervention of having a grow-LED garden setup on my desk), and in a second maybe related matter we’ve found using blue light blocking glasses an hour before bed to be the most impactful single intervention around sleep quality and onset (the ones that are like orange laser safety glasses, not the mildly reflective desk-work glasses)
I had great success reflecting 80,000 lumens of work lights off my living rooms ceiling during winter for a couple years.
At a new home, I remodeled four rooms to have three bands wide of LED lighting surrounding the ceilings, hidden from below by cove molding. It is an actual sunny day, with an “an actual” sunny sky inside. Winter, midnight, eclipse? Not a concern.
Having all that intense light reflecting off entire ceilings creates soft diffuse lighting, no shadows, even though it is extremely bright.
Helped a lot with waking up and avoiding depression, all year round.
On the sleep treatment, anything that can help sleep is good, my body has always operated well on a 30 hour day, which means terribly almost all the time, by default. But I do a lot of things that help, so my sleep is pretty good most of the time.
I would see sleep aids as a pretty narrow interventions relative to my ADHD.
The 30 hour day feeling resonates. If I have no external schedule or I'm just living as I see fit, I end up gravitating to 3am bed, ~12pm wake sorta schedule. The only real problem is that it's functionally incompatible with jobs and many other services, even fully remote
I can confirm this effect. One winter I left 2x300w living room lights on perm, and it had a dramatic effect. The only issue is that its nice to turn lights off at night, and if you do that, now you're in habit-dependent territory.
one thing i've been paying the adhd tax on is automating / making habits lower activation energy. smart bulbs / blinds are a great thing for me especially when i am already in bed and have too much executive dysfunction to walk 3 feet to the light switch / shade
I had a contractor and an electrician! There is some significant power draw.
It’s been five years, so I expect the best components are different, more efficient and cheaper.
In winter, the lights can be considered part of my heating system. In summer, windows get opened. If I did it again, I would have some little fans up there expelling air from the cove directly outside.
But that is fine tuning. I am really happy. (When the lights are on. /h)
The following (informally described) symptoms are well-known consequences of ADHD:
- Delayed Sleep Phase [1]
- Staying Up Late [2]
- Revenge Bedtime Procrastination [3]
Newsflash, getting a full night's sleep helps alleviate ADHD symptoms, while being perpetually sleep-deprived wrecks us.
But there are reasons why we stay up late. Simply forcing us to sleep doesn't address those reasons.
Which is why I wrote about it so much, and keep spamming these links even though it feels so darn obvious. Not to the authors of the study, it appears.
Then add in the use of powerful stimulants (e.g. Adderall) to power through a workday, only to have that cause insomnia that night, and a wrecked sleep schedule for the following 3 days.
Dr. Sandra Kooij is a good person to look up if you are interested in adult ADHD and sleep. She has a book about it. From what I remember, there are a few things that are known:
1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia
2. you can induce ADHD-like symptoms in normal people by restricting sleep
3. Some of the interventions that improve sleep timing and quality affect ADHD (but it isn't a total cure)
> 1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia
I would think this wouldn't be such a problem if society would acknowledge night owls exist and allow work to adjust accordingly. Forcing a night owl to live the life of a morning lark is likely not the best way to get their best work. The person suffers who has to try and live in a world not designed for when they sleep, and the employer suffers by getting less out of those people.
I have ADHD and left to my own devices I would go to sleep somewhere between 2-4am. At work, I don't function so well before about 2pm some days... and by that point that day is almost over.
Completely agree, and tend towards the same schedule. I don't even mind working in-person with people, but this idea that everyone should just be uniformly aligned to operate on the same hours is alienating and humiliating at times.
For a time I had to wake up at 6AM for work and it was a period where I struggled the most with my ADHD symptoms.
I hope there is more awareness in the future about the importance of sleep for neurodivergent people. This could help with the social jet lag most of us feel with having to follow a schedule that simply does not work for us.
adhd is a socially constructed disorder with significant heterogeneity and is only becoming moreso with the advent of scrollable video media and patient communities/advocacy. i am highly skeptical of results pointing to an easily identified physiological cause. the studies cited in this paper are generally low quality and fall apart under scrutiny.
Beyond the blatant appeal to authority, it is funny that you think even psychiatrists have a consensus on issues like these. Psychiatry is rightly described as the humanities arm of the medical profession.
Psychiatry is pseudoscience for the most part. They just give you meds that give you brain zaps or turn you into a vegetable. Imagine if the entire medical profession worked like that.
Believe it or not, some of us are well read on the disorders we have to live with every day. Also, reading research papers will never replace the deep understanding of living with the disorder itself.
