It is 1 a.m. You were tired at 9 p.m., yawning through the last episode of a show, and now you are wide awake replaying a conversation from Tuesday. If you are an adult with ADHD, this probably sounds familiar. Trouble sleeping is one of the most common complaints among adults with ADHD, and it is rarely a matter of willpower.
How Common Are Sleep Problems in Adults With ADHD?
Sleep problems can be fairly common for anyone struggling with ADHD in their adult life. A large-scale study of adults with ADHD, published in the Journal of Attention Disorders and summarized by CHADD, found that 60% reported some type of sleep disorder. More than a third (36%) had trouble falling asleep, 31% reported insomnia, and 29% reported restless leg syndrome or periodic limb movement disorder.
Adults with ADHD can go years without hearing about all of this. Lying awake is not just a bad habit you picked up. For a lot of people with ADHD, it is part of how the condition shows up.
Why Can You Not Switch Your Brain Off at Night?
There is no single reason. Most adults with ADHD are dealing with a mix of the following, and which one weighs most can change from week to week.
Your Body Clock May Run Late
Your circadian rhythm, often called your body clock, is the internal clock that tells your body when to feel sleepy. In many adults with ADHD, that clock appears to run late. In a 2010 study in Biological Psychiatry, researchers found that 31 of 40 adults with ADHD (about 78%) had chronic sleep-onset insomnia. For this group of individuals, the evening rise in melatonin – the hormone that signals that it is time to sleep – came about later than we see in people without ADHD.
When this pattern is strong and persistent, clinicians may call it delayed sleep phase. In plain terms, your body is not ready to sleep at 11 p.m., even if your alarm still goes off at 7 a.m.
A Busy Mind That Stays Switched On
During the daytime, work, errands, and conversations keep your attention pulled in a dozen directions. At night, all of that goes quiet, and the thoughts you held back come flooding in: plans for tomorrow, something you forgot to reply to, or an idea that suddenly feels urgent.
This state of mental alertness at the wrong time is often described as overstimulation. Your body may be tired, but your brain is still running at daytime speed, and lying still in the dark only gives it more room.
Revenge Bedtime Procrastination
This is a popular name for a very real habit: staying up late on purpose, scrolling or watching or reading, because it is the only part of the day that feels like yours. For adults with ADHD, whose days often feel spent on catching up, that quiet stretch after everyone else has gone to bed can be hard to give up.
The trouble is that the time comes straight out of your sleep, and the fatigue the next day makes it even harder to stay on top of things. So the cycle repeats.
Other Sleep Disorders
The 29% figure for restless legs and limb movement disorders is a reminder that not every sleep problem in ADHD is about the mind. Some are physical. Uncomfortable sensations in the legs at night, kicking during sleep, or waking up unrefreshed no matter how long you slept are all symptoms worth bringing up with a doctor, because they need their own assessment. Our post on what causes restless leg syndrome explains more.
Does ADHD Medication Cause Insomnia?
It can. Stimulant medicines are designed to increase alertness, and trouble sleeping is a commonly reported side effect. For some adults, this is one of the reasons sleep gets worse after starting treatment.
At the same time, untreated ADHD can disrupt sleep on its own, so medication is not always the cause. If you think yours is keeping you up, do not change how or when you take it by yourself. Bring it up with your prescriber, who can look at the full picture of your medication management and decide whether anything about your plan should change. Our guide on how to know if your ADHD medication is working covers what else to consider.
How Poor Sleep Makes ADHD Harder
Sleep and ADHD feed into each other. A short night makes it harder for anyone to concentrate, manage emotions or keep track of details, and for adults with ADHD those are the areas already under strain. You may find that a bad night makes the next day feel twice as scattered, which then makes it harder to wind down the following evening.
Lack of sleep can affect mood too. Our post on whether lack of sleep causes anxiety looks at how poor sleep and anxious thoughts can keep each other going.
What Can Help You Fall Asleep With ADHD
There is no perfect routine, and advice that works for one person can feel impossible for another. Still, a few changes help many adults with ADHD.
Keep the same wake time. A fixed wake time, even on weekends, gives your body clock something steady to set itself by. It tends to matter more than the time you go to bed.
Get daylight early. Natural light in the morning is one of the main signals your body clock uses. A short walk outside or breakfast by a window can help shift a late routine earlier over time.
Give your thoughts somewhere to go. If your mind races at night, keep a notepad by the bed and write down whatever comes up. It sounds small, but it tells your brain the thought has been saved and does not need to be held onto.
Make the wind-down easier to start than to skip. Leave your phone charging outside the bedroom, or set it to stop notifications at a fixed hour, such as the “Do Not Disturb” or “Sleep” mode. The goal is to remove the decision, because decisions at midnight rarely go well.
Ask about therapy for insomnia. Cognitive behavioral therapy for insomnia, often called CBT-I, is a structured approach to changing the habits and thoughts that keep you awake. The American College of Physicians recommends it as the first treatment for chronic insomnia in adults. Ask your therapist whether it, or CBT techniques more broadly, could be part of your plan.
Before trying melatonin or any over-the-counter sleep aid, check with your prescriber, especially if you already take ADHD medication.
When to Talk to Someone
It is worth getting help if sleep problems have lasted for weeks, if you are struggling to function during the day, or if you have never been assessed for ADHD and wonder whether it explains a lifetime of late nights. A clinician can look at how ADHD, sleep, mood, and any medication fit together, instead of treating each one as a separate problem.
If you are having thoughts of suicide, please do not wait for an appointment. Call or text 988 to reach the Suicide and Crisis Lifeline, or call 911 in an emergency.
Adult ADHD Care in Illinois at BNBA
BNBA offers ADHD testing and treatment, therapy, and medication management for adults 18 and older in Illinois, with locations in Chicago and Decatur. Appointments are available by telehealth across the state, and in person at offices that offer it. The Chicago office is virtual only.
If sleep is one of the reasons you are looking for help, mention it when you book, so your clinician can factor it into your evaluation or treatment plan. You can read more about ADHD services at BNBA, call (508) 979-5557, or request an appointment online.
Frequently Asked Questions
Why Is It So Hard to Sleep With ADHD?
For many adults with ADHD, the body clock runs later than usual, the mind stays active at night, and bedtime keeps getting pushed back for some quiet time alone. Medication and other sleep disorders can also play a part.
Does ADHD Medication Cause Insomnia?
It can. Trouble sleeping is a commonly reported side effect of stimulant medication. Untreated ADHD can also disrupt sleep, so talk to your prescriber before changing anything about your medication.
How Can I Fall Asleep Faster With ADHD?
A fixed wake time, morning daylight, writing down racing thoughts, and keeping your phone out of the bedroom are all small daily fixes that help many adults. If insomnia has lasted a long time, ask your therapist about CBT for insomnia.
Can Treating ADHD Improve Sleep?
For some adults, yes. When ADHD symptoms are better managed, evenings can feel less chaotic as it is easier to wind down. Your clinician can help you track how sleep changes as treatment progresses.