Sleep Hygiene for ADHD and Autism: 8 Dependable Strategies
Sleep hygiene can be a critical practice for ADHD and Autism. If you are Autistic or have ADHD, It’s likely you have struggled with (or are currently struggling with) falling asleep, staying asleep, feeling rested in the morning, and so on. As a neurodivergent clinician, I understand, from both personal and professional experiences, how devastating poor sleep can be on every aspect of our lives.
The good news is: there’s so much we can do to get better sleep at night! One of those things is upping our sleep hygiene practices.
In this article, I will discuss sleep hygiene, why it’s important to ADHDers and Autistic people, and how to add more good sleep hygiene practices into our lives. I will also talk about why it is hard for us and what to do about that! If you want more information about other sleep techniques and the connection between sleep struggles and neurodivergence, check out my article on Autism, ADHD, and sleep.
And if you want an in-depth guide with lots of work pages and practices to help you sleep better at night, check out my Neurodivergent Sleep Guide. The guide provides workbook pages, more practices and resources, and information about sleep patterns.
Disclaimer: 1) This article is for educational purposes only and is not meant to diagnose any medical conditions. If you are experiencing chronic sleep issues (such as chronic insomnia or snoring), then I suggest seeing a doctor or health care professional to rule out any underlying medical conditions. 2) This article includes affiliate links, which means that at no cost to you, I earn a small commission if you click on a link and make a purchase.
Let’s get into it!
What is Sleep Hygiene for ADHD and Autism?
Simply put, sleep hygiene encompasses everything you do to take care of your sleep. This includes your bedtime routines, your sleep practices, and all your bedtime habits. Good sleep hygiene means having a toolbox of habits and routines that promote rest and regulation at the end of the day.
So why is sleep hygiene important? Just like brushing your teeth and showering helps keep your body healthy, sleep hygiene keeps your brain, hormones, sleep, and circadian rhythm healthy. Poor sleep hygiene can cause poor sleep, disruptions in our hormone cycles, difficulty waking, and worsening of mental health symptoms. And, because of our increased sensitivities and vulnerabilities to sleep disorders, it is especially important for ADHD and Autistic people to maintain good sleep hygiene.
Sleep Hygiene for ADHD and Autism Basics
Introducing new habits and routines can be challenging for anyone, but especially for Autistic and ADHD people! So before we dive into the suggested practices, let’s talk about how to go about making these changes so that we achieve consistent, sustainable good sleep.
How to Introduce These Practices into your Routine
1) Make these changes gradually! Especially for ADHDers, it is easy to want to make all the changes you can all at once. It can be really difficult to see long-term goals and to work toward them sustainably. However, if we want to make these changes sustainable practices, it’s really important not to do that.
2) Identify what is working! To make changes to your sleep hygiene routine, identify what you’re doing well! Identify (and celebrate) the things you are already doing. (For example: You don’t drink alcohol, right before bed? Great, check that off the list and move on).
3) Identify what isn’t working. Go through the sleep hygiene list and see what is left on the list, and identify any changes that seem most important and/or the changes that are easiest for you to make.
4) Next, out of that list, choose one (yes, just one!) practice to start with. Make the change and practice it consistently for three to four weeks. Once you believe the change has been fully incorporated into your routine (it won’t take much effort from you to continue doing that practice in the future), you can move on to make one more small change.
5) Stick with it! Studies show that it takes about 28 days for practices to become mindless habits. So it is important to practice consistently for that amount of time before moving on to the next thing. And if we make too many changes at once, we overwhelm the body, and the body resists the changes.
That being said, here is a list of sleep hygiene practices that work best for Autists and ADHDers:
Sleep Hygiene 101
Sleep in a dark, cool, quiet room
When we go to bed in a room with lots of lights and noise, it’s difficult for the brain to relax enough to fall asleep. This is especially true for neurodivergent people with sensitivities to light and sound. Therefore, sleeping in a dark and quiet room allows the brain to unwind and fall asleep. If this is not possible, try a sound machine, ear plugs, eye mask, fan, and/or black-out curtains to help you with this.
Also, when we sleep in a slightly cooler room, we tend to sleep harder and have more success staying asleep and sleeping deeply. Sleeping with a fan can help you with this.
Put away screens two hours before bed
As it’s pretty well known at this point, screens throw off our circadian rhythms by waking up the brain. Screens provide a lot of stimulation which wakes up the brain. It can also disrupt our melatonin patterns (something we’re already vulnerable to as Autistic-ADHD people)! The harsh light strains the eyes and confuses the brain by sending signals that it’s not nighttime. Allowing your body to wind down naturally is the best way to help your body fall asleep easily, and this means avoiding screens right before going to bed.
Avoid caffeine and naps after 2 pm
Caffeine stays in the body’s system for a long time. On average, neurodivergent people take longer to detox substances like caffeine than the average person, so this may be particularly important for us to consider. If we eat or drink caffeinated substances too late in the day, the caffeine can keep us too wired to fall asleep when we want to. This can make the sleep/wake cycle more difficult in the long run.
Taking naps too late in the day can have a similar effect. This can throw off the circadian rhythm and wake the body up, making it more difficult to fall asleep at night.
Exercise during the day
When we exercise during the day, it uses up the body’s energy and makes us more sleepy at night. Exercise also releases endorphins, which promote a better mood and help the body to regulate emotions better. As a bonus, this added boost to your emotional regulation makes it easier to fall asleep by decreasing the anxiety and stress that can keep us awake.
