Dr. Roberto Olivardia is a clinical psychologist and a lecturer in the Department of Psychiatry at Harvard Medical School. He specializes in the treatment of ADHD and within the field of ADHD, he further specializes in comorbid disorders, such as OCD, bipolar disorder, eating disorders, and body dysmorphic disorder.
However, in true ADHD, fashion during our pre-interview chat we decided to switch the direction of the podcast to instead deal with sleep. In our conversation we talk about Dr. Olivardia’s own issues with sleep and how sleep is just one of those issues that seems to plague everyone with ADHD. We get into some of what underpins ADHD sleep issues and some of the things that we can do to try and get ourselves a good night’s sleep.
I had a blast recording this and I hope you enjoy just as much as I did.
William Curb: All right. Well, I am here today with Dr. Roberto Oliverdia. And can you do a quick introduction for yourself? Because there's a lot there.
Roberto Olivardia: Sure. I am a clinical psychologist and a lecturer in the Department of Psychiatry at Harvard Medical School in Boston, Massachusetts, that was born and raised. I have a private practice in Lexington, Massachusetts, specializing in ADHD of all ages and particularly specialized ADHD with co-morbid disorders. So people who have ADHD and you name it, you know, ADHD and OCD, OCD, ADHD and bipolar disorder, ADHD and eating disorders. And then in addition to that, specialized in the treatment of obsessive compulsive disorder, body dysmorphic disorder, and then work with over the last 30 years have been researching, treating, writing about boys and men with eating disorders. And then I also have ADHD myself and have two children with ADHD and dyslexia. So come at it from a very personal lived experience as well.
William Curb: Awesome. Yeah. And we're not going to discuss any of that because as we were discussing before the show, I was like, I have all these questions about eating disorders. But then I was like, but really want to talk about sleep because that's a true ADHD fashion. Like I'll just toss everything out and we'll go with go with what's on the brain right now. So my understanding is that there is a huge percentage of people with ADHD that also deal with sleep issues.
Roberto Olivardia: Yeah. I mean, I can tell you I don't know anyone with ADHD and I know a lot of people with ADHD. I mean, obviously my clients, but also just in my personal life, I don't know anyone with ADHD that doesn't have some issue with sleep. And studies and empirical data backs this up that people with ADHD have higher rates of onset of being able to get to sleep are more likely to wake up frequently throughout the night. I'm more likely to have difficulty waking up in the morning. I'm more likely to have sleep disorders such as narcolepsy, sleep apnea, be sleepwalkers, sleep talkers, kids with ADHD have a higher prevalence of bedwetting while asleep. So you see the whole range basically. And I can tell you personally that almost all of the above that I have had throughout my life. Sleep has always been this strange enigma relationship.
And then on top of it, we know that folks with ADHD often have this kind of conflict with sleep because we kind of find it a little bit boring sometimes. I mean, you know, going to sleep. I don't remember where I heard it, but I heard this great quote that for someone with ADHD, going to sleep is laying in a dark room waiting for nothing to happen. I totally fit the bill. And it honestly, like it's probably been in the last, I don't know, five to eight years that I really finally feel like I've been kind of on track with it. But I had a mentality when I was younger that sleep was just disposable, that it was just I could easily add hours to the day in having fun or being productive by just letting go of sleep.
And the truth was is I was the kind of person who I could pull in all nighter. You wouldn't know the difference. I mean, I wasn't irritable the next day. I didn't have headaches the next day. I didn't know that doesn't mean and I want to stress some listeners out there. That doesn't mean it was good for me. And actually, it was not good for my body. I have probably shaved some years off my life from all of the sleep deprivation. And I would get like sick. I mean, at some points, you know, I'd been go through long stretches of sleep deprivation. And then I'm like, why do I have mono? Why do I have shingles? Like, I mean, your immune system gets really taxed when you're not sleeping well.
So I never got, though, the short term consequences of poor sleep because I'd be like, oh, I'm fine, but I get those sort of longer term problems. And then as I've gotten older, I'm like, I really have to really pay attention to this because, you know, your whole mindset of health changes, you know, as you get older, when, you know, when I'm 20, I never imagine being 50, you know, and like it just seems like an eternity away. And I still feel very young. I mean, I don't think old is ever going to be in my vocabulary, frankly. And at the same time, I am aware. And as I look at research of how important sleep is to the brain and particularly to an ADHD brain that already is vulnerable from an executive functioning perspective. So it's very, very prevalent in ADHD communities.
William Curb: Yeah, like on that short term note, I was also just thinking like, yeah, there are also like times I'm like, man, I got very little sleeping on me before our night or something because of kids, but I'm feeling fine during the day. But I'm not noticing where I'm not fine.
Roberto Olivardia: Yes, exactly.
William Curb: Like I'll like if I try to do some mentally taxing task, I'm like, I'm going to write this thing real quickly. And I just sit there and I'm like blank for a while and I'm like, oh, that's the sleep.
Roberto Olivardia: Absolutely. No, but that's a great point because as we know with ADHD, you know, we can have a hard time paying attention to anything that isn't highly stimulating. And so lack of sleep sometimes for some people, it's very impactful and obvious. And in my case, it was more insidious. And so like you said, like it would be it would just take me longer to do something like my eating choices are definitely affected when I'm not sleeping well. When I was younger, far more impulsive. I mean, I'm an impulsive person on a good day of sleep. But when I was younger, like just the choices and decisions that you make, but it didn't seem obvious to me at the time.
