July 11, 2023

Delayed Circadian Rhythm in Adults With ADHD

Sleep makes the world go round. So why can’t we ever seem to get enough of it? This week, I’m re-releasing an older episode with a bit more introductory commentary on how ADHD interrupts regular sleep patterns.

This is such an important topic to not only chat about but do research on. Did you know there is a surprisingly decent amount of research on Delayed Sleep Phase Syndrome (DSPS) in people with ADHD?

In this episode, I share everything I’ve learned about DSPS, circadian rhythm, and what feels like a normal sleep pattern when you have ADHD. I’ve recently been experiencing old feelings of stress and hypervigilance at bedtime, and it’s made me realize that this is something we should all be cognizant of. 

Near the end of the episode, I share my own simple tips and tricks I’ve used to adhere to a neurotypical sleep schedule, and I encourage you to talk to your doctor about what might help you out too!

Don’t let yourself feel ashamed about going to sleep late and rising later. In my group coaching program FOCUSED, you’ll learn that you’re in good company and definitely not alone! 

Research References:

  1. StanfordHealthCare.org – DSPS
  2. The Sleep Foundation’s definition of Circadian Rhythm
  3. APSARD – Sandra Kooij
  4. Sage Medical Journal online – ADHD connection to DSPS



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Kristen Carder 0:05
Welcome to the I have ADHD podcast, where it’s all about education, encouragement and coaching for adults with ADHD. I’m your host, Kristen Carter and I have ADHD. Let’s chat about the frustrations, humor and challenges of adulting relationships working and achieving with this neurodevelopmental disorder. I’ll help you understand your unique brain. Unlock your potential and move from point A to point B. Hey, what’s up? This is Kristen Carter and you’re listening to the I have ADHD podcast, am medicated. I am caffeinated. I am regulated and I am ready to roll.

What’s up? What’s up? How are you? How’s it going? Welcome to the podcast. I’m really glad you’re here. If this is your first time listening, or maybe it’s your first time in a long time, I just want to extend a very warm welcome to you. Maybe you have ADHD or someone you love has ADHD or perhaps you’re just curious about it. And my friends, I just want you to know that you are welcome in this space. As you’re listening, make sure to hit that follow or subscribe or Add to Library button so that you can hang out with me every single week. Okay. I like to remind listeners that if you do have ADHD, you’re probably going to forget that this podcast exists as soon as you start going about your business today, because ADHD ears are notoriously out of sight, out of mind kinds of people. So hitting that follow button will allow you to get these episodes magically in your feed every week, and bam, you just remember to listen. It’s amazing. I am recording this on the Fourth of July. So sad. It’s so sad.

But that’s okay, June was wild. And even though I worked hard to keep up, I worked hard to get ahead. It just wasn’t enough. And y’all sometimes our best efforts are just not enough. And that’s the truth. And it’s just okay, doesn’t mean that we’re a bad person, or that something went terribly wrong. It just means we’re not robots, we’re human. And as a human life comes at you fast. And so even with all of my prep and trying to get ahead, I can play and I can work ahead. But life just eventually happens. Kids get sick. Vacations are more tiring than they are reviving. Sometimes work is hard and stressful. And sometimes life just happened. So my question to you is, how supportive of yourself, are you when life gets busy and hard and overwhelming? when life happens? How do you treat yourself.

So I’ve decided in an effort to be supportive of myself, and yet still continue with my job and my purpose in life. I’ve decided for the first time ever to re release a podcast episode for your listening enjoyment. Now, even if you’ve already heard this podcast, it’s 100%. Amazing, and it bears repeating. Remember, as someone with ADHD, your working memory sucks. Sorry, I know that was very direct and assertive, but it is just the truth. And this is how we roll up in here. So if you’ve listened to this episode, maybe two years ago when it came out or caught it recently, because you just found this podcast, I want you to know that it’s an important one full of research on ADHD and sleep. And it has helpful tips to improve your sleep hygiene.

