For those with ADHD, getting a good night’s sleep can feel like trying to tune a radio to the right frequency—just when you think you’ve found the station, static interrupts again. Sleep and ADHD often have a complicated relationship, where rest seems elusive, and mornings can feel like a struggle to catch up.
If you or a loved one is navigating the challenges of ADHD, you’ve likely noticed how sleep doesn’t always follow the same rules. From lying wide awake at night to waking up at odd hours or feeling groggy despite long hours in bed, ADHD can disrupt sleep in ways that can leave you feeling out of sync.
But rest assured, understanding these patterns and finding solutions is possible. In this article, we’ll explore the unique link between ADHD and sleep, from common problems and natural remedies to when it’s time to seek professional help. With the right strategies, a restful night can go from feeling impossible to becoming a consistent and welcome part of your routine.
If you or your child regularly experience sleep problems and you are wondering whether this may be a sign of ADHD, we offer private ADHD Assessment in London, Oxford and surrounding areas, so contact us for more information on how to get a swift diagnosis so you can begin to successfully address any associated difficulties, including sleep.
Nightly struggles like these can be frustrating, as sleep seems to come so easily to most people! This frustration can give rise to feelings of poor self worth and cycles of negative thinking about our neurological differences. Our article What are People with ADHD Good At? may serve as a useful reminder that many of these differences can also be strengths.
How Does ADHD Affect Sleep?
For many people with ADHD, sleep can feel like a never-ending battle. ADHD affects brain function in ways that can make winding down and staying asleep particularly challenging. The same traits that drive creativity, energy, and focus during the day can often make it harder to relax and switch off at night.
Common Sleep Problems in Children and Adults
Children and adults with ADHD often experience a range of sleep issues, including:
- Difficulty falling asleep: Racing thoughts and restlessness can delay sleep onset [1].
- Unsettled sleep [1]: Sleep disruptions can make restful nights rare.
- Trouble waking up: Struggling to wake in the morning, even after a full night’s sleep, is common [1].
- Oversleeping: For some, excessive sleep can also be a problem, often tied to irregular sleep patterns.
Problems with sleep in people with ADHD are common. A 2023 study found that 84% of young people studied who had ADHD met the clinical criteria for a sleep disorder [2], while another recent study found 60% of adults with ADHD suffer from sleep disorders [3]. While children might exhibit hyperactivity that makes bedtime a challenge, adults may face a more internalised struggle with restlessness and anxiety, impacting sleep in similar ways.
Why Do People with ADHD Often Wake During the Night?
Frequent waking during the night, sometimes around the early hours, is a common sleep issue for individuals with ADHD, although no specific research directly links ADHD to waking at specific times. The reasons for these night-time disruptions often stem from broader sleep challenges associated with ADHD, such as:
- Hyperactivity in the brain: The ADHD brain can remain overactive even during rest, making it harder to stay in deep, uninterrupted sleep.
- Emotional sensitivity and stress: ADHD often comes with heightened emotional responses, and stress or anxiety can lead to night-time awakenings.
- Disrupted sleep cycles: Irregular sleeping patterns, difficulty sticking to a schedule, or delayed sleep onset can fragment the overall quality of sleep.
While the exact timing of night awakenings may vary, understanding these broader patterns provides insight into why restful sleep can be elusive for those with ADHD. The good news is that with the right sleep hygiene practices and strategies, these disruptions can often be minimised, leading to more consistent and refreshing rest.
Understanding the Link Between ADHD and Sleep Disorders
ADHD doesn’t just impact attention and focus during the day—it can also play a significant role in the development or worsening of certain sleep disorders. These conditions often overlap with ADHD, further complicating an already challenging sleep routine.
ADHD and Sleep Apnoea
Sleep apnoea, a condition where breathing repeatedly stops and starts during sleep, is more common in individuals with ADHD. Symptoms such as snoring, daytime fatigue, and restless sleep can mimic or exacerbate ADHD symptoms, creating a cycle that affects both sleep quality and daily functioning.