And even like when I talk about like mono and shingles, like some of these things that I mean, I have a good sense of humor. I laugh at these things now, but I got shingles in my early thirties. And it was during a period I just was sleeping probably three to four hours a night for like three weeks straight. So not good for you. But because my work is I love what I do. I love what I do. And I'm so stimulated by it that even when my doctor was like, like, aren't you falling asleep at work? I'm like, no, like I'm so energized by, you know, the work, which is a great thing that it's not even like because if I felt it coming out in that way, I would absolutely pay attention to it because doing the work I do is really, really important to me.
If I wasn't present for my family, that it would really show itself. But it was those other things, like you said, that maybe our kind of either less on the radar. But the first question when I did get shingles, which is a painful thing. Oh, my gosh, don't wish it on my worst enemy. I don't know that I have enemies, but and I said to my doctor, what is going on? I have this rash and it's it feels like knives, like blades, like going in my skin. And my doctor, who you've retired, but he sounded like John Wayne, the actor. He's like, Roberto, it sounds like you have shingles.
And I'm like, what? Like, don't people in their eighties get shingles? And the first question he asked me is, how have you been sleeping? I'm like, have you been stressed lately? And I was there was a period of time that was going through a lot of stress. And he's like, your body basically is telling you, you need to slow down and stop. You know, but even then I mean, that should have been a major wake up call. And it was for a little bit. And then it sort of just fades away.
And that's kind of the ADHD thing sometimes is even when we are like, I'm so going to pay attention to my sleep now. And then we're on. And then it just sort of fades away until the next punishment that our body has. And I don't want that anymore. I mean, now I look back and like, how did that not really with me completely into shape? But it just it didn't. I mean, it's just so easy. And then now with technology and everything, it's so easy to keep ourselves occupied to the hours of the night.
William Curb: Yeah, I was recently doing some things with my sleep. And I'm like, OK, I'm going to try and cut social media off a little bit earlier in the evening, put some blocks on my phone. I'm like, still tempted to do it. But I always try and keep reminding myself never seen anything while scrolling that has made me want to go to bed more.
Roberto Olivardia: Yes, that's a great observation.
William Curb: It only amps me up and wants makes me want to read more or do stuff. I like the only way it gets there is I get to a point where I'm scrolling and I'm not interested anymore. And that's I could do something else that would get me better self regulated to go to sleep than scrolling.
Roberto Olivardia: Yes absolutely. Yeah, it's almost like the adage of nothing really good is going to happen after three a.m.
William Curb: Yeah, absolutely.
Roberto Olivardia: When I would be up, like I'm probably going to get into some mischief, which I would, you know, after three a.m. Like I should be asleep right now.
William Curb: And then we also have like this issue of like bedtime procrastination because like we want to like have fun during our day. And we have been doing work an all day and we like, oh, this is my me time. I can like play games or
Roberto Olivardia: Yes!
William Curb: Do whatever. And it makes it so much harder to go to bed when it's like, oh, yeah, and watch some more Netflix because this is the only time I get for me.
Roberto Olivardia: That's 100 percent true of me. It's funny because looking back in my life, I remember before having children and even in grad school, I was like, I need at least four hours of downtime, four hours, which now would be like I don't even luxury. I mean, but that's what I needed, you know, especially in grad school and I would have my TV shows and everything. And then you have children, which is the most spiritually miraculous thing that has happened in my life. It's amazing. And you also realize you don't have four hours of downtime anymore. And it's filled up with other great, wonderful things, but you have to adjust that idea.
But I like that me time. And interestingly, now for the first time, I mean, over the last since the pandemic started about four years ago, which is so weird, I am actually becoming more of a morning person, which I never thought I would utter those words because I was a very nocturnal, even as an infant. My mother said I was up all night and wanted to sleep like during the day. And she said I was like I wasn't a colicky kid. She said I was always looking like I was ready for a party.
Even in the crib. And but now when I come in my office, sometimes at seven a.m., my first client might be at nine and I enjoy having a cup of coffee. I have my music playing and it's just like, you know, it's there is something very grounding about that. And so for anyone with ADHD, we just have to find those moments, but not at midnight all the time, you know, in that way. So there is that procrastination. And I still I mean, there's still something I don't know. It's something almost existential. I feel where I just don't want to let go of a day. It almost feels like a loss to me in some ways.
Like, even if it's not a great day and, you know, luckily, I have more good days than not good days, but even if it's not a good day, there's something I don't know about like, oh, this day will never be again. It's gone. And I just don't want to let it go. Even when sometimes I'll be up and it's not even like I'm doing anything productive. Or I don't know, it's just like just go to bed. I have to say that to myself. And then sometimes certainly this is less the case now, but when I was younger, it was almost it was a necessity to just be up late because I wasn't getting my homework done and the papers written earlier in the day.
