🌟 If you've got a question you'd love Kate's input on, or you're after some more individual support, there are two ways to connect with Kate this summer. She's hosting an Ask Me Anything Q&A workshop on Monday 13th July at 6.30pm, where you can submit your question ahead of time and join the conversation live on Zoom. Book your space here.

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This week's episode: How often do you feel completely exhausted all day, yet when you get yourself to bed early, your brain switches on, and you're unable to sleep?

You do everything you're told to: no screens, no caffeine, a cool dark room, yet your brain is still filled with thoughts, to-do lists and the things you said 5 years ago.

But the reality is, for ADHD brains, sleep isn't a habit problem... It's a neurological problem. And the standard advice around skeeo hygiene and behaviour was never built with us in mind.

This week on The ADHD Women's Wellbeing Podcast, I'm joined by ADHD sleep expert, Heather Darwall-Smith, a psychotherapist specialising in sleep, with a particular focus on adults with ADHD.

Heather was herself diagnosed with ADHD late in life, and that lived experience sits alongside her clinical expertise in everything she does. Her new book, The ADHD Sleep Book: A Compassionate Guide for the Wired and Overtired Brain, is the first book dedicated specifically to ADHD and sleep.

In this episode, we explore:

• Why 75% of people with ADHD experience chronic sleep problems
• Chronotypes, body clocks, and ADHD sleep disorders explained
• Heather's late ADHD diagnosis: from panic attacks and bipolar misdiagnosis to clarity
• How the ADHD stress response causes hyperarousal and disrupted sleep at night
• ADHD medication timing and sleep: why getting both right is so complex
• How family sleep beliefs and intergenerational patterns affect ADHD rest
• Phone addiction, sleep, and navigating different sleep needs as a couple
• The hidden link between ADHD, binge eating, and sleep apnea
• Why perfectionism and insomnia feed each other in the ADHD brain
• Hormones, perimenopause, and ADHD, sleep, and when to get your bloods checked

Heather brings a unique blend of neuroscience, psychology, personal experience and genuine compassion to a topic that so many of us have struggled with in silence. If you have ever felt like you're the only one who can't sleep or just need to try harder, this episode is for you.

The ADHD Women's Wellbeing Live Event Recording is here!

My first-ever ADHD Women's Wellbeing Live event sold out, and now the full experience is available to you wherever you are, whenever it feels right.

Alongside three neuro-affirming experts, we spent four hours exploring the questions that matter most to women diagnosed late. Get lifetime access here!

Inside the ADHD Women's Wellbeing Live Recording, you'll find:

• Kate Moryoussef on post-diagnosis growth and her gentle framework for what comes next
• Dr Hannah Cullen on the neuroscience of ADHD and why your brain works the way it does
• Hannah Miller on reconnecting with purpose through a neurodivergent lens
• Adele Wimsett myth-busting on hormones, HRT, progesterone and perimenopause

Understand yourself more deeply, feel less alone, and finally access the expert knowledge you deserve. Because every woman with ADHD deserves access to the knowledge, expertise and understanding that for too long simply hasn't been available to us.

To get lifetime access for £44, click here.

Links and Resources:

• Find my popular ADHD workshops and resources on my website [here].
• Follow the podcast on Instagram: @adhd_womenswellbeing_pod
• Visit Heather's website: heatherdarwallsmith.com or adhdsleepclub.com
• Connect with Heather on Instagram @thesleeppsychotherapist and @adhdsleepclub
• Check out Heather's book, The ADHD Sleep Book

Kate Moryoussef is a women's ADHD lifestyle and wellbeing coach and EFT practitioner who helps overwhelmed and unfulfilled newly diagnosed women with ADHD find more calm, balance, hope, health, compassion, creativity, and clarity.

Welcome to the ADHD Women's Wellbeing Podcast.

I'm Kate Moore Youssef and I'm a wellbeing and lifestyle coach, EFT practitioner, mum to four kids and passionate about helping more women to understand and accept their amazing ADHD brains.

After speaking to many women just like me and probably you, I know there is a need for more health and lifestyle support for women newly diagnosed with adhd.

In these conversations, you'll learn from insightful guests, hear new findings, and discover powerful perspectives and lifestyle tools to enable you to live your most fulfilled, calm and purposeful life wherever you are on your ADHD journey.

Here's today's episode.

Today we're talking about something so important that I can't believe that we've only had a few episodes that dedicated to the topic itself, and that is ADHD and sleep.

And I'm absolutely delighted to welcome an absolute expert in this area.

Her name is Heather Darwell Smith.

Now, she is an accredited psychotherapist and sleep specialist who works with individuals with ADHD and sleep disorders.

A huge, huge crossover.

And Heather herself was diagnosed late in life with ADHD and determined to understand why sleep is so uniquely difficult for neurodiverse minds.

She spent years combining scientific research with therapeutic insight.

And she knows firsthand what it's like to live with a disco ball of brain that refuses to switch off, especially at night.

This blend of professional expertise and personal experience allows her to speak with both authority and deep empathy.