So I truly believe that it will be a valuable resource to you even if you’re hearing it for the second time. Now, I do want to let you know that this episode was recorded prior to my realization that my own hypervigilance and trauma history played a massive role in my inability to sleep. So that is one caveat that I want to add in before we get to the meat of the episode. If you struggle to sleep. And if you have delayed sleep phase syndrome, I would invite you to consider in addition to all of the other things that I mentioned, as this podcast goes on, I would invite you to consider whether or not it’s possible that you’re stuck in constant hyper vigilance of fight flight freeze fun.

Now, I’m going to overshare here for a second as I do from time to time, but I’ve been sleeping beautifully for the last six months, just like really well things have improved so much, but recently had some stuff happen in my extended family and it stirred up some hyper vigilance patterns for me this week. And I have really struggled to sleep. And I was reminded of how I used to lay in bed at night for hours and hours and not be able to settle down even as a small child. So yes, delayed sleep phase syndrome is a legit thing. And ADHD years struggle more than most with sleep. And sometimes it’s because we’re stuck in a constant state of hyper vigilance. So I just wanted to throw that out here. As we begin to listen to this episode, it is full of ADHD research, you will find all of that research linked in the show notes. And if you suspect that in addition to what you’re hearing in this podcast, you also might be struggling with some trauma responses with some hyper vigilance with some fight flight freeze finds an inability to settle your nervous system down, just as I was, if you feel like maybe that is additionally, a contributing factor to your poor sleep hygiene, I encourage you to reach out to a trauma informed therapist if you have access to that for some specific treatment around this. Alright, let’s get into the bulk of the episode. I hope you really enjoy it.

And today, we’re talking about a fascinating topic. I can’t wait to bring it to you. And I literally just learned about this a few months ago, actually, Dr. Russell Barkley was on my podcast back in July, I think. And while we were chatting, he mentioned this topic, and I was like, okay, that it wasn’t the point of our conversation. So I literally wrote it down, put a pin in it and was like, I need to go research this because I had no idea. And the topic is delayed circadian rhythm and adults with ADHD or he called it delayed D or no rhythm, which is just a daily rhythm. I’ve done a lot of research. I have so much to share with you today.

And let me tell you, I’m kinda pissed. I’m kind of pissed that I hadn’t heard about this before. Like, what in the world? Why are we all told this a diagnosis? Like I just can’t wait to tell you everything. But you know, before we get started, you know what time it is. It is ad time, baby. That’s right. I’m getting my ad voice on I’m going to tell you all about a life changing program for adults with ADHD. Ready, ready, ready?

Here we go. Hmm. This podcast is brought to you by focused focus is a monthly coaching program where I help adults with ADHD, understand their diagnosis and make significant and sustainable changes in their lives. Focused is not therapy. I’m not a therapist focused is a group coaching program. And I’m an ADHD expert and life coach with years of experience and 1000s of coaching hours under her belt focused helps functional adults level up and reach their potential. And it’s a beautiful companion to an ADHD treatment protocol. So if you’re looking to understand your ADHD on a deeper level and make some big shifts in your life, I’ve got you covered. Go to I have adhd.com/focus to learn more.

Oh, K, let us get to it. I cannot wait to bring you today’s content I have been researching, I have been writing this is actually my second time recording it because the first time was really kind of like confusing. And I really want to distill this down for you so that it is very much a ball. Do you know what I mean? Like I just want you to be able to munch it, like get the info, understand it and totally munch on it. So today we are talking about delayed sleep phase syndrome, which is something that affects so many of us with ADHD.

Now I grew up in a family of ADHDers and so it was really common for us to be awake super late at night have trouble with sleeping, maybe always waking up in different times in the mornings sometimes sleeping in sometimes waking up early. It was just like the norm to not sleep. Well. I can remember being up really late as a kid like playing in my bed. I know I was annoying to my parents. Sorry, mom. I just wouldn’t leave them alone because I was just totally wired. Wow, that word took me a minute to get out. I’m so sorry. I was wired. I would concoct stories and little fantasies and just play in my brain for hours because sleep was just not a thing that came easily to me at sleepovers I was always the last one to fall asleep. I was never able to fall asleep in a car on a plane and hardly napped at all as a kid I still don’t nap as an adult. I close my eyes. And I think that counts is a nap but I definitely don’t sleep.