And it was like, oh, now it's like, do or die. I got to get it done. And many a time in college and grad school writing papers overnight and such. But even without all of that, there are a substantial amount of research looking at how the ADHD brain is wired in some ways towards sleep dysregulation. And even just for people who are tired and going to bed, you know, the idea of 15 to 20 minutes where your head hits the pillow to the time you go to sleep is like, that's hard for someone with ADHD to just be lying there and they're like, OK, why am I not asleep yet? I'm asleep yet.
Why am I not asleep yet? And then, of course, the more we're doing that, the more we're activating ourselves. So we need different strategies like for me to go to sleep. It's almost like feels like a little like a multimodal village, you know, of the pillow I use, the temperature in my room, the room darkening shades. You know, sometimes I have to have very light music, very low volume in repeat the same song just to kind of have my mind be occupied with something.
Because if it's not occupied with something, it's going to be occupied by everything. And then that's just going to activate for me to go to bed healthily. Because when I first got a sleep study and my doctor said, oh, do you have how long does it take you to fall asleep when your head hits the pillow? I'm like, oh, instantly. Like I go to bed immediately. And then when she thought, oh, wow, that's unusual. And then when she asked me what time I go to bed. And at that time when I was getting the sleep study, I was like, oh, usually I'm going to bed at two. She said, oh, that's why you're falling asleep. You should have been going to bed out. You're like starving for sleep at that point.
That's not healthy. So the idea that you people go to bed and they just kind of are lying there. And then eventually that I'm like, really? Like how my head would just be filled instantly with, oh, what am I going to do tomorrow? Or I'm going to let's solve this world problem right now. Or maybe I'm thinking of something creative. Maybe I'm thinking of something I'm anxious about. Like it just so I need to kind of fill that gap, I feel, to get myself grounded.
William Curb: Yeah, I do a lot of fiction reading before bed because that can like I can do that and be ready to like fall asleep when I like turn the light off and everything. Because otherwise, yeah, it's like people like, oh, yeah, you can do these things like counting down or like these visualization things. And I'm like, it works for about 10 seconds. And then I get distracted by another thought floating by and I go with that thought. And then suddenly I'm like, oh, I forgot I was supposed to be counting.
Roberto Olivardia: Right. And that's the thing. It's like everybody it's interesting, you know, in sort of polling people with ADHD about what they do. And I hear a variety of different things. Everything from the Harry Potter audiobook. Interestingly, that comes up a lot with people of different ages. Apparently, the narrator is really good in that book. I haven't read any of the Harry Potter books, but to people having, you know, certain like visualizations, like for me, I love the beach.
And so sometimes I will like picture myself on the beach and like feel the sun on my skin. And I'm a very visual thinker, so I can access that very easily. But not everybody can see pictures like in their heads, you know. And so then you might need another modality. And sometimes the same modality doesn't work all the time consistently. So you almost have to have various tools in the toolbox. But as we're talking about sleep, we're also talking about virtually a lot of other things that involve ADHD, which is we need various tools in the toolbox, whether it's how do we regulate our attention?
How do we get this task done? How do we manage our impulses about X, Y and Z? And sleep does require it's a very active process to go to sleep. And it is so important because poor sleep only will exacerbate ADHD symptoms. And then, you know, those symptoms can alter sleep. And then it just becomes this back and forth.
William Curb: Yeah. I had an interesting article I wrote recently about it takes a lot of tools to manage my ADHD. And like while sleep is my most important tool, usually sleep alone won't solve my ADHD either.
Roberto Olivardia: Right. Right.
William Curb: Like I can have like the great night of sleep and if I don't do anything else, it's going to be a terrible day. And then I was like, but also to get to that tool, I have to do so many things. Like I can't just do dark in my room and be like, no, it's going to be great sleep. There's a lot of things that need to go into that one activity to make sure that it's going to be effective.
Roberto Olivardia: Absolutely. I mean, it's very similar to when I think about what it required for me to sit and focus on getting like homework done and papers done when I was a student. Like it wasn't just OK, I'm in my room. In fact, like it was very nuanced. Like writing, I had to be in my room. Music always had to be playing every time when I was writing a paper. No one can be around me reading. It's the opposite. I do better when I would read in like public places on the subway train in a Starbucks, like I need activity and people around me. Otherwise, I will fall asleep. Reading is not an enjoyable activity to me. I probably have a mild dyslexia on top of the ADHD that I am not a fast reader. I don't audible hearing books on audible.
That's a different story. But sight reading, I if I did that in my dorm room, my head would be on the desk in five minutes and I'd be asleep. Even if it's something I'm pretty interested in, it's just tiring like my eyes fatigue a lot when I read. Now, when I'm in a public space, it's different. And so that's part of the ADHD experiences. And this is what I always tell you in my youngest patients are if you avail yourself to your curiosity around your own experience, you will know yourself so well. Like I know myself really, really well at this point in my life because I've had to in some ways always. I couldn't just take for face value what worked for everybody else as I'm sure you can relate to anyone with ADHD can relate to. So I had to kind of be my own investigator, my own researcher, like what's going to work?
Oh, this works. And then it feels so great like when something works and that's the same with sleep. It's to really find that it almost feels like that alchemy of everything sort of being balanced in a certain way to make this thing happen and just really appreciating it. But it's also just having again, that psychological mindset of being invested in even realizing how important it is. And that's a lot of the work I do with some of my patients is getting them on board with why this is something that we really want to focus on.