And Heather is here to tell us all about her brand new book, which is fantastic.

It's called the ADHD Sleep Book, A Compassionate Guide for the Wired and Overtired Brain.

And Heather, am I right in saying that this is the first book dedicated specifically to ADHD and sleep?

It is, yeah.

I find that a little bit mind blowing.

And it's like the whole way through writing it, I was thinking, am I wrong?

I know I'm not, but.

So, no, I'm delighted to be here talking about it because it's a subject that I'm very passionate about.

But also there's something at the heart of it that people, people often don't know.

And it's a real game changer when you do know.

Yeah.

I mean, I've not met anyone neurodiverse who hasn't struggled in some way with sleep.

And whether that is getting to sleep, whether that's waking up in the middle of the night or in my husband's case, and it's quite a sort of a genetic side on his family, they wake up Very, very early, they wake up and it's almost like the way he describes it is he.

It's like this cortisol like rushing through his body and from sort of half four, five o' clock in the morning he is awake and he, and that is it.

But he, he falls asleep very early.

So for him he would happily his sort of like.

Well, his sleep hours would be probably from sort of 9:30 till about 4:45.

And we've tried lots of things and we've realized now that that's, you know, how he operates.

But he describes it as just his brain is wide awake, ready to go and.

Yeah, so it is interesting.

It's not never just one profile, is it, with ADHD and sleep?

Mm, no, it's really diverse when you think that ADHD has three separate types anyway and even within the typography of it, they're very different in that too.

But in my work, whether neurodiverse or not, at the basic, in every cell of our body we have clock timing chronotype and that chronotype determines our sleep wake time.

So it sounds like your husband is a real chromosome, classic early bird.

And so his body wants to go to bed.

That's his natural sleep timing.

So there's nothing wrong with what's happening there.

That's his timing.

And that feeling of the cortisol rush as we're pushing towards wakefulness, the body is producing cortisol anyway to push us upwards.

So it's interesting that he is experiencing it as intensely as that there is a normal to cortisol spiking in the morning because that's what pushes us into wakefulness.

But so his timing, there's nothing wrong with that.

That is his timing.

This is where it becomes really tricky because so many people don't know that we have these different clocks and they're trying to fit this single mold of the nine to five world.

And I mean school and college and university of course really forces that issue.

But when the clocks are so different, you're potentially trying to do something that you can't do from a biological level.

Yeah.

First of all, let's just take a little step back, tell me a little bit about yourself and what made you want to go into the world of sleep, maybe even before you were diagnosed or even understood really about the prominence of neurodivergence.

Because I just want to use this quote here saying that with research showing that up to 75% of individuals with ADHD experience chronic sleep difficulties, so it's clear that sleep is Central, not peripheral to the neurodivergent mind.

So that's 75% of people with ADHD are suffering.

And I'm interested to know what led you to the world of sleep.

And then when did you realize, my goodness, most of my clients are probably neurodivergent.

I've always been interested in how the body works.

I had a real fascination for that.

I mean, I was told as a child that I was a poor sleeper.

And there's a whole backstory to, to that and how I felt about my sleep.

But then my first career, I worked in advertising.

I was an art director.

And during that period, I.

It was the first time, I was about 29, I think, and I started having panic attacks and I genuinely thought.

I genuinely thought I was going mad.

I had no idea what was happening.

And it's really, it's classic that people get admitted to A and E thinking they're having a heart attack and then A and E just brush you off and go off.

You're having a panic attack.

So, mate, I feel like I'm dying here.

And my sleep was up the wall.

I mean, looking back in those days, of course, a room full of creatives, probably a lot of neurodiversity and a lot of night owls.

Well, of course we were all working at different hours.

But it wasn't till a few years later when I made the switch to train as a psychotherapist.

I was also training in body work and doing an anatomy, a physiology training.

When the first time someone explained to me how the stress response works, I was like, well, of course I was having panic attacks.

It was so logical to me that it was like A plus B equals C. Well, of course.

And that logic then also plays into the interest I had in sleep.

Because if you're in a state of hyperarousal or anxiety, why are you going to be able to sleep?

If we're talking about something like insomnia, you're not going to be able to sleep because your body thinks you're in trouble.

So it's going to keep you awake to protect you.

And that was a real light bulb moment for me.

I was like, hang on a minute.

Okay, so I'm training as a psychotherapist and sleep has this massive impact on our neurology and psychology.

What am I doing as a psychotherapist if I'm not working with sleep?

When.

Because what is the quality of therapy if I'm sleep deprived or my client is sleep deprived?

And it just sort of snowballed and went from there.

Unbeknownst to me, I didn't realize at that time that there are over 80 different sleep disorders and just how complicated the world of sleep really is.

But then I was working in a sleep clinic and my role there was very much to work with the psychological aspect, often with a lot of insomnia, circadian rhythm disorders, parasomnias, which are nightmares, that sort of thing.

A little bit of support too on working with people with sleep apnea.

But I kept seeing people with insomnia who could potentially and I'm aware, I'm simplifying, but if they go to sleep at this time, they can sleep fine.

