Dr. Russell Barkley

And trying to cope with it by simply saying, well, I just need to learn better ways to fall asleep.

Well, I'm sorry, biologically, you're not programmed to fall asleep when other people do.

So that's all by way of saying that, you know, a lot of times we have to address that sleep problem through other means, whether it's through another medication, whether it's through switching away from a stimulant because stimulants cause insomnia, whereas the non stimulants don't.

Maybe we have to send you to a sleep lab for a 24 hour, you know, polysomnogram.

where we look at your rhythm day and night, but particularly during sleep to see if it's inefficient.

We know that about 10% of the people with sleep problems, it's due to obstructed airways.

So tonsillectomies are indicated and result in significant improvement.

in children and possibly adults, but it's more of the research is on kids.

So if you're snoring a lot, if you have sleep apnea, then we want to look at how do we expand that airway surgically or otherwise.

And you can find that that improves sleep and then the kids are better the next day.

So there's a lot going on around the sleep thing that I don't want to oversimplify.

And it isn't just procrastination.

There really is a diurnal rhythm problem here with alertness.

Now, that said, procrastination is probably the number one problem that adults with ADHD report as part of their attention deficits.

A lot of life and a lot of work we're asked to do is scut work that isn't very reinforcing to engage in.

But if you don't get it done, there's going to be hell to pay.

So the consequences for not doing it are longer term, whereas the thrill of doing it is absent.

And hence, as I said, the adult with ADHD is pulled along by things that are immediately gratifying more than things that involve delay of gratification.

And that's why work is very hard for them and why they procrastinate so much is that there are plenty of things around us that offer engagement, excitement, reinforcement, interest, stimulation, and yet a lot of what we have to do in life

is to turn away from those seductions and pursue that longer term goal, even though it's not very fun to do.