William Curb: Yeah. And it's one of the things I've struggled with with doing the podcast, too, is I'll be like, Oh, I want to talk about sleep. But I'm like, there are so many reasons that we have difficulty sleeping that it's hard to like be like, give general advice about it.
Roberto Olivardia: Right.
William Curb: Like they're certainly like, OK, we can talk about like very high level like sleep hygiene stuff with like the dark rooms and the room temperature and that stuff. Like if you have not hit all the sleep hygiene stuff, hit that first. That will be a huge difference.
Roberto Olivardia: Yeah.
William Curb: But then like after that one, like because I for a long time at a really hard time, I would be able to get to sleep, but I would wake up and not go back to sleep. So it'd be like three o'clock and I'm like, well, I guess I'm starting my day at three. And I would feel trash, but there was no amount of laying in bed that would fix that because it'd be like I didn't have any sleep inertia to get back to sleep.
Roberto Olivardia: Yeah, that's not an uncommon experience. And why that is sometimes, you know, so with sleep, just basic one on one is, you know, we have four stages of sleep and then REM sleep. So we can say five stages. So we go through stage one, two, three, four, REM, which is where we dream. And then back to four, three, two, one, one, two, three, four, REM. And we cycle throughout the night. And a cycle is approximately like 90 minutes. Now, what happens is stage one sleep is really the kind of sleep that could be marked by like micro sleep, the kind of sleep that if you're sitting on your couch watching a TV show, but you're kind of tired and you're like drifting off a little bit and your roommate or partner or family member is like, hey, you're falling asleep.
And you're like, no, I'm not like you have no subjective experience of being asleep. That's micro sleep. That's like stage one sleep. Now, what happens to most people is as we're cycling back up, a lot of people wake up actually in various times in the middle of the night, but they don't remember it because they almost easily just go right back down to stage two, three, four.
And for whatever reason and studies show this, that people with ADHD, when we wake up, it's just harder to soothe ourselves. It's not this fluid process to just get back in. Like we're almost like, whoa, I'm up. Why am I up? We're just like, it just kind of we're so activated in a way that is more so than a neurotypical individual, which then makes it harder to get back to sleep in that way.
And I could tell you, you know, one of the hacks that I've used, either when that happens or when it's just what I'm lying in bed and I just cannot fall asleep is I will. So I keep my room very cool, which is one of the tips that typically is used because you want your bed to be cozy and inviting. So I'm lying in bed and I'm just wide awake. I will get out of my bed and not turn on, don't look at my phone, not turn on the light and literally just stand by my bed. And, you know, so I'm just in like T-shirt and shorts. So it's chilly in my room and just stand there. And interestingly, within minutes, it gets boring to just stand there.
But you're no longer resisting. You're not like lying down with this, I should be asleep. I should be asleep. It's like, OK, now I'm standing up. I'm not in bed. So I don't have the demand anymore of I should be asleep because I'm not even in my bed. So that demand isn't in my head cognitively. I'm standing by my bed and suddenly I start getting bored and I start getting tired and I literally start and I'm like chilly, which I don't like the feeling of being cold at all.
I would I'm the kind of guy I'd rather be in 90 degree weather than like cold weather. And so here I am standing in my dark room and I'm starting to micro sleep, like nodding off, standing up. And I let it go a little bit so that the bed, which literally moments ago was the bane of my existence, like the thing I just can't connect with and engage with. Now that I'm standing in the cold and I'm nodding off, it's like, oh, I want to get into that bed. And then I wait a couple minutes and I get in the bed and it's warm and it's cozy and I almost instantly fall asleep.
It's almost like I had to just shake up like the environment, it's like a little bit. But the other thing and this is why for any parents that are listening to our conversation, having ADHD, sometimes things are very paradoxical to like even the typical strategies that you might hear for other people. And I could tell you as a parent having kids with ADHD, so my son, who is we have a lot in common and it was so evident that I could diagnose him with ADHD in the womb. And so when he was an infant, he like his father, when I was younger, had a very, very, he just did not want to go to sleep and to soothe him. So, you know, you have those baby swings, you know, that you put a baby in and it goes, la, la, bye.
And it's like very soothing. And so we would have different settings. And the highest setting, it would go like, like really fast, like this. Like so fast, it looks you'd almost worry that the swing was just going to like break off, you know, from the thing and like fly in the air. He would not fall asleep with the la, la, bye. Like so we put it on the second setting. I put on the third. I would put it on the highest setting. And I'm telling you, Will, like it was it literally looked dangerous almost. Like it was like back and forth. And his eyes would get heavier and heavier and he would fall asleep. When I sang, music is a big part of my household. Like when I sang lullabies to him, they were not the typical lullabies.
I sang like punk songs to him in like in different octaves and like in ways that for most babies would irritate them, like would agitate them. He would get tired and fall asleep. So it was almost like the louder I sing, the more grounded he felt. The more that swing was going, I put him in the car and I drive around, you know, the block and then as he got older, when he was like four or five, I'd live in a cul-de-sac, we would run in a circle around the cul-de-sac, like laps around like maybe 45 minutes before we want him to go to bed. Now, to most parents, they'd be like, what are you doing? You're getting this kid so hyped up.