I've been using a smart switch to fade in a light (one of the "sun-like" full-spectrum ones) over my head in the morning and it's been really effective for regulating my circadian rhythm. Even with little sleep, I will naturally wake up in the morning at a much more regular time.
I have been using one of those sunrise alarm clocks for around 8 years now. If I go to bed at a reasonable time, the light will wake me up naturally before the alarm actually goes off. However, if I stay up too late the effect of the light fades. I'll sleep right through the light and need the alarm. On one occasion when I must have been really sleep deprived, I slept through the light, an hour of the alarm going off, and another 2-3 hours after that.
If the light turns on too quickly for me it’s super jarring and I hide under the covers. Did you find one that goes bright over the course of 30m or something? Or can you handle the quick increase in brightness?
You can make your artificial sunrise take as long as you want, and connect them to a sleep tracker so they're timed to wake you up during a comfortable phase.
I've been doing this for 12 years, and I don't think I have ever been upset to hear my alarm since, as long as I'm home and the lights have prepared me. Lately I've even been waking up before my alarm about half the time, even though I work on a schedule one time zone east of where I am.
It's shocking to me that it's not more popular for everybody. I guess the benefit is hard to explain.
I have a sunrise alarm clock, I think from Phillips. If I set the alarm for 8am, the light will start turning on at 7:30am then slowly increase in brightness over the next 30 minutes until 8am when it's at full brightness and the alarm goes off (which are nature sounds).
When it first starts, it's more of a warm glow than a light. The max brightness can also be set.
I still have problems, but my life categorically improved once I got diagnosed and treated for obstructive sleep apnea. I focus on things much better, I'm better at juggling tasks, and I'm just nicer to people, or at least my fuse is considerably longer than it used to be. Also I'm sure my wife is grateful that I'm not snoring or gasping for breath every night.
I would highly encourage anyone who can get a sleep study done to do it. Most insurance companies will at least cover the sleep study and sleep sleep apnea can lead to a lot of considerably-more-expensive issues later down the line. It's not very invasive anymore, all they had to do was have me sleep with a pulse oximeter for a few nights and apparently that was enough.
I am lucky I don't have disruptive sleep issues, but my brain still feels slightly foggy and my battery feels 75% charged in the morning. I imagine if I had disruptive sleep issues I might as well be toast. Or maybe I'm just not aware of disruptions in my sleep...
I was like you. A year ago, I was tired as hell despite sleeping (well, not enough, but I've never slept 'enough'). A few people said sleep apnea but i was not overweight and didn't snore. I tried the test anyway, and it turns out I wasn't breathing. I used an oral appliance and a year later, it's gone and I feel better.
Also, without doing anything my triglycerides, LDL cholesterol and blood sugar which had gone way out of whack, went back to normal.
I started using my oral appliance on a Monday. That Friday I was so energetic I ran 12 miles in one go. I hardly ever run or even practice that much, but I was just so wired that I couldn't help it. It was an amazing feeling. I highly suggest sleep apnea treatment even if you don't think it sounds like you.
How do the authors disintangle cause and effect here? It doesn't follow that sleep issues are an underlying cause, and not just one of the MANY symptoms of ADHD.
There seems to be some kind of hidden connection between autism and ADHD. At first sight the definitions are contradictory but in reality, many people have both. Sleep disturbance seem to be common among autistic people too.
ADHD treats with Lisdexamfetamine. Amfetamines, I repeat. People use this to study, to get high at parties, to be functional at work, so I really doubt there aren't patients out there abusing these drugs with valid prescriptions.
No, but if you're trying to argue that sleep therapy would be more effective for this group than non-stimulant form of medication, you need to prove this.
Sleepy therapy (CBT-I) may be the best supported treatment for insomnia, but it's still quite shit. ~50% of people will see little to no improvement after going through therapy.
ADHD is highly treatable with medication, and any other intervention is at best mild mitigation. So how many? Amongst people with ADHD, basically nobody.
Sun and proper sleep is certainly helpful for people with ADHD but the likelihood of them getting that is vastly increased if they’re medicated correctly.
Any psychiatrist worth a damn already considers these things.
"ADHD" symptoms can manifest for a variety of reasons, and that's why good ADHD testing involves multiple exams alongside the traditional ADHD ones to help figure out what actual issues are present.
Also, comorbidities make this all the more complicated. Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
> Any psychiatrist worth a damn already considers these things.
Protocols however are always changing depending on new findings. Not saying this is the case, but not considering something unknown at the time doesn't make a doctor not worth a damn.
> Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
if that was the case the treatment wouldn't be unecessary, like I specifically wrote in the comment you are replying to.
lists Melatonin, first, then behavioral pseudo-interventions.
stay tuned for more monthly product placements on frontiers in, best digested post prime time.
Welcome to your readjustment.
Willkommen beim Nachrichten.
hey, is anyone wondering if kleine & grosse Lauschangriffe are shared with private people or the guys working for these institutions are trustworthy enough and whether they actually deserved their Bachelor degrees or someone somehow decided they are worth it anyway? wait ... it's just a fucking Bachelors degree
> walk in
> see this title
> oh man that would explain a lot
Ok after reading a chunk of this the correlation is pretty wild. Having the data it’s quite striking. Sleep intervention as a form of ADHD treatment has always seemed reasonable to me but this gives a lot more clarity to the approach and mechanisms.
For me, the seasonal aspect of it aligns with their blue light findings (both driving symptoms and aligning with improvement under the intervention of having a grow-LED garden setup on my desk), and in a second maybe related matter we’ve found using blue light blocking glasses an hour before bed to be the most impactful single intervention around sleep quality and onset (the ones that are like orange laser safety glasses, not the mildly reflective desk-work glasses)
I had great success reflecting 80,000 lumens of work lights off my living rooms ceiling during winter for a couple years.
At a new home, I remodeled four rooms to have three bands wide of LED lighting surrounding the ceilings, hidden from below by cove molding. It is an actual sunny day, with an “an actual” sunny sky inside. Winter, midnight, eclipse? Not a concern.
Having all that intense light reflecting off entire ceilings creates soft diffuse lighting, no shadows, even though it is extremely bright.
Helped a lot with waking up and avoiding depression, all year round.
On the sleep treatment, anything that can help sleep is good, my body has always operated well on a 30 hour day, which means terribly almost all the time, by default. But I do a lot of things that help, so my sleep is pretty good most of the time.
I would see sleep aids as a pretty narrow interventions relative to my ADHD.
Correlation would be nowhere near equivalence.
The 30 hour day feeling resonates. If I have no external schedule or I'm just living as I see fit, I end up gravitating to 3am bed, ~12pm wake sorta schedule. The only real problem is that it's functionally incompatible with jobs and many other services, even fully remote
I can confirm this effect. One winter I left 2x300w living room lights on perm, and it had a dramatic effect. The only issue is that its nice to turn lights off at night, and if you do that, now you're in habit-dependent territory.
one thing i've been paying the adhd tax on is automating / making habits lower activation energy. smart bulbs / blinds are a great thing for me especially when i am already in bed and have too much executive dysfunction to walk 3 feet to the light switch / shade
This sounds amazing- do you have part list or pics/write up?
I had a contractor and an electrician! There is some significant power draw.
It’s been five years, so I expect the best components are different, more efficient and cheaper.
In winter, the lights can be considered part of my heating system. In summer, windows get opened. If I did it again, I would have some little fans up there expelling air from the cove directly outside.
But that is fine tuning. I am really happy. (When the lights are on. /h)
> walk in
> see this title
> think authors are reversing causation hard
-- signed, a deep Night Owl
Indeed.
The following (informally described) symptoms are well-known consequences of ADHD:
- Delayed Sleep Phase [1]
- Staying Up Late [2]
- Revenge Bedtime Procrastination [3]
Newsflash, getting a full night's sleep helps alleviate ADHD symptoms, while being perpetually sleep-deprived wrecks us.
But there are reasons why we stay up late. Simply forcing us to sleep doesn't address those reasons.
Which is why I wrote about it so much, and keep spamming these links even though it feels so darn obvious. Not to the authors of the study, it appears.
[1] https://romankogan.net/adhd/#Delayed%20Sleep%20Phase
[2] https://romankogan.net/adhd/#Staying%20Up%20Late
[3] https://romankogan.net/adhd/#Revenge%20Bedtime
going to bed early feels like i'm a child being punished.
staying up late rocks. its the funnest. why would i give that up? just to pay attention better at work? no thanks.
> staying up late rocks. its the funnest. why would i give that up? just to pay attention better at work? no thanks.
You may eventually find yourself in a situation where the tradeoff is worth it.
E.g., you have a family to feed, and your ability hold a well-paying job hinges on your performance.
Lots of the things on this site are normal things that everyone experiences to some degree ...right?
Almost my exact response.
And the cruel tragedy is that it becomes this self-reinforcing cycle.
Sleep bad > "Bad" ADHD day > Harder to fall asleep. Rinse. Repeat.