So to be clear, I am hyperactive so maybe we just need to back up a tiny bit here and remind everyone that there are three presentations of ADHD hyperactive type, inattentive type and combined type. So people who have been diagnosed with ADHD hyperactive type like myself will often have trouble sleeping whereas those of you who have been diagnosed with inattentive type might not struggle with it as much. Okay, so these are pretty broad generalizations, of course, but you guys with inattentive type might find yourself sleeping more like a lot for hours and hours and not being able to wake up. That’s a whole other thing. It’s super difficult. I am so sorry.

That has not been my problem. I’ve definitely noticed though, that there are sleep problems across the board for adults with ADHD. And after working with hundreds of clients, I just thought that I was gathering anecdotal evidence. I’ve coached on sleep a million times. And you know, I knew that ADHD years love to stay up late at night, and we have trouble waking up in the morning. But I didn’t realize that there was actual research to back this up. Now, I’m kind of like the sad, I’m sad that I didn’t know this before. As it turns out, there’s a growing body of evidence to show that ADHD is related to what is called delayed sleep phase syndrome.

Now, according to Stanford healthcare.org, delayed sleep phase syndrome, or D SP S, is a disorder in which a person’s sleep is delayed by two hours or more beyond what it is considered an acceptable or conventional bedtime sidebar here, that’s kind of annoying, that they use acceptable but whatever, we will forgive them. So continuing with the article, the delayed sleep then causes difficulty in being able to wake up at the desired time. For example, a person with DSPs may fall asleep after midnight instead of at 10pm. And then will have difficulty getting up in the morning for school or for work, like DHA. All of us with ADHD are like yeah, we know.

We know this is a thing like this is my life. I just didn’t know that there was research to show that adults with ADHD are going to struggle with this, I can’t wait to get to it. I also want you to know that in my research, I found a couple of different names for this phenomenon. One of them is like delayed circadian rhythm. And I just want you to know that I’m just going to be using the term delayed sleep phase syndrome, because I just want to have one memorable name that we use over and over and so that we’re not confused or you’re not like I can’t remember it because she called it a million different things. So definitely do some research on this topic. It’s, it’s wildly fascinating, in my opinion, especially since I’m just learning and gathering information about it. So we’re going to start at the beginning. We’re going to talk a little bit about sleep okay, so circadian rhythm is your body’s wake and sleep clock basically.

Okay, so here’s how the Sleep Foundation defines it. The Sleep Foundation says circadian rhythms are 24 hour cycles that are part of the body’s internal clock running in the background to carry out essential functions and processes. One of the most important and well known known circadian rhythms is the sleep wake cycle. Different systems of the body follow circadian rhythms that are synchronized with the master clock in the brain. The master clock is directly influenced by environmental cues, especially light which is why circadian rhythms are tied to the cycle of day and night.

So your circadian rhythm is just like when your body naturally falls asleep and naturally wakes up. Here’s the huge news for adults with ADHD for many of us 70% or more of us, our circadian rhythm is delayed and so this phenomenon is called delayed sleep phase syndrome. This means my friend that we naturally want to fall asleep several hours later than the typical human without ADHD or what Stanford have online calls acceptable. Okay, this is normal for us normal. You are normal. I am normal. My mind is blown. Alright, so oh my gosh, continuing with reading research because I think that this is really important for this particular topic. I’m going to read for you a part of a blog from the app side website now episode is the American professional society of ADHD and related disorders. This article is by a woman whose name I do not know how to pronounce I’m going to spell it for you her last name is Ko i j. So it’s we’re going to call her Dr. Sandra Okay, Dr. Sandra, and here’s what she says about ADHD and sleep.

She says ADHD is related to several sleep problems, but the most frequent being the delayed sleep phase syndrome, a disturbance in the circadian rhythm. Research in children adults with ADHD when compared to controls shows that the majority of these individuals has a late sleep onset that is associated with the late onset of the sleep hormone melatonin so sidebar here What she’s saying is that melatonin is released later in people with ADHD. And so it’s not actually our fault that we stay up late. It’s just that we’re getting a little hit of melatonin, later than the typical human.