Nope. For my son, it calmed him down and he was able to get to sleep better. And for me, you know, for years, when I would go to the gym. I would work out at this 24 hour gym at like 10 o'clock at night and do very intense workouts, come home, take a shower. And I was guaranteed to get a better night sleep that night, which down to some people that would totally activate them. But this is the thing with ADHD. It's not a one size fits all even amongst people with ADHD.
I wouldn't say that works for everyone with ADHD. I mean, you know, some people would be like, Oh, I can't do that. I, you know, some people can't drink getting caffeine past three PM. I can do that. I can drink a cup of coffee an hour before going to bed. And I think the stimulant in the caffeine actually enables me to focus better on going to sleep. And I'm not suggesting that that's a treatment for insomnia or anything. But to know that the ADHD brain, sometimes what works for it is because it's not, it's not typical. It's not a typical brain. So typical strategies won't always work.
William Curb: Yeah, I've definitely heard that with a number of people saying, Yeah, like the caffeine is what helps them get to sleep. I've seen stuff about quality of sleep while on caffeine. And so I'm just like, but you know, it's having no sleep versus being able to get to sleep with slightly less quality, probably go with get some sleep.
Roberto Olivardia: Yeah. And that's the thing. It's like, it really is an individual experience and something that, you know, I always recommend people talk to their doctors about sleep because even to be like if somebody is asked, Oh, how many hours of sleep? Do you get when I do an intake for a new patient? I'm always asking about how many hours of sleep do you get?
And then when are those hours? Because truthfully, and I was a little bit, it was a very depressing day when I came across this research many years ago, that it going to we are supposed to sleep when the sun is down. That is how our ancestral evolutionary brains work. That is what is associated with better health, with better mood states and better executive functions. So if I'm sleeping eight hours, but I'm going to bed at two to three a.m. and waking up at 10, that is not the same quality of sleep as going to bed at 11 p.m. So it's a control study. So people who would not have gravitated to night work for various reasons that find that once people start working night shifts, they are more, you'll often see some decline in executive function, higher prevalence of depression, of psychosomatic illnesses like migraine headaches, irritable bowel syndrome.
Like it just, it's really not good for us. So it's not even just sleeping seven hours, eight hours, it's when are those hours? How much are you waking up during the night? I'm typically the kind of person, when I'm asleep, I'm asleep. Like I rarely wake up. Now when I was a kid, I used to sleep walk. I had night terrors.
I sleep talk. And that's not uncommon for folks with ADHD. So my quality of sleep back then probably wasn't very great then too, because it was clearly some activity going on in my body that was sort of coming out in those other ways.
But it's so important to really look at sleep. I mean, if you think of what do we need to survive? We need to eat. We need to drink water. We need to sleep.
So somehow didn't really embed in my consciousness in the ways that it should have. So I just want to spread that message of how important it is to talk to your health care professionals about sleep.
William Curb: Yeah. Well, I mean, because there's so much less so now than like in the 80s and 90s, but like, you know, like sleep is the thing you can sacrifice to grind and, you know, like you can sleep when you're dead kind of stuff. And it's just like, no. Right. Yeah. The more I learned with stuff, but like, I'm like, they can have sleep debt, but you can't really pay it off.
Roberto Olivardia: That's exactly right. And that was again, when I heard that, like, oh, really? Like you really in its true, you never make up for sleep deprivation. So when we think, oh, I'll sleep five hours and then the weekend I'll catch up.
Well, no, on the weekend you might get more sleep because you're just sleep deprived, but you're not undoing the damage of that sleep deprivation. And that's, I mean, it's a little scary, but honestly, that's what I needed to hear to really start making changes in terms of, you know, my health is realizing, no, I'm not actually making up for it. I'm just, you know, just basically dealing with the consequences of, you know, that sleep deprivation. And even like with cramming, I mean, one of the things we know from research is that sleep, which sounds like a passive process is a very active process. Like lots of things are happening in our bodies when we're sleeping, you know, and I think of it as like these little, think of it as like a lot of elves in your bodies that are shining parts of your body up and they're cleaning out some of the dusty areas.
And but one of the things, especially when we think about cramming, let's say for a final exam is the best thing you can do actually to for a test you have the next eight is get a good night's sleep. Because one of the things that happens is our brain consolidates like information together, almost like imagining like we have a library of books that are just all in the wrong order, you know, during the day, because we just don't have time to put them in the nice, dewy decimal system. When we go to sleep, those little elves in our brain are putting those books in the dewy decimal system. It's organizing that information. So when we take that exam the next day, we're better able to find that book and access it as opposed to looking all the bookshelves to try to find that one book because it's somewhere out of order.
It's so much more inefficient. But I didn't know that information. And frankly, even when I was in college or graduate school, even if I did, I don't know if it would have changed my behavior, but it definitely helps it now. And as a parent, I was very strict about sleep with my kids. And thankfully, I mean, you know, my son was saying the other he's a freshman in college that he said, Yeah, you know, I went to bed, you know, the latest like on a weekday, I went to bed at, you know, midnight.
