Research Recap with Skye: Circadian Rhythm
Welcome to Hacking Your ADHD. I'm your host, William Curb, and I have ADHD. On this podcast, I dig into the tools, tactics, and best practices to help you work with your ADHD brain. Today, I'm joined by Skye Waterson for our Research Recap series. In this series, we take a look at a single research paper and dive into what the paper says, how it was conducted, and try to find any practical takeaways.
In this episode, we're going to be discussing a paper called "ADHD as a Circadian Rhythm Disorder: Evidence and Implications for Chronotherapy." Now, this is a perspective paper looking at the available research on circadian rhythm dysfunction in ADHD and what works for correcting some of that dysfunction.
So as we get into it, I think a great place for us to start is to talk about what a perspective paper is, because it's a little different than what we usually take on.
If you'd life to follow along on the show notes page you can find that at https://HackingYourADHD.com/300
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William Curb: Welcome to Hacking Your ADHD. I'm your host, William Curb, and I have ADHD. On this podcast, I dig into the tools, tactics, and best practices to help you work with your ADHD brain. Today, I'm joined by Skye Waterson for our Research Recap series. In this series, we take a look at a single research paper and dive into what the paper says, how it was conducted, and try to find any practical takeaways.
In this episode, we're going to be discussing a paper called "ADHD as a Circadian Rhythm Disorder: Evidence and Implications for Chronotherapy." Now, this is a perspective paper looking at the available research on circadian rhythm dysfunction in ADHD and what works for correcting some of that dysfunction.
So as we get into it, I think a great place for us to start is to talk about what a perspective paper is, because it's a little different than what we usually take on.
Skye Waterson: Yeah, I mean, the biggest difference is that this is not a paper that has a methods section or a results section. It's not... well, it kind of is examining a bunch of different papers, but it's not doing it in that meta-analytical way. Instead, it's looking at the accumulated evidence.
William Curb: Yeah. And it's like an opinion piece, but it's not like a blog article. Everything has to be evidence-based. It has to be grounded and supported by the existing scientific literature. So it's a more rigorous opinion.
Skye Waterson: Yes, exactly. I will say, I didn't know that blog pieces weren't that, which is probably why I ended up being read a lot when I started writing my articles. Because yeah, this is what you would expect. It's an academically rigorous article, basically.
William Curb: So they really looked at this idea of, okay, what is happening with ADHD and sleep? Because for those of you who don't know, there is something happening with ADHD and sleep. If you're like, "My sleep is strange," and people don't... you know, I've noticed it.
Skye Waterson: Maybe you haven't said it. Maybe you just assume it's a bad week, bad day, bad life. But in reality, there are some very specific differences that we can see in people who have ADHD and how they sleep, both on a behavioral level, but also on more of a neurological level, and what they're seeing in that. So do you want to take us through what some of those are?
William Curb: So naturally for humans, when things get dimmer, we start developing melatonin. This is just what the circadian rhythm is. It's our connection with the sun, our 24-hour clock, and it is often set by light. They found that with ADHD, that's delayed for us by 45 minutes in children, and about 90 minutes in adults, which is a huge deal.
Skye Waterson: When everyone else is getting ready to go to sleep, we're not feeling those same hormones going through our bodies. In fact, anecdotally, I've heard from a lot of clients and experienced it myself, we can have a second wind.
William Curb: Yeah, because one of the things to understand about our circadian rhythm is it's like this energy level going up and down throughout the day. And it's also related to ultradian rhythms, which are like 90-minute cycles. Having your circadian rhythm off does not necessarily mean your other bodily rhythms are going to be off too, so you can have energy when you're supposed to be asleep.
Skye Waterson: Mm-hmm. Yeah, exactly, exactly. And they also found... so they found different sleep issues. With the melatonin, they also noticed that some studies found abnormally high levels of melatonin during the day in children with ADHD. I thought that was really interesting because in a previous episode, you and I had talked about the idea of daytime sleepiness, and now what we're seeing is some real physical evidence that daytime sleepiness is occurring. It feels a bit chicken and egg, because in that article that we read before, that wasn't part of the conversation. It was just like, is it that they didn't get enough sleep the day before, et cetera, et cetera.
William Curb: Yeah. But if it's specifically that your circadian rhythm is off, that explains a lot of that effect.
Skye Waterson: And let's break this down for a second because, if you think about this in a rational way, right? Let's say maybe—and I have no idea—some people are evolved to have different watch and sleep cycles, for whatever reason. If you were somebody who stayed up later as a general rule, for whatever reason, it makes sense that you would also be somebody who'd want to take an afternoon nap because you'd be tired because you stayed up later.