And they are developing insomnia because they're trying to do something, they're trying to pull their sleep backwards or forwards.

And it reminds me of I was studying sleep medicine at Oxford and my tutor, Professor Russell Foster, learning all about clocks and how we all have these different clocks.

And I'm sat there thinking, but if your clock wants you to go to sleep at 2 and you're trying to go to sleep at 10, we have a problem here.

This is not just insomnia, this is a circadian rhythm disorder.

And it was, I mean people not necessarily diagnosed and we know, don't we, that there's a massive under diagnosis situation out there.

But it's within.

If we just think about these clocks, if you've got a different clock and you're trying to go to sleep at a different time, the chances are you could well develop insomnia or worse.

So I would see people who are drinking too much because they're using alcohol to go to sleep, they're using pills, they're doing.

Because you're going to do anything you can to get to sleep so you can get the sleep you need for the next day.

But the knock on too, if you're sleeping at the wrong time, is that you're waking up in what is your biological night.

This whole thing just goes around in this awful 24 hour loop.

Yeah, that's where it sort of just came from and has become the thing that I do.

So obviously you were doing it for a long time.

When did the dots start connecting?

I know that this, in this world, you know, neurodiversity has never really been a huge conversation up until about five years ago.

Really understanding and really still understanding many doctors and GPs and, you know, we're not knowing the biological connections.

When did that sort of land to you going, oh my goodness, this is not just mindset our way out of this let's not just cbt, you know, this is like understanding the deep root cause, which ADHD is often that deep root cause that then kind of like filters out into so many different health conditions and mental health issues and again, sleep disorders.

When did you start connecting those dots?

Funnily enough, bearing in mind what I do in training and stuff, it took a long time.

So I had a bipolar diagnosis in my 20s, which I've subsequently learned is really common in.

It's a misdiagnosis.

And no bipolar medication ever made the slightest jot of difference.

But for me, it was very much type 2.

It was very much, I've got loads of energy and then I'm crashing.

I never had the mania side of it, but I often hit the burnout, crash part of it because I could go and go and go and then just bang.

And then during, during my masters for my psychotherapy, I completely, completely messed up my dissertation.

And the whole way through studying, my tutors kept saying, there's something here, there's something.

How can we help you?

And I'd be like, well, I don't know how you can help me because I do me.

But I do know I have a really serious problem with writing.

That's when I got my dyslexia diagnosis.

And at the same time, the cluster of dyslexia, dyspraxia and dyscalculus.

I said to you earlier, me, and numbers and dates, forget it.

But at the time the E.D.

Psych said to me, I think there's ADHD in here too.

But I was just like, too busy, didn't really clock it.

And then because I had a diagnosis, I.

When I went to study sleep medicine, I was able to access disabled students allowance, which meant I had a tutor.

And as I tend to do, I turned up on the wrong day at the wrong time.

And I was very, very upset about it.

And she's like, why are you so upset?

Well, because I've made a mess of something again.

And she said, well, why do you think you can do this?

There's no judgment.

And she sort of bit the muse.

She said, I'm sure you have adhd.

I'm sure you've got a really big problem with dates and time.

Why didn't you get diagnosis?

And I was a bit like.

And it was her response.

She was so kind and so compassionate and just.

So you're trying to do something that structurally you are really struggling with and you're beating the living daylights out of yourself for it.

And that was.

That was When I got.

Then I got the ADHD diagnosis, and it was like a light bulb moment to go through, as I.

So many of us have.

I mean, I think it also coincided with the.

The fun that is perimenopause.

And as those hormones drop out, the ability to just hold it just dropped.

And.

And going through it, I'm sat there thinking.

But I see this all the time in my work.

I've seen it over and over, and it was so interesting because I. I tend to get clusters of people coming in to see me, and I had a whole cluster of people coming in.

Adhd, Ellis Danhos, and, And.

And with sleep issues.

And when you start to unpick all of that, you like.

Well, there's no question.

I get it.

Yeah, I really get it.

And it sort of went from there.

But just because I have it doesn't make me an expert.

One of the things that fascinates me, and I've seen hundreds of people now, is how differently it shows up.

It is so.

It can be so different.

It's just my ADHD is likely to be very different from yours, and it travels with friends.

We all tend to have a cluster of other diagnosis too.

And the absolute difference that I see is it's huge.

Yeah, totally see it not in women.

You know, like, we kind of think, oh, women present in one way, men in another.

But it's so different in women.

And it's so different if you've got that.

The blend of different things, the different recipes, you know, it's like a banana bread.

Everyone has their own little tiny tweak to the banana bread.

So it's so important that we do understand that.

And again, it's the same with sleep.

We know that.

Again, not to generalize, but a lot of people with ADHD struggle to go to bed, and once they get into bed, switch off.

We know you talk a lot about phones and technology in the book I was reading, like, different case studies that again, we've got the dopamine seeking, but also for women.

We finally breathe at night.

Finally, no one's asking anything of us, and we just kind of want to reclaim our time a little bit at night.

Before we know it, we're on the couch, maybe our partner's gone to bed, and we are just trying to decompress a little bit.