And I'm thinking, Oh, that's like music to my ears. Because that was the earliest. I don't even think I went to bed that early in college. You know, midnight.
Like that was like early time for me. But he and my daughter, who's in high school, take their sleep very seriously. And I feel like, Oh, it's a big, that's a big win, because I did not want them to have the habits that I had.
William Curb: Yeah, I've been really surprised to sometimes I'd like be talking to other parents about like bedtime stuff. And I'm like, your kids that late, what are you doing? Yeah. And it's only like, you know, like, they're like, Oh, yeah, they stay up till nine. I'm like, Yeah, that's these are little kids, they need to they need a lot of sleep. It's like, Oh, yeah, up in the morning. Oh, they're terrible in the morning. I don't like that my kids get up before me, but they get into bed nice really well. So right, definitely.
Roberto Olivardia: Yeah, we are. I mean, we're a sleep deprived country. I mean, even putting aside from ADHD, I mean, the average person is sleeping less than we ever have because we have again, these technologies that just can keep us stimulated and and I'm a social media, but especially with ADHD kids, it's hard.
And I appreciate you know, I, and I think for parents too, it's, it's very, very difficult to find, you know, what is that magic formula? I mean, I'm so glad I didn't grow up with the internet as much as I love it. And because it would have absolutely been a problem for me. I mean, as it was, my parents, we got cable television. Like I grew up in, you know, 70s and 80s.
I love music. I wanted my MTV and begged my parents for cable and nope, we just had one. I had a black and white television in my house.
So I was in high school and I'm, you know, grew up in a middle class family. We could have afforded a color TV, but they did not want television to be as appealing. And it was, I love watching TV. They got cable the day I went to college, the day they couldn't even wait 24 hours for me to be on the house. And I was so mad, like, what, like you got cable now and my mother's like, yeah, your father wanted ESPN. He bought it and I'm like, oh, okay, he didn't want ESPN before. But honestly, and clearly we were not going to have TVs in our bedrooms.
Like that was like a big no, no. But looking back, I'm so grateful for that. Like they knew, even though I was not diagnosed with ADHD as a kid, because back then there was just so little known about it. And the kids who I knew who were diagnosed back then, like had conduct disorders. And in a lot of them were my friends. I was a pretty mischievous kid, but I didn't have a conduct disorder. But they knew who they're they knew who I was that would not have been good for me. And so instead I listened to a lot of music and in very creative ways.
And I wrote songs and I did other stuff. But then at like 11, there's really nothing left on TV. And my dad would watch the news and I just go to bed. It was just like, okay, there's nothing, you know, to do.
But now we have more available outlets. So it's so important of, you know, do you have your kid have their phone in their bedroom? Or do you have them turn it in somewhere in a basket at the end of the night and have a good old fashioned alarm clock and not use their phone? I think it's too tempting. I think it's too difficult to have a phone in your room.
William Curb: Yeah, I mean, I don't keep my phone in the room for the same. Like it is too tempting for me.
Roberto Olivardia: And they are less developed than I am. Exactly. And it's not an issue. And I always, you know, emphasize it's not an issue of trust, because it's just an issue of like just impulse and, you know, and just like, yeah, it's like putting a kid in a candy store and saying, Oh, don't have a piece of candy. It's like, then why am I here? Like, what? Like, it's not an issue of, oh, I don't trust that there are I trust they're going to be on the phone.
So, no, I didn't want them to even be in the position of temptation for a thing that is designed to have people be on it. I mean, the phone and it don't get me wrong. Like I am amazed by, you know, by our technology. I'm amazed by it. Like, and I love I'm a very intellectually curious person. I love that I can Google literally anything and find the answer to because I was the kid that would ask random questions like that. And it would I'd find the answer, but it might take me weeks to go through like an encyclopedia or something like that to find the answer.
My friends used to call me random man, but I love that. And at the same time, there's a part of it that's just so overwhelming and too much and too tempting and like a little rabbit hole that we could just go in. So it's like I have this kind of love hate relationship with the phone.
William Curb: It's like when it's in my bedroom, I'll be like, oh, I have the every intention of not doing anything on it. And then I'm like, oh, but I have this one question that I need to like, you know, there's something I need to check my calendar for tomorrow and I'll pull it up. And without thinking on Twitter.
Roberto Olivardia: Absolutely. Or just even the light from the phone. I mean, you know, just the light emanating into your eyes. And we know this from research on the optic nerve even being stimulated by light. Like even if you're literally just opening up a blank page of something on the phone, that light is already activating, you know, your brain to be like, oh, OK, like what are we doing now? Oh, you know, we're not sleeping anymore. We're we're engaging something here.
William Curb: Yeah. And one question I had that I was thinking about too is melatonin is something that I know a lot of people are interested in, but has mixed research on and like I don't I don't remember seeing a lot of research specifically on ADHD and melatonin.
Roberto Olivardia: Yeah, there is mixed research. I mean, you know, and again, with this, I always preface, you know, people that always talk to their doctors about this because, you know, and there's some research that shows that people are using it sometimes in the wrong ways. Like a lot of people will use it like right before they go to bed. And apparently it's really supposed to be like a half hour to 45 minutes before you want to be going to sleep that it's really trying to sort of stimulate your brain to be ready, you know, for falling asleep as opposed to it.