And so Dr. Sandra continues that for most adults, the onset of melatonin was around 9:30pm. And in adults with ADHD, the onset of melatonin is 90 minutes later, it usually takes an adult two hours to fall asleep after melatonin. But for adults with ADHD, it can be up to three hours after so we’re getting our melatonin later, and it’s taking us longer to fall asleep. Back to Dr. Sandra, she says this late onset of melatonin is driven by genes that regulate the biological clock. And those genes have been linked to psychiatric disorders like ADHD and bipolar disorder. Do you hear it? Do you hear it my friend, melatonin is a natural hormone released in all humans. And in typical adults, it’s released around 930. And then after that’s released, takes a typical about adult up to two hours to fall asleep. So our society has deemed like 10 to 1130 a, quote unquote, acceptable time to fall asleep, right.

And so that’s why the neurotypical is just fall asleep like a normal time. All right. But in adults with ADHD, melatonin is released later, around 11pm. And then it can take up to three hours for us to fall asleep, which is why staying up until 12, one, two, it’s pretty typical. It’s pretty easy. It feels pretty natural to us. All right. And of course, if we’re up until 1am, we’re not going to be wanting to wake up at 6am to get the kids out the door for school and get to work. Okay, this just explains so much. And I just want to take a minute and sit here together in solidarity with one another. This just kind of sucks.

Like not only are we dealing with ADHD symptoms all day long. But even when it comes to falling asleep, even when it comes to shutting down and shutting everything off, we still struggle. And so the way that our bodies naturally work is that we just want to stay up. And we even find that we have this like second wind, and we want to be active in the evening. We want to be active at night. And this causes us to stay up much later than what is healthy. And the reason for that being is that we have to get up the next day and function in a normal society. function for me in a typical American society where my kids are walking out the door to go to school, hear me 6:45am is when they have to leave the house.

Oh my god. Oh my goodness. So this is why when people try to tell me that ADHD is a gift, I am like, What are you even saying to me right now? Not a gift. This part sucks. We struggle all day long, and we can’t even go to sleep at night. Are you kidding me? This sucks. This is not a gift. Okay? I’m sorry for you gifts. Like if you’re in the camp of like, this is a gift. I love you. I respect you. And just very, very respectfully disagree.

This does not feel like a gift. I don’t want this gift. I want to return it or is the receipt oligos. Okay. Now, if you’re living off the grid, if you don’t have to wake up at a certain time, if it doesn’t matter when you wake up then like it, this is fine. It’s not a big deal. But for most of us who have typical jobs and typical, like kids schedules, it’s kind of a big deal. Right? If we have to be on and functioning and performing during the hours of 8am to 5pm. It’s just hard. So if you’re hurting right now, because of this, I’m sending you the biggest hug ever.

So ADHDers, if you’re struggling to settle down at night struggling to wake up in the morning, guess what? You likely have delayed sleep phase syndrome. Join the club so it is your girl Kristen Carter. A study published in the sage medical journal online concluded that adult ADHD is associated with delayed sleep phase disorder. And it showed that stimulants are also a contributing factor to this.

So, yes, this happens naturally because of the late onset of melatonin release in our brains, but also, stimulant medication can contribute to us staying up later. And so anecdotally speaking, even though I was always awful at sleeping, when I was taking a stimulant medication, it was much, much worse, it was much harder for me to sleep harder for me to fall asleep. And that’s one of the reasons why I opted for a different medication. When I decided to be medicated several years ago, and no, I will not tell you what medication I’m on because I am not your doctor, talk to your doctor about meds. Okay? So whether you’re taking a stimulant medication, or you just struggle to go to sleep at a time that society has deemed the normal natural time to fall asleep.