Phone, Netflix, whatever that might be, and just peeling ourselves, getting the energy and putting ourselves to bed.

The executive functioning of putting ourselves to bed is hard work.

You know, people just, you know, say, just sort your sleep hygiene out, go to bed earlier.

You know all of that.

You hear it on podcasts.

Sleep is a priority.

Sleep is a priority.

Well, how do you prioritize sleep if you've got all these different roadblocks and hurdles that many of us don't even understand?

And then we've got all these unhealthy patterns that we found ourselves in.

Like you say about sleep, about self medicating.

People I know have been self medicating for years, whether it's weed, alcohol, sleeping tablets, food, all sorts.

It's such a huge subject and you cover so much of it in the book.

And that is why I'm so grateful that you've written a book like this.

I'd be interested to know, what do you think about medication?

Because obviously we've got people get diagnosed and they go on medication.

Some people find the medication incredibly helpful for sleep if it's timed correctly and it's the right medication.

And some people say it makes their sleep even worse.

What have you experienced, I guess in a clinic of what have you seen and is it very different?

Yeah, it is different.

I mean it's important to say I'm not a prescriber but I will work alongside prescribed prescribing teams, certainly through titration and things like that.

I think I'm very pro medication because when it works it's a game changer.

But not everybody can get on with it.

And there's lots of different reasons for why the timing piece is so important.

Getting your timing and your levels right is everything.

Which of course in a population of people for whom time means something else entirely is our first big hurdle.

It's often a real push and pull in between.

We need to stabilize someone's sleep pattern to be able to get the timing right because so many people have got a late body clock.

So it might be that I'm sorting out helping someone move their clock so that they can go to sleep earlier, so that they take their medication earlier.

Because everything has this 24 hour knock on effect.

It's a constant cycle of where do we go first, do we go for medication timing?

But it depends on what your sleep timing is doing.

And then is your prescriber working closely with you to see because of course some of the medications there in your body, 12 to 14 hours, bang, they're gone.

Some people, depending on what they're doing for their life, their job, they might need a top up.

It's a really complicated process as to getting sleep timing and medication timing right because you've really got to take it first thing so that you've got the loop because it does drop out.

Yeah.

Finding clinicians, like you say you work with prescribers, that's incredible.

But very often, and I hear this too often, is that people are just sort of left.

They're titrated, go away for three months, try it, and there's no support and you're just there, like winging it.

And then most of the time you give up because you haven't really got someone who really understands these.

These little tweaks.

It's also, you know, combine it with food and nutrition and protein, and it is.

It's very complex and it's very overwhelming.

And then you combine that with a neurodivergent person who has struggled for years, and then you're saying, right, change this, add that, eat this, da, da, da.

And it becomes so, you know, everyone.

You want to shut it down.

And I'm just saying that.

Cause I don't want it to sort of.

I don't want people to be like, well, I'm.

This is it now.

I've got no options.

But I think it's important to state it because that's.

It's a struggle for.

For many people.

Do you see people, I guess, who have lived for a very long time not understanding themselves and their brains and their bodies, their nervous systems, all of this, and to just to break the cycles is really hard.

Like break the scaffolding or the crutches or just the way they've lived, which may not be great for them, but at least it's like a routine that feels safe to them.

How do you go about breaking a lifetime of.

I don't even want to say unhealthy or wrong sleep routines, but I guess sort of like going back to the foundations again very slowly.

Yeah, very slowly.

I do things very, very.

And.

And in the culture in which we live and the ADHD mind, slow is.

Is uncomfortable.

But we have to do it slowly.

We have to do it bit by bit, because if we try and do it all at once, it's just going to go to overwhelm and the whole thing is just going to blur.

So there's something here about that, about making the process slow and steady and layering bit by bit and knowing that it's going to be bumpy.

That's okay.

And a big part of the work is laying out at the beginning.

Right.

If we do this and this happens, how are we going to manage it?

So preparing to make the change.

We don't just make the change.

We prepare to make the change.

Because I can't take one thing out and then leave someone like, well, what do I do with that?

We've got to know that that's safe.

I talk about it in the book.

There's a case study of someone, we're removing alcohol.

Well, we can't just take it away because then most brains, and especially the ADHD brain's gonna.

It's like that pulse, pulse, pulse.

What am I gonna replace it with?

We've got a plan for it.

So there's a lot of preparation in the work that I do before we actually start working, so that we try to look at the whole picture, we map out what your life looks like and how are we going to get in there and make those changes.

And I'm acutely aware of the privilege of it because I work in private practice and I.

This service doesn't exist on the nhs.

I wish it did because it would probably ultimately save a lot of money.

But when we look at the big picture and we think, right, which bid are we going to go to first?

And then we build it and layer it, because you cannot do it all at once, because it's that thing, isn't it?

We go out there, we've got a thousand notebooks, we're starting the new hobby and we're so enthusiastic.

And then two weeks later, it's like, so we have to work with the nature of that, that's absolutely fine, but there's a whole bunch of mindsets that we have to, over time, tease out, because there's a lot of defensiveness in here.