- Why the connection? Research suggests that the underlying neurological and behavioural patterns of ADHD may make people more prone to disrupted breathing during sleep, with around a quarter of ADHD children thought to be affected [4,5].
- Impact: Sleep-disordered breathing in individuals with ADHD is linked to heightened inattention, persistent fatigue, excessive daytime drowsiness, and challenges with language, cognitive abilities, and processing information [6].
If sleep apnoea is suspected, seeking a professional evaluation is essential, as treatment options like CPAP machines or lifestyle changes can significantly improve sleep and ADHD symptoms. It’s important to recognise that sleep-disordered breathing doesn’t affect everyone with ADHD. The connection is multifaceted and may be influenced by various factors, such as genetic predispositions, neurological variations, and environmental conditions.
Can ADHD Cause Sleep Paralysis?
While ADHD itself doesn’t directly cause sleep paralysis, given the higher propensity toward sleeping disorders in general, it is possible that individuals with ADHD may be more likely to experience sleep paralysis, however there is no evidence which confirms this correlation specifically. Sleep paralysis occurs during the transition between wakefulness and sleep when a person is briefly unable to move or speak, often accompanied by a feeling of fear or hallucinations.
- Why does it happen? Irregular sleep schedules and poor sleep quality, both common in ADHD, may increase the likelihood of experiencing sleep paralysis.
- Managing the risk: Maintaining a consistent sleep routine and addressing ADHD-related sleep issues can help reduce the chances of sleep paralysis episodes.
ADHD and Sleepwalking
Sleepwalking is another sleep issue that can be associated with ADHD, particularly in children. In one sleep study, nearly half – 47.6% – of children with ADHD were recognised to experience episodes of sleepwalking [7], a significantly higher prevalence compared to children without ADHD.
Why Does Sleepwalking Occur in Children with ADHD?
The exact reasons behind the connection between ADHD and sleepwalking are not fully understood, but several factors may play a role:
- Disrupted Sleep Patterns: ADHD often interferes with the natural sleep cycle, increasing the likelihood of disturbances like sleepwalking.
- Neurological Factors: Differences in brain activity and arousal regulation in individuals with ADHD could contribute to these episodes.
- Co-occurring Conditions: Conditions like anxiety or restless leg syndrome, which are more common in people with ADHD, may also increase the risk of sleepwalking.
Managing Sleepwalking in Children with ADHD
While sleepwalking episodes can be unsettling, there are ways to reduce their frequency and impact:
- Establish a Consistent Sleep Routine: Regular bedtimes and calming bedtime activities can help promote restful sleep.
- Create a Safe Environment: Removing obstacles or locking doors can ensure the child’s safety during sleepwalking episodes.
- Seek Professional Advice: If sleepwalking is frequent or severe, consulting a healthcare professional can help identify and address underlying causes.
Sleepwalking is just one of many sleep-related challenges that may accompany ADHD. Understanding and managing these issues can significantly improve the child’s overall wellbeing and daily functioning.
How Much Sleep Do Adults with ADHD Need?
Adults with ADHD need 7 to 9 hours of sleep per night, just like anyone else. However, ADHD often presents challenges that affect both the ability to get to sleep and the overall quality of rest, leading to persistent fatigue even with sufficient time in bed.
Trouble Getting to Sleep
Falling asleep can be one of the biggest hurdles for adults with ADHD. Racing thoughts, difficulty calming the mind, and a tendency to become overstimulated in the evening can make winding down feel nearly impossible. This delay in sleep onset often leads to shorter sleep durations and increased tiredness the following day.
Frequent Waking During the Night
Even after falling asleep, individuals with ADHD often experience frequent awakenings. These disruptions interfere with the natural progression of sleep cycles, preventing the body and mind from fully recharging. As a result, mornings often bring feelings of grogginess and a lack of energy.
