Sleep Hygiene Guide

A client with ADHD who is a marketing director reports lying awake for 45 minutes to an hour most nights as her mind accelerates the moment she puts down her phone. She cycles through tomorrow's meetings, unfinished decisions, and conversations she should have had differently. She has tried progressive relaxation apps and meditation but cannot sustain them when her mind is running. She is getting six hours of sleep on a good night and experiences consistent cognitive fatigue by 2pm. The coaching focus is on the specific ADHD-driven sleep onset problem, not general sleep hygiene.

Go directly to Tip 4 (Address Racing Thoughts) rather than starting at Tip 1: 'The guide has ten practices. For you, the starting point is Tip 4, because the racing mind is what is keeping you awake. The other practices support better sleep generally, but this one addresses the specific problem.' Frame the brain dump and scheduled worry time as external memory systems rather than relaxation techniques: 'Your brain is keeping you awake because it does not trust that these things will be remembered. The brain dump is proof that they won't be lost. Once your brain has that proof, it can stop cycling through the list.' After she understands Tip 4, add Tips 1 and 8 (environment and screen limits) as the supporting interventions.

Watch for the client treating the brain dump as journaling - spending 20-30 minutes writing reflective sentences rather than a rapid-fire list of everything her mind is holding. The brain dump is a working memory offload, not a reflective practice. It should take five minutes maximum. Also watch for her skipping the brain dump on nights when she feels less anxious - the ADHD consistency problem. The practice needs to happen every night, not only when the racing mind is severe, to build the association between external recording and internal permission to stop.

Ask about the specific nights she tried the brain dump: 'What did you write? How long did it take? Did you feel the cycling slow down while you were writing?' The client's description of the experience tells you whether the mechanism is working or whether the implementation was off. If the brain dump helped on some nights but not others, look at what was different - usually either the timing (brain dump at 9pm versus 11pm has different efficacy) or the completeness (a partial list doesn't provide full permission to rest). Adjust accordingly before introducing additional tips.

A client with ADHD who is a freelance graphic designer has no consistent bedtime. He works until he is exhausted, then shifts to passive screen time for an hour or two before finally falling asleep. He reports knowing he should stop but finding the transition from working to winding down almost impossible to initiate without external pressure. His current sleep schedule ranges from midnight to 2:30am depending on the night. The ADHD executive function issue is not sleep hygiene knowledge - he knows what good sleep looks like - but the transition initiation failure that delays everything.

Frame the guide's Tip 7 (Bedtime Routine) as a transition structure, not a sleep practice: 'The routine is not about relaxation. It's about your brain having a signal that the work day has ended. Without it, there is no boundary - the active state and the rest state blur together because there is nothing to mark the transition.' The ADHD-specific problem is that time blindness plus transition difficulty means the natural end of the day never arrives. Tip 5 (Consistent Sleep Schedule) pairs with Tip 7: an alarm for bedtime (not just wake-up) provides the external cue the ADHD brain needs to initiate the wind-down. Name this explicitly in session so he understands why a bedtime alarm is a different function from a wake alarm.

Watch for the client designing a bedtime routine that is too long or too demanding to initiate - 'I'll stretch for fifteen minutes, then journal, then read for thirty minutes.' A demanding routine requires initiation energy at exactly the point in the day when initiation energy is lowest. The effective bedtime routine for ADHD clients is short (10-15 minutes), specific, and low-demand. It functions as a transition ramp, not a wellness practice. Also watch for screen use migrating from work mode to entertainment mode as the 'wind-down' - he is already doing this, and the guide's Tip 8 needs to address the specific function screens are serving in his transition.

Start with the bedtime alarm experiment: 'Did you set an alarm for bedtime? What happened when it went off?' If he ignored it, ask what he was doing at that moment - the answer reveals what competes with the transition. If the alarm worked, explore what made it possible to respond. Then move to Tip 6 (If You Cannot Sleep, Get Up): this counterintuitive tip often resonates with ADHD clients who spend time lying awake frustrated, because it gives them something active to do rather than tolerating the non-doing.

A client with ADHD who is a hospital administrator has been tracking that her worst ADHD days - scattered focus, emotional reactivity, poor decision-making - consistently follow nights under six hours of sleep. She has made this connection herself but has not translated it into a priority change. She continues to sacrifice sleep to finish work that feels urgent at 11pm. The coaching goal is not teaching her about sleep - she knows - but examining why sleep keeps losing to the urgency signal and what environmental changes could shift the outcome.

Do not lead with the guide's ten practices. Lead with her own observation: 'You said your worst ADHD days follow your worst sleep nights. You've already done the analysis. What has stopped you from acting on that?' The guide functions as reference material after that conversation, not as the entry point. When the conversation surfaces what is competing with sleep (real deadline pressure, ADHD time blindness, the difficulty stopping stimulating tasks), then use the specific tips that address those mechanisms: Tip 5 for schedule consistency, Tip 4 for racing thoughts, Tip 8 for screen stopping.

Watch for the client treating sleep as a leisure variable that can be managed by willpower when deadlines are tight. The guide explicitly frames poor sleep as degrading executive function - which is the capacity she most needs intact to meet deadlines. The cost-benefit calculation she is running is wrong: she is trading sleep for deadline completion at a net loss. Making that calculation explicit rather than abstract is the coaching move. Also watch for her identifying good practices in the guide (brain dump, bedtime alarm) and agreeing to try them while changing nothing about her actual schedule.

After one week with at least two to three of the identified practices: ask about a specific night where she was able to stop working and move into the routine. What made that night different? The answer is almost always either external pressure (someone else was involved, a natural stopping point existed) or a pre-made decision (she committed to a specific stop time in session). Use that to build the stopping rule for the following week - not 'I'll try to stop earlier' but a specific if-then condition.