If you're late, diagnosed, you've got through a whole life and the grief that can come from that realization of, oh, oh, that wasn't my fault, or the shaming that's happened, or being made to feel terrible for who you are.

Yeah, there's so much to unpick here.

Yeah.

I mean, I come from a long line of family members who have always struggled to sleep.

You know, it's always been a thing and I guess you must see that as well.

And like generational, where it's like I'm, you know, like what you say, it's like the beliefs, I'm not a good sleeper or I don't sleep well.

And it's almost just like, you see it.

And, you know, I remember my grandma, there was always sleeping pills by her bed.

My mum, other family members and I, from a very young age, because I saw my mum, she always slept with earplugs.

And I remember not Being able to fall asleep.

And she said to me, why don't you try earplugs?

And I put them in.

I was like, oh my God, this is like, suddenly I can't hear the noise.

I couldn't hear the noise in my head and I couldn't hear like a clock or a tick or a waft or like I've got, you know, such sensitive hearing.

And I put them in and I.

They are my literal lifeline.

Like, I have earplugs in every take going away bag I have in my handbag.

Like just in case I have to fall asleep somewhere, I need my earplugs.

I don't see that as an unhealthy scaffolding.

I just see that as just something that really, really helps me.

I've also realized how intrinsic my hormones are with sleep and how I've noticed, you know, my sleep cycle changed in my, in my cycles.

But especially now with perimenopause, I talk about it all the time in the podcast, that progesterone is literally my lifesaver.

What is that kind of like healthy balance of.

Yes, we're taking things away.

That may have been sort of self medicating and relying on the other things, but there's still a deep dependence of our nervous system knowing that if I don't have that, I can't sleep, or I don't have my, my spray or my pillow or something.

What should I be shaming myself about this or is it okay?

Please tell me it's okay.

So it is.

Yeah, you know, it is okay.

I mean, oh, heaven's ab.

It takes what it takes, doesn't it?

But there's also something really important here that a lot working in mental health, you don't have this to fall back on.

Biologically, we can all sleep.

There is an absolute truth that biologically we can sleep.

And we know that because when the brain gets out of the way, people will say to me sometimes, oh, am I going to die from lack of sleep?

No, but you might, because someone is drowsy driving and they've fallen asleep driving.

So we know that if your sleep pressure is high enough, you will fall asleep.

And that is a biological fact.

So a lot of the work I do is about building that pressure so that you can sleep at the time you want to sleep.

So there is something here about being able to lean into the biological fact that you can sleep.

That is a truth that I'm always so grateful for.

But you're laying out a lot more in what you're saying, because there is something too about the learning of the language.

Growing up in an atmosphere where people are talking about sleep as though it's this thing.

And I mean, mothers get shamed for everything, don't they?

I mean, let's just like, oh, well, I heard, I'm talking about my sleep now.

My kids are learning that.

And so it's like.

But the language we use is really important.

The example I often give is that when I was a kid, apparently I announced that I didn't like onions.

And to this day I don't.

But my mother says, oh, it's because your dad said he didn't like onions.

So we, we listen and we learn because of course we do.

That's what happens.

So if the conversation in the home is about sleep is a problem, it will go down the generations.

And I might sometimes do a piece of work with someone where we look at the intergenerational relationship to sleep.

And it's a really powerful process because why was your grandmother using sleeping pills?

Why did your mother suggest earplugs?

And that intergenerational aspect of it is a very, very specific work we do in psychotherapy as to working with sleep, because it's sort of.

There could be a really good reason that your nervous system, not just because of neurodiversity, is alert.

What's going on in the home.

That thread is huge, absolutely huge.

Because that logic of there may be a really good reason for this.

Yeah, no, absolutely.

And I know my nervous system is always very hyper vigilant and very wired and takes a lot for me to, you know, I always say that's why you can hear.

I can hear.

And I can't fall asleep in any public places.

My husband will sit on a plane and fall asleep before takeoff.

I probably wouldn't.

I've never fallen asleep on a train or a bust.

Like I am the person that's always awake until I can literally put my earplugs in.

I don't know where it comes from, but I just know I have a nervous system that is very wired for sort of hyper vigilance.

I'm sure with several psychotherapy sessions, I'm sure we could get down to it.

But would you say that your.

Am I using the right word?

Chronotype?

Yeah, sleep, chronotype.

How much is it genetic, biological?

Is it maybe from trauma or learned behavior?

It's genetic.

It is what it is.

Okay.

Yeah.

That in a way frees us from that pressure.

It's like, well, that is who I am.

My Husband is an early riser.

I typically fall asleep later and need and wake up later.

I would say mine is probably like 11 till 7, he's maybe 9, 9 till 4, 30.

It is just what it is.

Does that level of acceptance help a lot of people when they just.

But then, then you've got to kind of marry it with your lifestyle and your work and your job.

And how do you blend the two together with acceptance?

That's partly why I'm really pro people sleeping separately.

Because if you can sleep to your genetic chronotype, your sleep is likely to be much better.