Difficulty Reaching Deep Sleep
ADHD can also affect the ability to enter and stay in the deep stages of sleep that are vital for physical and mental restoration. Overactivity in the brain may prevent the relaxation needed to achieve this restorative sleep, leaving individuals feeling drained despite spending enough hours in bed.
Restlessness During Sleep
Restlessness, such as tossing and turning, is another common issue for adults with ADHD. This constant movement reduces overall sleep efficiency, meaning less time is spent in truly restful sleep. Over time, this can lead to chronic exhaustion and difficulty concentrating during the day.
Addressing these challenges often requires a holistic approach, including establishing a consistent bedtime routine, creating a calming sleep environment, and managing co-occurring issues such as anxiety or overstimulation. By focusing on both getting to sleep and improving sleep quality, adults with ADHD can achieve the rest they need to feel their best.
Practical Tips for Managing Sleep Issues with ADHD
Sleep can be a challenge for individuals with ADHD, but there are effective strategies to improve both the ability to fall asleep and overall sleep quality. With a consistent approach, restful nights are within reach.
Sleep Hygiene Strategies for ADHD
Good sleep hygiene is the foundation of managing sleep issues related to ADHD. These strategies can help create an environment and routine conducive to better sleep:
- Set a Consistent Sleep Schedule
Going to bed and waking up at the same time each day helps regulate your body’s internal clock. Even on weekends, try to stick to your schedule to maintain a steady rhythm. - Create a Calming Bedtime Routine
Develop a relaxing pre-sleep routine, such as reading, meditating, or taking a warm bath. This signals your brain that it’s time to wind down and prepare for sleep. - Limit Screen Time Before Bed
The blue light from screens can interfere with the production of melatonin, a hormone essential for sleep. Avoid phones, tablets, and computers at least an hour before bedtime. - Optimise Your Sleep Environment
Keep your bedroom dark, quiet, and cool. Consider using blackout curtains, white noise machines, or fans to create a soothing environment free of distractions. - Watch What You Eat and Drink
Avoid caffeine and heavy meals in the evening, as they can make it harder to fall asleep. Opt for light snacks if needed, such as a banana or a handful of nuts, to keep hunger at bay without overstimulation. - Manage Daytime Hyperactivity
Regular physical activity can help reduce restlessness and make it easier to relax at night. However, avoid intense exercise close to bedtime, as it can have the opposite effect. - Address ADHD-Related Stress
Practise relaxation techniques like deep breathing or mindfulness to reduce anxiety that may interfere with sleep. Journalling can also help offload racing thoughts before bed.
Trying to incorporating all these sleep hygiene practices into daily life may be difficult or overwhelming to try all at once, so try making only a few simple adjustments initially and add more over time. With consistency and practise, individuals with ADHD can use these tips to help improve their ability to fall asleep, stay asleep, and wake up feeling more refreshed and ready to face the day.
Sleep Aids for ADHD
For many individuals with ADHD, additional support may be needed beyond sleep hygiene strategies to achieve better rest. Both natural and medicinal options can help, but it’s essential to consult a healthcare professional for tailored advice, especially for children.
Natural Remedies for Better Sleep
Natural approaches can gently improve sleep quality and work well alongside other strategies:
- Magnesium and Zinc Supplements: These minerals can help promote relaxation and support the nervous system, potentially improving sleep.
- Herbal Teas and Extracts: Ingredients such as chamomile, valerian root, or lavender may reduce restlessness and encourage calm before bed.
- Aromatherapy: Scents like lavender or sandalwood can create a soothing atmosphere to ease bedtime routines.
- Mindfulness and Relaxation Practices: Techniques such as progressive muscle relaxation, breathing exercises, or meditation can help settle a racing mind.
ADHD Sleep Medication Options
When sleep problems persist, prescription options may be explored under professional supervision:
- Melatonin for Children: Melatonin, a hormone that regulates sleep-wake cycles, is available in the UK by prescription only. However, its use in children is highly regulated. GPs cannot prescribe melatonin for children; this must be done by a paediatrician, often as part of a broader ADHD management plan. It is typically reserved for children with severe sleep disturbances and should only be used under close medical guidance.