So it's weird that in a world where we take out school and we take out work, and we just let people do whatever feels natural for them, people with ADHD would still be getting enough sleep because they'd be sleeping in the afternoon and staying up later in the evening.
William Curb: Yeah. Now, with that in mind, they also did talk a lot about light therapy and its effect on this melatonin release, and how that was incredibly effective at helping move you back into the right circadian rhythm.
Skye Waterson: Yes, exactly. Exactly. So they were looking at light therapy in the morning and then obviously melatonin supplements as well, as two things that could be very helpful.
William Curb: Yeah. And just a note for people that are considering melatonin supplements: less is better. They were looking at 0.5 milligrams. If you go into the grocery store, you might see something that's five milligrams of melatonin. That's way too much. It's not going to work, and it's going to be less effective than taking a lower dose. Also, there are other studies that show that just getting over-the-counter melatonin can be really hit-or-miss on your dosage.
Skye Waterson: Interesting. I was gonna ask if you've ever taken melatonin supplements, because I haven't, and I do know people who have. I haven't really heard a lot about the effects, so this was an interesting study for me to kind of get to grips with what this looks like.
William Curb: Yeah, I take a one-milligram supplement going to bed, and I do find that it helps me get in... I don't know if it's actually the melatonin or the ritual.
Skye Waterson: Yeah. Interesting. That's really interesting. Yeah, I have three children four and under, so I don't need melatonin right now to go to sleep.
William Curb: Something that we really do need to consider when we're thinking about the sleep effects and specifically with the circadian rhythm is: are we doing things that are hurting our circadian rhythm or not?
Skye Waterson: Yeah.
William Curb: And specifically, a lot of the light exposure late at night, versus actually getting sunlight in the morning or using a light therapy machine. Although those are expensive, you can sometimes just use an app on your phone that will measure the light output of something, because it's measured in lux. Then you can figure out, "Hey, is this actually really bright, or do I just feel like it's really bright?"
Skye Waterson: Yeah. Yeah, that is interesting. And I will say, I don't do the melatonin, but I am a big proponent of turning off all the overhead lights at a certain time. I have an alarm that goes off, and I try to turn off all the overhead lights at that point. I find that's really helpful with going to bed as a family, even if we're not going to bed right then, and quite frankly, maybe the TV is still even on.
If everything is turned off, all the overhead lights are turned off, then we tend to keep our TV on quite dim just in general. And then the next day, yeah, going outside and standing outside in the morning, even if it's not a super sunny day, it's still a lot brighter in terms of lux than you think it is.
William Curb: It is so much brighter. Even on my Washington State super overcast days, out in the morning, I pop out my lux meter and I'm like, "That is still plenty of light."
Skye Waterson: Yeah, yeah. It just doesn't feel like the same energy, but it's funny, I do feel a bit like you. I'm like, I'm not sure if it's working or if it's the ritual. Because again, with ADHD, it's all like it's now or it's not now. And if I'm outside in the morning and the birds are doing their thing, or I'm turning off the lights in the evening, it is very much part of the routine and the ritual, which is so important for ADHD as well.
William Curb: Yeah. Yeah, and another thing for evening light too is I've put some dimmer things on some of the lights in my house. I don't know how dimming the lights makes me so sleepy sometimes, but I'll just be like, "Oh, now it's dim, and I want to go to sleep. I'm very sleepy now."
Skye Waterson: It is true. It is true, and then sometimes occasionally someone will turn on an overhead light and I'm like, "No, what did you do? I'll be up for hours."
William Curb: Yeah. It's funny too, like having all the lights off is not a huge aspect of making me really sleepy, because I'm like, "It's darkness. I expect it to be dark." But when it's really dim, my body is like, "Oh, it's slow-down time."
Skye Waterson: Yeah. No, I'm a big fan of lamps and things, if the kids can't break them, which is always a problem.
William Curb: Some things just to mention with this paper: so again, it's a perspective paper. There's nothing being measured in this paper or anything. It's just looking at the science that's available. But it does have a fairly compelling argument that doing some chronotherapy things—light exposure, melatonin, and other aspects of trying to affect your circadian rhythm—is an effective way to help treat some of this circadian rhythm disorder that is apparent with ADHD.
Skye Waterson: And also the fact that it is apparent with ADHD. So if you didn't know that, and you were just wondering why your kids are waking up at 8:00, like mine, and everyone else's kids are waking up at 6:00, that might be why.