Because of course, one of the things I think is really bloody unfair with neurodiversity is not only are you having to work really hard about just being in the world, but if you've also got a late chronotype, you're working really bloody hard to manage your sleep.

It's like I'm exhausted thinking about it.

But if you can, I mean, I've got.

I've seen people who decide that they're going to go to bed at 5:00am and get up at midday, 1:00 clock because that's their chronotype.

That's fine.

If that works for you, happy days.

But of course for the majority of us it doesn't.

It's that negotiation that goes on between a couple.

It's like, well, okay, how are we going to do this?

Do we want sleep together?

So how do we do it?

What's involved in that?

The recognition that each other may have different needs.

It's not that I'm going to bed because I'm avoiding you, it's because I'm going to bed because this is my sleep time.

It's sort of getting it out on the table and going, this is my timing, this is your timing.

We could meet in the middle, but we both have to work at it.

And if we're not, how are we going to do it?

Because we can work to move clocks, which we do through light and sometimes prescribed melatonin.

And we do it in a very timed fashion.

We move people's clocks forwards, backwards in different directions.

But of course it takes work, which is fine and we have to do it a lot, especially when people are at university.

I mean, I don't work under 18, but a really big piece is when people graduate and suddenly they go into the work workplace and all of a sudden we've got to do a really big clock move because they cannot get up in the morning.

It's not their fault.

It's this biological difference.

So and it's profound in young adults.

So working out what your timing is and how the pair of you are going to do this is something that is really, I work on every day as to how does this work?

Because if we can protect each other's sleep.

One of the things someone says to me quite often when I say, well, let's.

What about sleeping separately?

Oh, well, well, we'll never have sex again.

Well, frankly, you're not having sex now.

Are you better slept?

You will, because everything will work much better.

Your libido will work better, his testosterone will be better if you're better slept.

And yeah, you might have to actively plan date nights, but there's something about that conscious act of the recognition, this is what's going on and this is what we're going to do.

Whereas we tend to just let these things drift and not say anything about it and then all of a sudden we've got a problem.

What are your thoughts on the impact?

Again, I said about the case studies in the book.

There's quite a lot of case studies regarding tech phones, phone addiction.

I've got a 20 year old son at university.

Everything you were just saying.

And then hits home very, very hard.

I know he goes to bed crazy hours and it's, he's always struggled with getting up in the morning.

He's got a couple more years at uni and then he's out in this big bad world where unfortunately he's probably gonna have to change his circadian rhythm quite a bit.

When I say unfortunate, it's probably a good thing.

But what are your thoughts on social media, phones, tech?

Like have you been working this space long enough to see the, the pre and the post?

Almost, almost.

I've had a really progressive, changing relationship dynamic with it.

When I first started working sleep, we were really militant.

No phones because of the light and blah, blah, blah.

But I started to see over the years real distress in people when you take the phone out of the picture.

I've seen full on panic in people when I'm asking them to put their phone down for a duration of time.

And it's not our fault.

These phones have been designed by geniuses to keep us hooked.

I mean there's, I can't remember whether I say it in this book or the previous one.

They know they're monetizing our attention.

They know they're doing it.

There's a quote from a guy who was at Google who talks about it.

So we are being hooked in by very powerful forces to use these devices.

So I'm often having to work with people of any age.

It's not just kids, every age, on our connection, our attachment to our phone, because it's become an attachment object and it's staggering.

When you take the phone away, people are like, well, I don't know what to do with myself now.

And that's really, really tricky because we have to.

From a sleep perspective, there could well be a period where you are going to be awake now.

I'm not completely anti.

Anti device devices, because they are.

If you can.

If you can use it as a tool and you can have a.

You prepare, you've got a list of you.

Like, I know the podcast I'm going to listen to.

I might listen to this yoga Nidra.

I might.

And you know, a resource that you can go to on your device.

Fine, happy days.

But if you can't avoid getting sucked into social media and everything else that's there, then we've got this problem with it.

It's working out someone's relationship to this tool that can be really useful.

Is it useful for you?

Is it not?

And how are we going to do it?

Because they're here, they're not going anywhere.

But that attachment object is like, wow, do you know what to do if you haven't got a phone?

Yeah.

And I think you're right in saying that.

It's been here for so long now, that attachment to it, and it's hard to just turn around and go, right, phone's out of the room.

I know it's best practice, good sleep hygiene, but in reality that black and.

White cause more stress.

Yeah.

Yeah.

Before we close, I wanted to ask you about sleep apnea and the connection with adhd.

What do you see and what is that connection and why are we more prone to sleep apnea?

I'm really glad you've asked because if you've read the section in the book, you'll know that I'm really passionate about it.

Sleep apnea is really common and it's massively underdiagnosed.

There's a lot of stigma about going to sleep apnea treatment.

Working in a sleep clinic, it can be.

You'd often see a wife dragging her husband in and I'm.

I know it might sound like I'm generalizing, but that is the pattern I've seen because she's got secondary insomnia from his snoring and it's driving her mad and they're on the verge of divorce.