It's not a sleep aid specifically. So there's some research that shows it can be very helpful. There's some research that shows it could be helpful, but then people can grow tolerance to it or it just stops working for them. And I have some clients who they swear by and they use it and they don't have any health effects.
Their doctors are like, this is fine, you know, use it. You know, like I personally tried melatonin. It did nothing for me.
Nothing. I tried it an hour before going to bed, a half hour before going to bed. It didn't make my sleep worse in any way, but it didn't make it better.
It just, it didn't do anything. So now I know like magnesium is sometimes a supplement to use and that has been helpful for me. I don't use it daily. And again, always talk to your doctor about using that. But, you know, there are supplements that maybe people can use that could be helpful.
But it's always understanding, especially in this day and age where there's so much information. Oh, try this, try that, that you're still anything you're putting in your body, you are an individual system. And so what might work really well for one person might not work well for you because of a whole interplay of different factors. I've not seen much research show it. I don't think with ADHD, I mean, I've heard more anecdotal reports. I haven't seen any sort of long term studies looking at that.
William Curb: Yeah, I've seen something about ADHD with delayed circadian rhythms and how we don't produce melatonin at the right time. So that can be helpful there.
Roberto Olivardia: Yeah. And I mean, interestingly, so when I got a sleep study, I was diagnosed with something called a delayed sleep phase syndrome or DSPS, which is common in folks with ADHD. And that's basically one of the things that that is is your circadian rhythms are kind of just almost in like a whole phase or two deviation after. And many people might relate to this where not only are you not getting tired at 10, 11 o'clock at night, but you actually get a rush of energy at that time, like the second wind. And then you're up and then it's at about 2am that you start to finally like feel tired.
And I, you know, before having kids and especially through grad school, I would tell you my ideal hours of sleep were between like two and eight or two and nine, like six, I just need six to seven hours of sleep. And and this is where it's again, this interesting interplay, how much of that is all the stuff we were talking about before the procrastination, the oh, I don't want to let the day go. And when I got the sleep study to know, oh, on top of that, there is this biological neurological underpinning of something called the delayed sleep phase syndrome.
Maybe that's what was happening all the time, which then lent me to not want the data and and be like because I was up anyway, because I would get and that was my whole life. I mean, I remember it's seven, eight years old. I'm like, but I'm not tired. Like, in fact, I have like a lot of energy and that wasn't even at a time where I was procrastinating work and, you know, in third grade or fourth grade or something. So yeah, so there is data that does show that our brains are not always doing the things that it's supposed to be doing according to schedule. It's almost like like ADHD itself where we're late, you know, in terms of in terms of our brain saying, hey, we're supposed to be in bed. The brain's like, no, we have some more energy. We can arrive at the sleep party a little bit later.
William Curb: Yeah. I've also seen stuff too with like we have our like circadian rhythm and ultradian rhythms like matching up to get us to sleep with sleep cycles. And if we miss that spot, we start going up in energy and it's be like, oh man, yes, I wait like 90 minutes. I'm going to be ready to go to sleep again. It's I just miss my window.
Roberto Olivardia: Oh, absolutely. And it's very sensitive. I mean, that window. And I find with a lot of things with ADHD, there's just a higher sensitivity to lots of things. And that's one of them that, you know, it's almost like if neurotypical brains have, you know, I don't know, a four foot window to get through. We might have a two foot window, you know, to get through that.
That's why it's so to be. And yet, so when you have the two foot window, what does that require that requires you to probably be more attuned to all those things, which we're inherently not. And so that's where mindfulness skills and and again, being kind of your own researcher of saying, hmm, like, what if I if I wasn't done my phone for a couple hours, if I didn't have TV, would I just fall asleep easier? Like how much of it is I'm not tired versus I'm just stimulating myself so much. That's why I'm not tired. You know, if I were just in a quiet room right now, would I just immediately fall asleep or would it be still hard?
And it varies. I mean, for some people, even without any distraction, it's very hard like for them to fall asleep. And then other times people like conk out instantly, you know, if they just are without their phone or whatnot.
William Curb: Yeah. And again, it's just because it's so easy to do like it's so easy. I guess I have to put this stuff away from me when I'm getting ready for bed because otherwise, even with the best intentions, I'll find a way to get on it.
Roberto Olivardia: Yeah. And it is. And I, you know, always want people or I rather I don't want people to feel shame or to feel weak or lack of willpower to understand that that product is designed for that. It is designed with we want people on this. Like, so I don't have any social media for a reason. I mean, like social media apps are designed to have people on it all the time. That's how they profit. So when we know that we're up against something where a team of top researchers and neuroscientists who are working, maybe not for the good of the people are working towards what will enable us to continue to be on this.
Of course, it's going to be, you know, difficult. And so I want people to always look at it from that picture and then say, OK, then maybe I just shouldn't have it in the room at all. I have to be honest with myself as to, you know, even engaging with my phone. Like sometimes if I'm like, oh, I'm going to take a five minute break and I'll just go and, you know, look at this YouTube video. Then eventually I have to be honest with myself. Can I really take just five minutes and look at YouTube or is that going to turn into 20 minutes? 25 minutes.