Then add in the use of powerful stimulants (e.g. Adderall) to power through a workday, only to have that cause insomnia that night, and a wrecked sleep schedule for the following 3 days.
Dr. Sandra Kooij is a good person to look up if you are interested in adult ADHD and sleep. She has a book about it. From what I remember, there are a few things that are known:
1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia
2. you can induce ADHD-like symptoms in normal people by restricting sleep
3. Some of the interventions that improve sleep timing and quality affect ADHD (but it isn't a total cure)
> 1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia
I would think this wouldn't be such a problem if society would acknowledge night owls exist and allow work to adjust accordingly. Forcing a night owl to live the life of a morning lark is likely not the best way to get their best work. The person suffers who has to try and live in a world not designed for when they sleep, and the employer suffers by getting less out of those people.
I have ADHD and left to my own devices I would go to sleep somewhere between 2-4am. At work, I don't function so well before about 2pm some days... and by that point that day is almost over.
Completely agree, and tend towards the same schedule. I don't even mind working in-person with people, but this idea that everyone should just be uniformly aligned to operate on the same hours is alienating and humiliating at times.
being a night owl is not good for your health for a lot of reasons (I am one).
There seems to be almost nothing new here. I see that the main studies the they cite are actually from the 2010s:
https://www.bmj.com/content/350/bmj.h68.abstract
https://www.sciencedirect.com/science/article/abs/pii/S13899...
I'd be curious to see if there's been any larger scale follow up on this since.
well it's a review article
I'm used to reviews of recent work, not of work from a decade ago
For a time I had to wake up at 6AM for work and it was a period where I struggled the most with my ADHD symptoms.
I hope there is more awareness in the future about the importance of sleep for neurodivergent people. This could help with the social jet lag most of us feel with having to follow a schedule that simply does not work for us.
adhd is a socially constructed disorder with significant heterogeneity and is only becoming moreso with the advent of scrollable video media and patient communities/advocacy. i am highly skeptical of results pointing to an easily identified physiological cause. the studies cited in this paper are generally low quality and fall apart under scrutiny.
Yes random Hacker News poster, you know more than the entire psychiatric profession.
All those peoples with doctorates who spent their lives studying the human brain are wrong, but you alone know the truth.
Beyond the blatant appeal to authority, it is funny that you think even psychiatrists have a consensus on issues like these. Psychiatry is rightly described as the humanities arm of the medical profession.
Psychiatry is pseudoscience for the most part. They just give you meds that give you brain zaps or turn you into a vegetable. Imagine if the entire medical profession worked like that.
Believe it or not, some of us are well read on the disorders we have to live with every day. Also, reading research papers will never replace the deep understanding of living with the disorder itself.
This article is 100% conflating cause and effect.
you are so utterly and completely wrong it's not worth engaging in anything you wrote.
please educate yourself: https://pmc.ncbi.nlm.nih.gov/articles/PMC8328933/
I've been using a smart switch to fade in a light (one of the "sun-like" full-spectrum ones) over my head in the morning and it's been really effective for regulating my circadian rhythm. Even with little sleep, I will naturally wake up in the morning at a much more regular time.
I have been using one of those sunrise alarm clocks for around 8 years now. If I go to bed at a reasonable time, the light will wake me up naturally before the alarm actually goes off. However, if I stay up too late the effect of the light fades. I'll sleep right through the light and need the alarm. On one occasion when I must have been really sleep deprived, I slept through the light, an hour of the alarm going off, and another 2-3 hours after that.
If the light turns on too quickly for me it’s super jarring and I hide under the covers. Did you find one that goes bright over the course of 30m or something? Or can you handle the quick increase in brightness?
Smart bulbs.
You can make your artificial sunrise take as long as you want, and connect them to a sleep tracker so they're timed to wake you up during a comfortable phase.
I've been doing this for 12 years, and I don't think I have ever been upset to hear my alarm since, as long as I'm home and the lights have prepared me. Lately I've even been waking up before my alarm about half the time, even though I work on a schedule one time zone east of where I am.
It's shocking to me that it's not more popular for everybody. I guess the benefit is hard to explain.
I have a sunrise alarm clock, I think from Phillips. If I set the alarm for 8am, the light will start turning on at 7:30am then slowly increase in brightness over the next 30 minutes until 8am when it's at full brightness and the alarm goes off (which are nature sounds).
When it first starts, it's more of a warm glow than a light. The max brightness can also be set.
Google for "wake-up light". Philips is the brand I'm familiar with but there are others.
It's a controllable dimmer switch that I fade in over the course of an hour or so using a Home Assistant script.