You treat sleep apnea, it's a game changer.

The thing that's really hard with ADHD is if you're sleep deprived, your hunger hormones invert so you don't know that you're satisfied or full.

So this I'm talking about when you're getting about four or five hours of sleep a night on a long term basis.

So if we've got that in play, there's a chance that you're going to gain weight and weight gain is one of the triggers for apnea.

But in ADHD there's a massive link to binge eating.

So we've got this situation where your coping strategy.

That's how I see it.

Binge eating is a coping strategy for stress.

So you're binge eating and you're gaining weight, so.

So you have apnea.

And then we're trying to sort out the binge eating and then we're trying to sort out the relationship to it because we're trying to bring your weight down because you're in this cycle and.

Drinking, I guess as well.

Yeah, yeah.

The binge eating piece is so not recognized and not talked about.

And it's so common.

It is very common.

It is.

And it's got dopamine seeking, self soothing, calming, decompressing, like you say.

It can sort of come in all different ways, whether it's scrolling.

There's a common denominator there with ADHD that we seek something to either.

Yes, it's that fix.

Correct.

But of course then we're.

So then we gain weight and if we have apnea, we then, and we don't know we've got apnea, we're then fragmenting our sleep and we are sleep deprived, so we've got adhd, we're binge eating anyway, we're then sleep deprived, so we're inverting our hunger hormones.

So we don't know we're full on the satisfied.

And this loop is really tough.

What do you do with someone that comes to you and says, I think I've got sleep apnoea?

Like what is the course there?

Everyone I see I screen and sleep apnea is part of the screening and I will always immediately refer on either through the NHS or privately because there are lots of me.

There's about 80 different sleep disorders.

Some are psychological in origin, some are.

That is something that needs to be treated medically.

That's a structural, respiratory piece of work.

That is not a behavioral.

This bit that I'm talking about is behavioural.

But actually you need to see a doctor and there are.

I mean, there's things like narcolepsy, there's different things that I will always refer onwards, always.

No question.

But alongside that, I might be looking at, okay, you get an apnea diagnosis.

What does it feel like to use the mask?

Because the claustrophobic aspect of using the mask could be something we're working on.

Okay, you have sleep apnea and you work shifts.

How are we going to manage that?

There's lots of different configurations to how that might show up from a behavioral perspective.

But always if I.

It's part of my screening, straight up.

If I suspect immediate referral because it can change your life.

Getting treatment for sleep apnea really, genuinely can.

Yeah.

And that's only going to make your ADHD worse if you're not getting good quality sleep and disjointed sleep and sleep.

Deprivation can look like adhd.

So, thankfully, I'm not in the.

I'm not in the territory of diagnosis, but I am aware of people who have had ADHD diagnosis and actually it's sleep apnea.

Wow.

So interesting.

I know we mentioned right at the beginning about the different sleep chronotypes.

I'm not going to ask you to name all the disorders because we know you go into such fantastic detail, but can you just very quickly give us some of the chronotypes that people might be able to relate to?

Well, it's just.

It's three, mate.

There is a book by Michael.

I think it's Michael Bruce.

It's got lots of different chronotypes.

But I work with.

You're either an early bird intermediate in the middle or a night owl.

And then there's extremities of.

So keep it very simple.

There's three.

And quite often early birds are married to night owls.

That's a really.

It seems to be normal because we.

Need someone to get up with the kids.

Yeah.

And that's it.

It's that ancestral tribal piece.

Somebody in the tribe always needs to be awake.

That's why we have different chronic times.

It's so true that actually I think about my friends and there's always the one that needs to get into bed early and is okay, good in the morning and one that tidies the kitchen and sorts the house out and they're flat out on the couch.

But it's all our energy levels as well during the day.

Chronotype affects so much.

So we've all got energy peaks and troughs at different times and yet we all seem to think we can just go, go, go, go, go all the time, not recognizing.

We do it's that there's a natural up and down and we do it at different times.

And often people with ADHD did a big energy boost in the evening, so circadian and chronotype difference is massive in our.

In this work.

It's just.

It's a huge thing.

Yeah.

It feels like you were really just scratching the surface.

And thank goodness that you've written such a comprehensive book.

I would highly recommend it, but not only to people, but I would say psychologists, therapists, doctors, people that really need to understand the connection between adhd, neurodivergence and sleep, because it's not discussed enough.

And purely just to say, sort your sleep hygiene out or prioritize sleep.

That is not helpful.

Don't get me ranting on sleep hygiene and prioritizing sleep.

Sleep doesn't like tension.

The more we focus, like insomnia, insomnia's best friend is perfectionism.

And the more pressure we put on it.

Sleep's like, get me out of here.

It doesn't respond to tight attention, tight routines at all.

It will keep it going.

It keeps the whole loop because there's a pressure to it.

It needs you to let go.

So sleep hygiene for me is very basic.

Keep it cool, calm and quiet.

Get up at the same time every night.

I take a very basic approach to these things because I work on the biological underpinnings that your body knows how to do it.

And we try and stabilize a lot of that so that the psychological work becomes easier.