Yeah, it's probably going to do that. So I have to be honest with myself. But being honest with oneself, you have to observe it and you have to really take in that mindful data to begin with. And with sleep, I tell people a lot of times we think of sleep as the five minutes before we go to sleep, what we need to do as opposed to it can even be a four hour window before you go to sleep.
What are you doing? What are you not doing that kind of readies your body to do that? I mean, I remember years ago, I mean, I wouldn't change out of my clothes. Like I change into like my sleeping clothes right when I was going to bed. You know, like the set where now I changed into my sleeping clothes hours before to almost externally tell myself, oh, I guess I'm going to bed soon.
Like we have to almost take those cues from the outside in because they're not working all the time from the inside out. And so we have to dim the lights. I love illumination. I love lights. I love brightness. And I could be at home, you know, my study at home and the lights are on and bright.
I learned, OK, you know what? I should probably dim it or use a lamp near, you know, my computer that sort of gives me the sense of, oh, it's actually dark outside as opposed to it being the middle of the day in that way. So using external cues that then tell us, oh, we're going to bed soon.
We are readying ourselves to go to bed. Like I even the programs that I might watch, like I usually have programs on while I'm doing work, like at night administrative work. And there's some like there are those shows that we all have that we've seen a thousand times that are just great background. Like Friends is one of those shows for me. Our rest of development shows that I grew up with like Threes Company, Golden Girls.
Like I love those shows that I've seen a million times. And I am not going to watch Law and Order Special Victims Unit, which is I've seen every episode, but I'm not going to watch that an hour before going to bed because I get too activated. The material is very heavy, you know, on that show and and it's very thought provoking. So that is not a show I watch an hour before going to bed because it's just going to be in my mind, you know, in a different way. So even being aware of what you're taking in is different. I can watch a YouTube video of a lecture, you know, an hour before going to bed and that's fine. If I watch a YouTube video of my favorite band, you know, in concert, that might do a little bit of a different thing, you know, for me. So it's just being observant of what you're taking in, not just the half hour before you go to bed, but even three hours before you go to bed.
William Curb: It's funny with that too. Like, I'm sure if I watched like a YouTube lecture, I would be thinking on that and being like, oh, I wonder if I could write something about that. And like, it would just be like turning those wheels so much right before I go to bed. And so like, yeah, it's always funny when I'm like, oh, yeah, people are different. Right.
Roberto Olivardia: Whereas when you said reading, I can't read before going to bed because I would feel the need of like, oh, let's just read one more. Oh, let's just finish this chapter. Oh, let's just, you know, and again, reading is not like I don't enjoy.
It's not like I do. I like getting information. And so I'll read to get information, but I haven't read a fiction book in almost 30 years. I read, I read nonfiction stuff.
So it's, yeah, it is very interesting. Or like when people talk about like a podcast, I could never go to sleep with a podcast ever. Like that wouldn't work for me. But what works for me might not work for other people. And so that that's the beauty is that we're all just sharing tips and strategies. And, and that's the whole thing is recognizing that we all need multiple tools and what those tools look like might be different for different people. Excellent. Yeah.
William Curb: Well, are there any final thoughts you want to leave the audience with?
Roberto Olivardia: I really just encourage people to really pay attention to sleep. And like I say to my patients, like I say to my own kids, like this is, I'm not coming from a place a holier than now place of I'm still figuring it out. And, you know, in it, but knowing the research and acquainting myself with the health benefits of good sleep and the health consequences of poor sleep.
And particularly with ADHD, it just makes the ADHD more difficult to manage. And especially if you're a young person, it might seem really hard to even imagine your life 10 years from now. I mean, I can't believe, I mean, I'm 51 now and I love, I mean, I'm youthful. Like I'm not complaining about it, but I can't even believe it. Like it's just time flies. And at the same time, I'm like, I do want to live to 100.
Like I really do. I want to live a high quality of life. And the one area that I really is just is the sleep area that, you know, not that I'm the best eater and, you know, I can do better with that and with exercise and things like that. But the thing that is really the area for me is sleep. So I just, I always want to implore for people just if you start building in those habits now, it becomes easier and easier as you get older.
William Curb: Awesome. Well, thank you so much for coming on the show.
Roberto Olivardia: Sure! My pleasure.
William Curb: And jumping on this topic because the time flew by for me.
Roberto Olivardia: Yeah, same here.
William Curb: And I'm sure the audience will get a ton out of this because we know they're all going to have sleep issues.
Roberto Olivardia: Yeah.
This Episode's Top Tips
Establish a pre-sleep routine that signals to your brain that it's time for bed. This might include changing into comfortable sleepwear, dimming the lights, and engaging in a relaxing activity like reading or listening to music. Or, as was the case for Dr. Olivardia, going and getting a workout in. Remember that sometimes to calm your ADHD brain down, you need a bit more stimulation.
Underpinning that last point again, not everything that is typically recommended for getting a good night's sleep always works for our ADHD. It’s important to experiment with different techniques to see what works and doesn’t work for you.
If sleep problems persist despite your best efforts it’s always good to consider consulting with a sleep specialist. We often don’t know what we don’t know when it comes to sleep and a specialist can help identify any underlying issues and recommend additional treatments.