I do the same with a lifx bulb, it can be set up to fade and colour shift over any duration you like.
Disruptions to sleep aggravates underlying issues, mentally or physically.
I still have problems, but my life categorically improved once I got diagnosed and treated for obstructive sleep apnea. I focus on things much better, I'm better at juggling tasks, and I'm just nicer to people, or at least my fuse is considerably longer than it used to be. Also I'm sure my wife is grateful that I'm not snoring or gasping for breath every night.
I would highly encourage anyone who can get a sleep study done to do it. Most insurance companies will at least cover the sleep study and sleep sleep apnea can lead to a lot of considerably-more-expensive issues later down the line. It's not very invasive anymore, all they had to do was have me sleep with a pulse oximeter for a few nights and apparently that was enough.
I am lucky I don't have disruptive sleep issues, but my brain still feels slightly foggy and my battery feels 75% charged in the morning. I imagine if I had disruptive sleep issues I might as well be toast. Or maybe I'm just not aware of disruptions in my sleep...
What's wrong with being toast? :P
My sleep issues are at least manageable.
I was like you. A year ago, I was tired as hell despite sleeping (well, not enough, but I've never slept 'enough'). A few people said sleep apnea but i was not overweight and didn't snore. I tried the test anyway, and it turns out I wasn't breathing. I used an oral appliance and a year later, it's gone and I feel better.
Also, without doing anything my triglycerides, LDL cholesterol and blood sugar which had gone way out of whack, went back to normal.
I started using my oral appliance on a Monday. That Friday I was so energetic I ran 12 miles in one go. I hardly ever run or even practice that much, but I was just so wired that I couldn't help it. It was an amazing feeling. I highly suggest sleep apnea treatment even if you don't think it sounds like you.
uBlock filter to fix selection:
How do the authors disintangle cause and effect here? It doesn't follow that sleep issues are an underlying cause, and not just one of the MANY symptoms of ADHD.
There seems to be some kind of hidden connection between autism and ADHD. At first sight the definitions are contradictory but in reality, many people have both. Sleep disturbance seem to be common among autistic people too.
Oh cool so now people will be told to go to sleep earlier and get more sun before you can prove that you deserve actual treatment. Fun...
Another way to look at this is how many people need more sun and regular sleep and instead are doing unnecessary treatments?
Roughly, zero. Stimulants are not a fun dependency, come with a bucket list of side effects and downsides, and only mitigate one aspect of ADHD.
ADHD treats with Lisdexamfetamine. Amfetamines, I repeat. People use this to study, to get high at parties, to be functional at work, so I really doubt there aren't patients out there abusing these drugs with valid prescriptions.
Yes, some people will abuse their prescriptions.
But the majority will not. Treating ADHD through stimulants usually has fantastic outcomes for patients.
So it isn't roughly zero, and this minority is what's being discussed here.
No, but if you're trying to argue that sleep therapy would be more effective for this group than non-stimulant form of medication, you need to prove this.
Sleepy therapy (CBT-I) may be the best supported treatment for insomnia, but it's still quite shit. ~50% of people will see little to no improvement after going through therapy.
ADHD is highly treatable with medication, and any other intervention is at best mild mitigation. So how many? Amongst people with ADHD, basically nobody.
Sun and proper sleep is certainly helpful for people with ADHD but the likelihood of them getting that is vastly increased if they’re medicated correctly.
That is doubly important given that one of the effects of the medications, is to disrupt sleep.
Any psychiatrist worth a damn already considers these things.
"ADHD" symptoms can manifest for a variety of reasons, and that's why good ADHD testing involves multiple exams alongside the traditional ADHD ones to help figure out what actual issues are present.
Also, comorbidities make this all the more complicated. Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
> Any psychiatrist worth a damn already considers these things.
Protocols however are always changing depending on new findings. Not saying this is the case, but not considering something unknown at the time doesn't make a doctor not worth a damn.
> Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
if that was the case the treatment wouldn't be unecessary, like I specifically wrote in the comment you are replying to.
lists Melatonin, first, then behavioral pseudo-interventions.
stay tuned for more monthly product placements on frontiers in, best digested post prime time.
Welcome to your readjustment. Willkommen beim Nachrichten.
hey, is anyone wondering if kleine & grosse Lauschangriffe are shared with private people or the guys working for these institutions are trustworthy enough and whether they actually deserved their Bachelor degrees or someone somehow decided they are worth it anyway? wait ... it's just a fucking Bachelors degree
Be me. Too AHDH to even open the article, let alone read the article before moving to the next HN post.