You are a typical ADHD ear. Okay? It doesn’t mean anything bad about you. It just means like, yeah, you’ve got ADHD, and this is part of it. Now, here’s an excerpt from an article from the American Association of sleep technologists. And this is written by Regina Patrick. Regina says in people with delayed sleep phase syndrome, the sleep wake phases occur later than normal. Thus, they naturally want to go to sleep one to three hours after midnight and awaken around 10 or 11am. Can I get an amen to that, like, my body has always wanted to do that I have worked very hard to train myself to go to bed earlier recently, but my body has naturally always wanted to stay up until about one or two and sleeping in till about nine or 10. That’s just the way my body wants to function.

So continuing with what Regina says she says, when trying to follow the societally normal schedule, people with delayed sleep phase syndrome have difficulty initiating sleep at night. And we call it insomnia, and difficulty awakening in the morning, when not following the normal schedule, the person’s sleep duration, and quality is normal. But the sleep and wakes phases are delayed. This disorder usually manifests during the teen years. So what she’s saying is we can get a normal amount of sleep, we just want to do it much later than a typical human. But when we’re trying to fit into a neurotypical box, we have trouble.

For some of you, you might want to plan your entire life around not having to struggle with this, you might want to plan your entire life around waking up later, so that you can be able to stay up later. And some of you have the freedom to do that. And that’s amazing. But most of us have to fit into a societally normal box. Most of us have jobs, and kids and things we got to get to in the morning. So for those of us, like this is a big deal, we have to work so hard at going to bed at a normal time, it does not come naturally to us.

Like, I just cannot believe that there’s actual research and evidence and studies that have been done on this. It is blowing my mind. In the study done by Dr. Sandra, Ko ij don’t know how to say her name, I definitely apologize. She notes that 73 to 78% children and adults with ADHD struggle with delayed sleep phase syndrome, or a delayed onset of sleep. That’s a lot. That’s a lot of us. If you struggle to go to bed, if you struggle with this, pull to stay up later. You’re super normal for an adult with ADHD.

So if you’ve been judging yourself for years, if you’ve been beating yourself up like I have for decades for not being able to go to bed like a quote unquote, normal human, you can just go ahead and stop the shame show. Isn’t that awesome? You can just stop beating yourself up because actually, you are very normal for an adult with ADHD, staying up later and wanting to get rolling later and then in the morning, totally normal. Now, like I said, for some of you this isn’t a problem. But for most of us, for most of us, it’s delayed sleep phase syndrome. It’s not compatible with our life. Right? Like I if I could call my kids school and be like, Listen, this doesn’t actually work for me. I’d like them to start at 10am Please that would be incredible. But that’s not It’s not possible. So here’s a question what can be done.

There are treatments for delayed sleep phase syndrome, okay and other sleep related disorders. So I would encourage you that if this is a big thing for you, and you’re not able to tweak it on your own, reach out to your doctor for help. The most common therapies used for sleep disorders, like delayed sleep phase syndrome are bright light therapy, Chrono therapy, cognitive behavioral therapy, and melatonin.

Okay, so I’m going to repeat that in case you want to write it down. Bright light therapy, Chrono therapy, cognitive behavioral therapy, and melatonin. So, I’m not going to go in to the details of the different types of treatments here, because those are totally Google herbal, and you can talk to your doctor about it. But I definitely want you to know that there are treatment options. That’s really, really important. There are treatment options. If delayed sleep phase syndrome is making your life difficult. If it’s impairing your ability to function, I would encourage you to reach out and seek treatment for it. But even if you don’t seek treatment, you can work to improve your sleep hygiene. And notice I said work, because this does not come naturally to us, right? So if you’re someone who needs to get up early, and get out the door, improving your sleep hygiene, improving your like, nighttime stuff is certainly going to help with this. And improving your sleep may actually improve your ADHD symptoms.

And this is a whole other podcast episode. But our friend, Dr. Sandra, is convinced that ADHD and poor sleep are related and that the symptoms are worse because of poor sleep. And she’s basically asking the question, which is coming first, the chicken or the egg. Again, not a podcast for right now, but a very interesting rabbit hole if you want to go down that rabbit hole. So research does show that our spacing is distractibility and ability to regulate ourselves. It worsens when we are not sleeping well. So if we can improve our sleep, we may be able to improve our ADHD symptoms, or at least make them so that they’re not as prominent.

