Ownership of the Mind: How Neurodiversity Is Taking Charge of Labels for Deeper Understanding, Part 2

Bedtime Procrastination or Revenge Bedtime Procrastination (BP/RBP) is a very real challenge for neurodiverse individuals.

I will NOT go to this wonder place! (Credit: Shutterstock)

First my story: I was diagnosed with ADHD a short time before turning 40. I had recently changed careers from secondary teacher to psychotherapist and was in the post graduate process of working toward licensure. I believed that a very rare subset of adolescents I had worked with demonstrated genuine ADHD challenges, but I was also skeptical about the increasing diagnosis rates and the use of medication to treat the condition. This was until I began to learn first as an intern and later as an associate for a prescribing psychologist the “soft signs” of diagnosis to look for in addition to the data obtained from parent and teacher checklists, self-reports, and continuous performance testing. The narrative histories and patterns of behavior and struggle that I was recording during sessions became more and more familiar over time. It was very easy for me to empathize with these individuals because their patterns were my patterns.

• On paper, general intellectual ability is very high, but academic performance very mediocre (I was identified “gifted” in the 1st grade yet made straight A’s only once during one quarter grading period in the third grade).
• Reports of conduct problems that often seemed unintentional (I typically received C’s in conduct but never D’s or F’s… for talking out of turn, getting out of my seat without permission, accidentally breaking things, but never for willful disobedience).
• Problems with paying attention, organizing behaviors and emotional regulation at home (I know my family loved me, but my older siblings were very honest about me talking too much, asking too many questions, misplacing too many things, and getting upset about too many things. My older sister would even switch our tea glasses at the dinner table right in front of me without me noticing and I would be confused about where my tea went, true story).
• Waiting until the last second to do important tasks (I was a pro-level B+ research paper writer in the early morning hours of deadline days from secondary school through my undergraduate years).
• Bizarre patterns of sleep and apparent insomnia (I used to simply say I had watched too many scary movies too young and would be afraid at night, but there were plenty of times that I just couldn’t turn off my brain and would entertain myself with my light on by reading, writing, or sneaking my pet beagle inside through my window to play with me).

There were still more patterns than these, and eventually, I chose to be evaluated and was diagnosed and treated for ADHD, late but not too late. There is that pesky life expectancy reduction with ADHD, but I am still here!

For some neurodevelopmental disorders like ADHD, the clinical presentation includes behaviors that are more frequent or intense when compared with those of normal children of the same developmental age and gender, as well as deficits and delays in achieving expected milestones. This is an important point to remember when considering statements like, “All kids hate having a bedtime.” This also applies to the adults who grow up with these challenges but don’t grow out of them. Adults oversee their own bedtime. Adults understand better the importance of a good night’s sleep. Neurodiverse adults are no different, but there is a behavioral disconnect between understanding and doing.

Fast forward a few years and countless hours of missed sleep, and I had a eureka moment with a young adult client we were treating for newly diagnosed ADHD. She was sleeping better since starting a stimulant and attending regular counseling, but sleep was still a work in progress. The deeper our discussion and exploration of variables, the less terms like “insomnia”, “poor sleep hygiene”, and “sleep maintenance” seemed to apply. It wasn’t that she couldn’t fall asleep or stay asleep, she just couldn’t seem to consistently get to the “head on pillow, brain off” point of her routine. This was sometime around 2015 and together we came up with the phrase bedtime procrastination.

This phrase became the key words for follow-up research, and I discovered the work of Floor M. Kroese, et. al. from the University of Utrecht in the Netherlands. Their article from June 2014 titled “Bedtime Procrastination: Introducing a New Area of Procrastination” was the first example that I found of someone seeking to operationalize this concept. Kroese’s colleague, Dr. Joel Anderson, is credited with originally coining the term. The New Yorker covered their research in the summer of 2016.

According to Kroese, bedtime procrastination (BP) is “going to bed later than intended without having external reasons for doing so.” While that seems like a simple fix (Just go to bed!), this is a self-regulation dysfunction. Consider the typical external and internal dialogue of a bedtime procrastinator.

“Sorry I can’t hang out tonight, I have to get up earlier than usual tomorrow, so I need to go to bed early.” Perhaps said aloud to a friend, this establishes the clear acknowledgement of needing a good night of sleep for a valid reason.

Then later at home the internal dialogue begins outside of the bedroom: It is past 10:00pm, remember you need to get up early. Probably need to get to bed soon, but not yet. I see that one of my favorite movies is on TV (starts watching even though already seen the movie a few times). Oh wow, it is already almost midnight! I am going to be sleepy tomorrow and I have so much to do. I am so sleepy now, just going to close my eyes for a minute (dozes briefly). Alright, you better get up and brush your teeth and get in bed now (20 more minutes pass). Okay, NOW.