- Non-Stimulant ADHD Medications: Drugs like guanfacine or clonidine, prescribed to manage ADHD symptoms, can have sedative side effects that aid sleep.
- Hypnotics and Sedatives: These are sometimes used for short-term support in adults but are not commonly recommended for children.
Melatonin and other medications should only be used when deemed necessary by a specialist and as part of a comprehensive treatment plan. For children, addressing underlying ADHD symptoms and implementing robust sleep routines remain the first steps to improving sleep. With the right guidance and support, both children and adults can achieve better, more restful nights.
Physical Aids for Better Sleep
Alongside natural remedies and, where necessary, medication, physical aids like light projectors, weighted blankets, and other tools can play a crucial role in creating a more relaxing and sleep-friendly environment and encourage a smoother transition between wakefulness and rest:
- Sunset and Sunrise Simulators: These devices gradually dim the light in the evening and brighten it in the morning, mimicking natural light cycles to support a healthy sleep-wake rhythm.
- Light Projectors: These devices cast gentle, calming patterns of light onto the ceiling or walls, such as waves or starry skies. The rhythmic movement of the lights can help focus and quiet the mind, making it easier for individuals with ADHD to relax and drift off to sleep.
- Weighted Blankets: The gentle pressure from weighted blankets can reduce restlessness and promote a sense of calm, making it easier to relax and fall asleep.
- White Noise Machines: Consistent background noise can block out distractions and help individuals with ADHD stay asleep through the night.
- Blackout Curtains: Blocking external light creates a dark and soothing environment conducive to deeper sleep.
When to Seek Professional Help for ADHD Sleep Problems
While many sleep challenges associated with ADHD can be managed with practical strategies, there are times when professional support becomes essential. Chronic sleep problems not only affect rest but can also worsen ADHD symptoms, impacting daily life, mood, and overall health.
Recognising the Signs of Severe Sleep Disruption
It’s important to know when sleep issues go beyond occasional difficulties and require expert intervention. Consider seeking professional help if you or your loved one experience:
- Persistent Sleep Disturbances: Frequent night-time awakenings, chronic difficulty falling asleep, or severe restlessness that disrupts sleep regularly.
- Daytime Fatigue Despite Adequate Sleep: Feeling excessively tired or unable to focus, even after what seems like a full night of rest.
- Signs of Co-occurring Sleep Disorders: Symptoms such as loud snoring, gasping for air, or other signs of sleep apnoea, as well as recurring sleep paralysis or vivid, distressing dreams.
- Significant Impacts on Daily Life: If sleep problems are interfering with work, school, relationships, or overall mental health, it’s time to consult a professional.
- Physical or Emotional Symptoms: Headaches, irritability, heightened anxiety, or depressive symptoms linked to sleep deprivation may signal the need for additional support.
A healthcare professional can assess the root causes of the sleep disruption, such as ADHD-related behaviours, co-occurring conditions like anxiety or sleep apnoea, or even medication side effects. They may recommend a tailored treatment plan that could include behavioural strategies, therapy, or medical interventions to address the specific issues.
By seeking help when needed, individuals with ADHD can improve their sleep quality, manage symptoms more effectively, and enhance their overall wellbeing.
CBT for ADHD Sleep Disorders
Cognitive Behavioural Therapy for Insomnia (CBT-I) has demonstrated effectiveness in treating sleep disturbances among individuals with ADHD. A study published in BMC Psychiatry evaluated a group-based CBT-I intervention tailored for adults with ADHD and found significant improvements in insomnia severity post-treatment, with benefits maintained at a three-month follow-up [8].
Additionally, the Sleep Intervention as Symptom Treatment for ADHD (SIESTA) study protocol outlines a blended CBT approach aimed at adolescents with ADHD. This intervention focuses on sleep hygiene and cognitive restructuring to address sleep problems prevalent in this population [9].