Avoid rigorous exercise two hours before bed
Although it’s recommended to get exercise throughout the day, it’s best to avoid rigorous exercise right before bed. This is because rigorous exercise wakes the body up and can even turn on the body’s trauma responses (flight/flight/freeze mode). If you don’t allow your body enough time to regulate itself after exercising, falling asleep can be really hard.
Wake up and go to sleep at the same time every day
When we wake up and go to bed at the same time every day, our body's circadian rhythms are more consistent, which allows our brains and bodies to wake up and get drowsy more easily when we want them to. It's also shown that when we have a consistent sleep schedule, the inflammation in our brains (we experience this as brain fog) decreases dramatically. This supports focus and emotional regulation throughout the day, which, in turn, allows us to experience less anxiety and stress as we're trying to fall asleep.
Avoid Alcohol two hours before bed
Even though alcohol may temporarily decrease stress and may even make you sleepy, alcohol is shown to worsen a person’s sleep. First, even if alcohol helps you fall asleep, it decreases the quality of your sleep (we don’t get as much deep and REM sleep when there is alcohol in our systems). Therefore, we wake feeling unrested, even agitated. Also, even though alcohol temporarily takes the edge off of stress and anxiety, it is known to make those things worse in the long run. This added stress to the body can worsen the stress that keeps us awake at night.
Avoid heavy meals two hours before bed
It takes time for our bodies to digest a heavy meal. However, when we fall asleep, our body's digestion slows, which means that a heavy meal is likely to sit in the stomach all night. This can cause the body discomfort and agitation, which can, in turn, make it more challenging to get good sleep. It's best to give the body at least two hours to digest a heavy meal before we go to bed.
Remember!
Making too many changes too quickly is an excellent way to stress out the body and worsen your sleep issues (I’m looking at you ADHDers!). It’s best if you take your time with these changes. Start by making one change, add it into your routine consistently for three to four weeks, then make the next change, and so on. The goal is for sustainable changes for better sleep in the long term.
Why is Sleep Hygiene Difficult for Autistic and ADHD People
Before concluding the topic of sleep hygiene, let’s also talk about why it’s hard for us. Personally, I know I do much better when I am on top of sleep hygiene; at the same time, I often struggle to implement these practices consistently! This is likely a contributing factor to why sleep is so difficult for many of us. Here are a few of the reasons sleep hygiene is difficult for many Autistic and ADHD people:
Revenge bedtime procrastination: revenge bedtime procrastination refers to the tendency to procrastinate bedtime as a form of “revenge” from the busyness of the day. For many Autistic-ADHD people, our days are filled with demands, sensory overload, and task-switching. Nighttime is a time many of us experience alone time and gets to spend time with our special interests or passions. We desperately need this time and space. The only difficulty is that it comes at the cost of our sleep.
Hyperfocus/Hyperfixation: This is related to the above point. We may wait until the demands of the day are behind us to focus on a project of interest. Because of our interest-based nervous systems, we often become hyperfocused and hyper-fixated. When in this mode, we lose track of time, and it is physically painful to stop. This makes it challenging to stick to a consistent routine and schedule.
Circadian Rhythm Disorders and Flattened Melatonin Curves: Our biology doesn’t necessarily support consistent routines, which can also interfere with maintaining quality sleep hygiene.
Chronic Pain: There is a high overlap between chronic pain, ADHD, and autism. Chronic pain can interfere with our ability to exercise and move throughout the day.
Addiction: ADHDers and Autistici people (particularly those with average to above average intelligence) are at elevated risks of developing substance abuse disorders. This can interfere with our ability to avoid stimulants and substances before bed.
Interoception Issues: Many ADHDers and Autistic people struggle with interoception. This means we may not register hunger and thirst signals in the same way as others. Many people may not eat throughout the day and then have a “revenge” meal at the end of the day. This means the body is working hard to digest a large meal before bed which can also interfere with sleep hygiene.
So how do we work with these vulnerabilities? Acknowledging them as vulnerabilities is the first step. Knowing our potential vulnerabilities is a way of identifying our “sleepless triggers.” It is also important to be gentle with ourselves. Realistically our sleep hygiene won’t be perfect, and that’s okay. When we are in a particularly rough sleep cycle, we can revisit these principles and try to implement them. When we fail to do so, self-compassion for the fact we struggle here is important. It may also mean that we need to rely more on the other sleep strategies available to us (sleep stimulus, sensory considerations, CBT-I and distraction techniques, and relaxation strategies).
More Sleep Resources for ADHD and Autism
Sometimes, sleep hygiene isn’t the source of our sleep troubles. If you practice healthy sleep hygiene or have worked to introduce healthy sleep hygiene practices into your routine and you’re still having difficulties with sleep, there’s still help for you! I recommend checking out my other sleep articles. Here, you’ll find lots of information about the causes of Autism and ADHD sleep struggles as well as plenty of other things you can do to get better sleep at night.
I have also curated an in-depth workbook for neurodivergent sleep in my Neurodivergent Sleep Guide. In the workbook, you’ll find lots of helpful information about Autism, ADHD, and sleep, plus you get 14 work pages, dozens of exercises, and expert help and guidance.
Conclusion: Sleep Hygiene for ADHD and Autism
Often, ADHD, Autism, and sleep issues go hand in hand. However, we can do some things to be proactive about getting good rest at night. One of those things is mindfully adding sleep hygiene practices into our routines. By taking care of ourselves through sleep hygiene, we are more likely to fall asleep quickly at night, wake up easier in the morning, decrease symptoms of mental health issues, balance our hormones, and more. Adding these practices in a sustainable way can take time, but they have a huge impact on our health in the long run.
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