The terrifying inevitability (Credit: Shutterstock)

Eventually, after much internal mental effort, the person gets off the couch and begins shutting the house down for the night. A very rapid bedtime routine begins: use bathroom, brush teeth, dress down to sleeping attire, set alarm, get into bed. In the age of smartphones, there may now be some “winding down” with games, social media, or reading articles which can go on for 10 minutes or even another hour. Then FINALLY… roll over, exhale, close eyes and fall asleep. It may now be 2:00am and the person sighs internally, four hours of sleep, tomorrow is going to be rough.

The struggle is genuine. Neurodiverse individuals are not illogical. Their brains do not regulate in regular ways. This is a serious health problem. Sleep is one-third of our existence. Self-professed “night owls” seem cool (and they are often creative and intelligent), but they suffer greatly in the long term.

At some later point, some of those with BP began to add the word revenge in social media posts to emphasize a conscious choice to take back free time they feel they were robbed of or didn’t enjoy because of daytime stressors. This addition seems to be a rationalization of BP more than an actual variant. While there indeed is an element of choice in all behavioral decisions, overcoming self-regulation challenges can range from simple to overwhelming depending on the moment.

While the original work of Kroese and his colleagues made no mention of ADHD, ASD, or other forms of neurodiversity, these individuals (me included) easily identify with the BP experience as a lifelong issue.

So no longer do I say that I had an “insomniac childhood and night owl adulthood” because I know that BP isn’t me, it is just something that I must work to overcome.

There are no medications indicated for BP as there are for insomnia. Those who struggle with BP can also have situational insomnia, but it is unlikely to become chronic outside of some additional medical condition. I can take a Benadryl when I know it might be hard to “turn off my brain” and it will work well. This is something I try to avoid though. Taking sleep medications for BP is like using a sledgehammer where a rubber mallet is more appropriate.

In my experience the following efforts might help, but the main goal is always HEAD ON PILLOW IN BED.

1. If you are married or sharing a bed with a partner, go to bed at the same time, all the time. This harnesses the social pressure strategy. If your partner loves you, they will worry about you not sleeping enough. Going to bed at the same time is also great for the relationship and staying connected. When snoring from either of you is a concern, try ear plugs or sleep apps with green noise.
2. If you live alone but are in a committed relationship, I recommend creating a bedtime communication ritual with your partner. A quick phone conversation that only begins once you are in bed can motivate you to get there. If you are single, find a surrogate bedtime connection by finding a short podcast you enjoy listening to once you get into bed. There are even multiple podcasts that feature bedtime stories that may be worth exploring.
3. Try to find a bedtime range instead of a deadline. This can control the “revenge” aspect of BP. Even self-imposed deadlines can trigger resistance and increase dysregulation.
4. If you tend to watch TV, read, etc. before going to bed most nights, sit up. Lying down on the couch leads to the dozing in and out cycle of BP. Those small bites of sleep on the couch are nowhere as restful as quality sleep architecture (alternating stages of REM and non-REM sleep).
5. BP often connects to other procrastination, such as putting off routine chores like dishes and laundry. Do these chores as early in the evening as possible so they do not compound resistance later.
6. Lock down a bedtime ritual. Do a specific series of actions in the same order. Secure the pets, turn off the lights, check the doors, use the bathroom, brush teeth, change into nightclothes, get under the covers. My partner is great about pouring two glasses of water as a signal of impending bedtime (she knows I struggle with hydration too, which will be covered later in this series). Glasses of water have become the first step of my bedtime ritual, as we take turns “getting us some waters.”
7. Keep your bedroom as clean as possible. Clutter and disorder do not encourage relaxation. You do not have to be a “neat freak”. Even if you identify as a person who can tolerate some messiness and can only seem to maintain one room in the house to be consistently neat and tidy, make it your bedroom. That one room will draw you to it like a siren song because it is a space where the only postponed decision is whether or not to get in the most comfy place you will be all day.
8. Keep your thermostat lower than a stereotypical dad would like. Cooler environments promote better sleep and colder houses/apartments make us crave covers.
9. Whenever you are successful at conquering BP, stay conscious of the positive impacts throughout your daily activities. You have earned how good you feel!
10. Be gentle with yourself. Overcoming self-regulation challenges is a daily task. It is not a simple do/don’t situation. Celebrate when you succeed, use loving self-talk and stay hopeful when you fail.

One final note about neurodiversity’s role in BP. We know it usually starts early in life. The genetics of neurodiversity suggests that your children may have similar challenges. The more effort you make for yourself will demonstrate the importance of effort for your kids. You can do this!

Next up: Part 3- Rejection Sensitivity Dysphoria (RSD)