Now, like I said, I had no idea that this was like a real research, proven thing for adults with ADHD. I just know that, like I said, good sleep. And so I’ve been working to improve my sleep hygiene. And I’ll tell you some simple things that I’ve done to help. So first of all, I got an alarm clock with with a bright light. So the alarm goes on, and the light turns on slowly. And then my room is bright. And that has really helped me to get out of bed because especially in Pennsylvania, like cozy, cozy winters where it’s just so dark and so cold. I’ve always struggled to get out of bed and being able to get out of bed at the same time every day like now that my kids are having to get up so early and out the door.

It has helped me so much so that bright light therapy really does work my friends, it really really does. Of course, this is not medical advice. But I do take melatonin every night right around the same time right around nine, which is so funny in reading this research that like in a typical adult. Melatonin is released at 9pm. But for me, it’s not and I’ve been taking it at 9pm for years now. So melatonin paired with a very small glass of red wine. Again, not an endorsement, just my own experience. It really does help me to fall asleep without frustration without drama.

Still, usually after Gregory Carter but at least not that much later. I’ve also established a very loose bedtime routine, which it’s not fancy, but I have an alarm set for 845 to remind me to start the bedtime process with my kids because I kept just forgetting that bedtime was a thing. And so my alarm is set at 845 it goes off every weeknight and it says start the bedtime process. So it’s a loud, annoying, obnoxious process. But usually during that time, I tried to force myself to get myself ready for bed too. So that’s when I’m like doing the jammy thing, taking out the contacts, taking off the makeup like all of that stuff. I’m trying to do that. When I tell my kids to do it, using them as a body double. That’s awesome when I take my melatonin.

The kids are usually in bed around 930 And I have a very strict boundary with myself that there is no thinking after 9:30pm No idea creation. No. Like watching the news. No reading the news no talking about politics nothing. No was thinking after 9:30pm, so that I’m not getting activated and excited. And like, all of the things that keep me up late, late, late, late, and then I try to use Greg as a body double when he falls asleep or when he’s ready for bed. I really, really try to be conscious and aware enough to say, Yes, I need to do this too. It’s not easy. And it doesn’t always work.

But it is my little routine that does seem to help. Now, I used to think that I should be able to go to sleep without help. And maybe this is you too. Why don’t I go to sleep like a normal human? Why am I always the last one awake? Why are the last one asleep? I guess the last one awake? And the last one is sleep? Why is this so hard for me, I should be better at this.

This shouldn’t be so hard. As per our usual with this podcast, and with everything else that I do with my clients, we’ve got to drop this way of thinking, if we’re going to improve the quality of our lives, I shouldn’t be able to sleep with a lot without a lot of help. And without a lot of work. Why? Because I have ADHD. And what does that mean? It means I have delayed sleep phase syndrome, it means that my circadian rhythm is totally off. It’s much, much later. And so if I’m going to function in a typical American society, I’ve got to get to sleep before 12am.

And in order to do this, I need help. That’s just the way it is. I can’t do that naturally on my own. It’s virtually impossible. There’s no shame in it. And especially now that I understand that delayed sleep phase syndrome is a whole thing. I can embrace this even more, which means I can implement even more support to help myself get even better at it. And so can you. So I’m wondering, what do you think? What’s your biggest takeaway here? Do you need to reach out to your doctor? Do you want to research treatment for delayed sleep phase syndrome? Do you want to work to improve your sleep hygiene? If so what does that look like? How are you going to remember to do it? How are you going to make it fun and cozy and delightful. I encourage you to do what you need to do to take care of yourself and improve your sleep so that you can improve your experience as an adult with ADHD.

I am sending you so much love. I’m gonna see you next week. Hey, ADHD, er, I see you. I know exactly what it’s like to feel lost, confused, frustrated and like no one out there really understands the way that your brain works. That’s why I created Focus. Focus is my monthly coaching program where I lead you through a step by step process of understanding yourself feeling better and creating the life that you know you’re meant for. You’ll study be coached grow and make amazing changes alongside of other educated professional adults with ADHD from all over the world. Visit Ihaveadhd.com/focused to learn more.

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