Ways To Improve Sustained Attention, Learning, And Sleep For ADHDers

Sustained attention, information retention (i.e. encoding and retaining new information), and sleep are often reported as areas of difficulty for ADHDers. Medication is a great tool for supporting sustained attention, and many ADHDers use melatonin to support sleep onset. But we are often asked whether there are any behavioural strategies or non-pharmacological treatments that have long term, observable effects on attention and sleep for ADHDers, and on their ability to retain new information. There are!

Below is a round up of current evidence based behavioural strategies that have been shown to have a moderate to large effect, provided they are applied consistently and integrated into your lifestyle.

Note: When I talk about sustained attention here I am not talking about spending time hyper-focusing on things you are interested in; sustained attention is about focusing your attention on task for an extended period of time, when that task isn’t highly rewarding (or maybe it used to be, but now it has lost its spark). It is about attention regulation – that is, controlling where your attention goes.

Outside of medication, exercise and movement have the largest impact on sustained attention skills for ADHDers.

Engagement in consistent exercise shows long term benefits on sustained attention skills for ADHDers, both in childhood and adulthood. There isn’t any evidence that more intense exercise has a larger effect, the key is consistency. It will be much more beneficial for your attention skills to engage in lower intensity exercise more regularly and consistently, rather than high intensity exercise sporadically.

ADHDers show significantly better sustained attention performance if they are physically moving, compared to when they are sitting still. Integrate movement into any activity that requires sustained attention and you will likely make less errors and take in more information.

Regularly consume long form content over short form content.

High consumption of short form content (e.g. TikTok, Instagram, short videos, reading the headlines only) is common for ADHDers, as it provides high dopamine reward without the cost of sustained mental effort. This content format is also becoming increasingly common more generally. However, emerging evidence is supporting what has been suspected anecdotally, which is that high consumption of short form media negatively impacts sustained attention skills over time.

Intentionally adding longer form content can counteract this. For example, watching a movie or long YouTube video, reading for 10 minutes or more, and setting daily time limits and / or having extended detox periods from high intensity short form media like TikTok and Instragram.

It is also likely that consuming longer form content rather than high volume short form content has a positive flow on effect on retention of information, by allowing more mental space and reducing information overload.

Work on your sleep practices.

Sleep quality has a profound impact on all areas of our functioning, including mood and emotional regulation, impulse control, attention, learning, and immune system regulation. Sleep issues are much more prevalent amongst ADHDers compared to neurotypical people, which is due to both biological differences and environmental factors. For example, ADHDers are more likely to have a later onset circadian rhythm, meaning that they tend to get sleepy later and want to wake up later. This is a biological factor. Because work and school tend to have a specific start time though, this can be problematic and lead to reduced sleep quantity and / or quality, which is an environmental factor. Reduced sleep quality / quantity has the flow on effect of making all forms of self-regulation harder (e.g. emotional, attentional, behavioural), and sleep intervention has been shown to reduce impulsivity, physical and mental hyperactivity, and emotional dysregulation in ADHDers.

To bring forward your circadian rhythm (i.e to help your body feel sleepier earlier and wake up earlier) implement the following:

• 30 minutes of bright light therapy before 8am, for a minimum of two weeks. Direct, natural sunlight works best (i.e. actually going outside), otherwise fluorescent lighting also works. You can also purchase high-power bright light therapy lights online.

• No overhead lighting after 4pm. Use dim, lamp lighting only. This supports earlier melatonin production. Again, this needs to be applied consistently to show noticeable effects.

• Basic behavioural practices around sleep have also been shown to have strong effectiveness in treating sub-clinical sleep problems. These include:

  • Avoid aerobic exercise for 2 hours before bed.

  • Avoid alcohol for 4 hours before bed.

  • Bed is for sleeping and sex – avoid working from bed.

  • Create routines and rituals around bed time.

  • Engage in consistent exercise (so annoying, I know!).