These findings suggest that CBT-I can be a valuable component in managing sleep disturbances associated with ADHD, offering a non-pharmacological approach to improve sleep quality and overall functioning.
Conclusion
Sleep issues and ADHD often go hand-in-hand, creating a cycle that impacts rest, focus, and overall wellbeing. From difficulty falling asleep to fragmented nights and persistent fatigue, the challenges can feel overwhelming—but they don’t have to be permanent. By understanding the unique relationship between ADHD and sleep, and by using tailored strategies and professional support, it is possible to improve sleep quality and enjoy the benefits of more restful nights.
At Oxford CBT, we offer help for individuals with ADHD to address their sleep challenges through evidence-based approaches like Cognitive Behavioural Therapy (CBT). CBT is highly effective in treating insomnia and other sleep issues by targeting the behaviours, thoughts, and emotional patterns that disrupt sleep. Whether it’s creating a structured sleep routine, managing racing thoughts, or addressing anxiety around bedtime, our trained therapists work with you to develop personalised solutions that fit your lifestyle and needs.
We also offer private ADHD assessments, which may be helpful if a diagnosis will allow you or your child to access specialist sleep support services.
For children and adults alike, we offer tailored support that considers the unique challenges ADHD presents. Our experienced team is here to guide you every step of the way, helping you navigate sleep difficulties with compassion and expertise.
If you’re ready to take control of your sleep and improve your quality of life, Oxford CBT is here to help. Contact us today to learn more about our services and how we can support you in achieving better rest and overall wellbeing.
References
- Hvolby et al. (2009) Parental rating of sleep in children with attention deficit/hyperactivity disorder. European child & adolescent psychiatry. https://pubmed.ncbi.nlm.nih.gov/19205782/
- Bond et al. (2023) Sleep problems in children and adolescents in an attention deficit hyperactivity disorder service. Irish journal of psychological medicine.
- Ham et al. (2024) Sleep Problems in Adults With ADHD: Prevalences and Their Relationship With Psychiatric Comorbidity. Journal of attention disorders.
- Goraya et al. (2009) Sleep study abnormalities in children with attention deficit hyperactivity disorder. Pediatric neurology. https://pubmed.ncbi.nlm.nih.gov/19068253/
- O’Brien et al. (2003) Sleep and neurobehavioral characteristics of 5- to 7-year-old children with parentally reported symptoms of attention-deficit/hyperactivity disorder. Pediatrics. https://pubmed.ncbi.nlm.nih.gov/12612236/
- Rebecca Joy Stanborough, MFA (2022) ADHD-Related Brain Fog: Causes, Symptoms, and Treatment Options . healthline.com.https://www.healthline.com/health/adhd-brain-fog
- Silvestri et al. (2009) Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep medicine.
- Jernelöv, S., Larsson, Y., Llenas, M. et al. Effects and clinical feasibility of a behavioral treatment for sleep problems in adult attention deficit hyperactivity disorder (ADHD): a pragmatic within-group pilot evaluation. BMC Psychiatry 19, 226 (2019). https://doi.org/10.1186/s12888-019-2216-2
- Keuppens L, Marten F, Baeyens D, et alSleep IntervEntion as Symptom Treatment for ADHD (SIESTA)-Blended CBT sleep intervention to improve sleep, ADHD symptoms and related problems in adolescents with ADHD: Protocol for a randomised controlled trialBMJ Open 2023;13:e065355. doi: 10.1136/bmjopen-2022-065355. Available at: https://bmjopen.bmj.com/content/13/4/e065355?utm_source=chatgpt.com
Author – Tom Murfitt
With over a decade’s experience in providing Cognitive Behavioural Therapy, Tom has worked in both the NHS and private sector to help adults and children to overcome a range of difficulties and improve their mental wellbeing. In addition to being an experienced CBT therapist, Tom is also an accredited Mindfulness teacher, providing courses locally, in businesses and schools. You can read more about us here.
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