Yeah, there's so much anxiety, isn't there, around sleep.

And just like you say, let's simplify it and.

Oh, that really landed with me.

What did you say sleep's nemesis is Attention or enemy.

Yeah, yeah.

It just.

I mean, it hates attention.

Insomnia's best friend is perfectionism, not sleep.

And they just keep each other going.

They go skipping off into the sunset and they'll keep you awake forever.

Sleep is an imperfect beast.

Some nights are good, some nights are bad.

When you've had a bad night, leave sleep to itself and it will change its architecture, it will change its structure over the next few days to get the repair from what you've just missed.

It's always going to go like this.

It's never going to be this steady.

One thing.

Yeah.

I used to put so much pressure on myself to sleep eight hours a night.

And I would tell myself that if I didn't get those eight hours a night, it would be horrendous.

I wouldn't be able to function in the morning and I Guess it's that.

That trauma of not understanding my adhd, so not trusting myself to know.

If I was going into the office and I'd feel groggy and.

And I'd always be fine.

I'd have a coffee and my, you know, whatever energy would get me through the adrenaline, the cortisol, all the things that maybe, you know.

But I got through the day and I've got four kids and I got through all their sleep, different issues and patterns, and I managed to, you know, make it through the day just about sometimes, you know, by the.

The skin of my teeth.

But it's so right.

It's like if we sort of, you know, constantly think about it and overthink it, it becomes a lot worse.

I'm not diminishing, though, the impact insomnia can have on people.

But brutal.

It's properly brutal.

It really is.

And it's heartbreaking.

It takes so much from people's lives.

It really does.

And it's the most human thing to do, to focus on that is how we're built.

That's why we're the top of the food chain.

Focus on something to solve it.

So it's very counterintuitive to say, well, actually, maybe if we focus on everything else.

That's why I wrote my second book, how to Be Awake, Sleep and Sleep through the Night is to work on everything during the day so that the night is more able to take care of itself.

Because that pressure is really tough.

Yeah, absolutely.

And I do.

I want to caveat all of this with.

If you're listening to this and you are going through perimenopause and you've noticed that you're already difficult, sleep has got even worse.

You know, it is so important that we don't gaslight ourselves to say we can mindset our way out of this.

Like, sometimes it is a very biological need to replenish hormones.

And that is, you know, sometimes.

Some women say it's the estrogen that works.

Some say it's the progesterone, some say it's the testosterone.

But would you also refer people to go and get their hormones checked and speak to a menopause expert as well?

Absolutely.

All the time.

Because, I mean, I will often say to people.

I mean, people come in with this big bag of supplements, and I'm like, can you please go and have your bloods checked now and again and again, because do you even need those supplements?

Please have your hormones checked, because if there's something out, you can make the decision whether it suits you or not to seek treatment.

We've got so many tools at our disposal but it's amazing the things that people will do and take without knowing actually what does my body really, really need?

So do I need hormonal treatment?

Do I need B12?

Do I need vitamin D?

Checking from a hard evidence perspective is important.

Yeah.

Thank you so, so much Heather, for all of this.

I think that we probably have only just scratched the surface, but I would encourage anybody to go and get your book, the ADHD sleep book, because there really is.

You will definitely relate to many different case studies.

Yes, we've both got it here.

My baby.

This is, this really is my baby.

It's writing is, is horrendous for me and I'm so excited about this one because as you've picked up on, there's a lot in here that's not known and I just, I just want people to know this stuff.

Yeah, absolutely.

And you know, congratulations on writing a book.

I know how difficult it is, especially dyslexia and adhd.

It's, it's no mean feat and it is a labor of love.

But I agree with you.

This is information that people really do need and I hope it's shared far and wide because it definitely deserving of that.

Thank you so much for, for being here today, Heather, and hopefully we'll speak again very soon.

Thank you.

Thank you for having me.

Thank you for being here and listening to today's episode.

I just to want, just want to remind you that if you are looking for more support on your ADHD journey, there are so many resources waiting for you over at ADHD womenswellbeing.co.uk so inside the ADHD Women's Wellbeing Workshop library you'll find practical and compassionate guidance on topics such as nervous system regulation, rejection, sensitive dysphoria, perfectionism, emotional regulation, hormones, parenting and so much more, all designed specifically for late diagnosed neurodivergent women.

You can also explore my new book, the ADHD Women's Wellbeing Toolkit, which was published by dk, which is also available in ebook and audiobook, which is packed full of tools to help you feel calmer, more regulated and more like yourself.

And if you do crave a bit more deeper connection and ongoing support can come and join us inside the More Yourself community.

It's a gentle space for learning, reflection and connection with other neurodivergent women.

And you'll also find the recordings from our first ever ADHD Women's Wellbeing Live event which brought together incredible speakers and a room full of inspiring women for a truly special day.

We have recorded it all for you.

And it's there to buy.

So whether you're just starting your journey or looking to go deep, deeper, there's something there for every stage.

Just head to ADHD women's wellbeing.co.uk to explore everything.

And as always, thank you so much for being here and for being part of this community.