By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS
Sleep is essential for well-being, yet for many autistic adults, achieving restful, consistent sleep can feel impossible. Sleep disturbances are one of the most commonly reported challenges for autistic individuals, and when ADHD is also present—often referred to as AuDHD—these difficulties become even more complex. Understanding the underlying mechanisms behind sleep struggles and implementing neurodivergent-friendly strategies can help improve sleep quality in ways that align with the unique neurological wiring of autistic and AuDHD adults.
Why Is Sleep So Difficult for Autistic Adults?
Research has consistently found that autistic individuals are significantly more likely to experience sleep disturbances than the general population. In fact, studies suggest that 50–80% of autistic individuals struggle with sleep-related issues, compared to 20–30% of neurotypical individuals (Richdale & Schreck, 2009; Cohen et al., 2014). These sleep challenges can manifest as:
Difficulty falling asleep (delayed sleep onset)
Frequent nighttime awakenings
Irregular sleep-wake cycles
Insomnia and hypersensitivity to sleep environments
Daytime fatigue despite sleeping for a full night
The Polyvagal Perspective: Chronic Fight-or-Flight and Sleep
From a Polyvagal Theory (PVT) perspective, one of the main contributors to poor sleep in autistic individuals is the dysregulation of the autonomic nervous system (Porges, 2011). Many autistic adults experience chronic hyperarousal—a persistent activation of the sympathetic nervous system (the “fight-or-flight” state). When the nervous system is in this heightened state, it becomes difficult to transition into the parasympathetic “rest-and-digest” mode, which is essential for sleep onset and maintenance.
Autistic individuals are often highly sensitive to sensory input, which can keep the nervous system on high alert. Sensory processing differences—such as sensitivity to noise, temperature, or even the texture of bedding—can further contribute to hyperarousal at bedtime (Tzischinsky et al., 2018). Even if an autistic person manages to fall asleep, their nervous system may remain easily startled, leading to fragmented sleep.
The Added Complexity of AuDHD: Sleep Disruptions on Overdrive
When ADHD is also present, sleep difficulties can become even more pronounced. Research shows that individuals with ADHD are significantly more likely to experience Delayed Sleep Phase Syndrome (DSPS), a condition in which the body's internal clock is shifted later, making it difficult to fall asleep at a conventional time (Gamble et al., 2013). This is because ADHD brains tend to produce lower levels of melatonin at night, further delaying sleep onset (Van der Heijden et al., 2005).
In addition to melatonin imbalances, AuDHD adults often experience:
Hyperfocus cycles that extend past bedtime (getting stuck in tasks or special interests)
Dysregulated dopamine levels that make sleep less appealing than stimulating activities
Difficulty recognizing internal cues for tiredness (interoception challenges common in both autism and ADHD)
Rejection Sensitivity Dysphoria (RSD)-related ruminations that keep the mind racing
This combination of autonomic dysregulation from autism and dopaminergic dysfunction from ADHD results in a perfect storm for sleep disruption.
Neurodivergent-Friendly Tips for Better Sleep
Rather than trying to “fix” sleep struggles with rigid sleep hygiene rules designed for neurotypicals, it’s important to work with the neurodivergent brain and nervous system to create a sleep routine that is regulating, not stressful. Here are some evidence-based, neurodivergent-friendly approaches to improving sleep:
1. Create a Polyvagal-Informed Bedtime Routine
Since many autistic adults struggle with nervous system hyperarousal, engaging in regulating activities before bed can help signal safety to the body. Instead of simply “relaxing,” focus on co-regulation and sensory comfort:
✔ Weighted blankets to activate the parasympathetic nervous system
✔ Slow, rhythmic movements (rocking, stretching, or swaying)
✔ Soft, predictable background noise (brown noise or ASMR, rather than complete silence)
✔ Breathwork focused on exhaling longer than inhaling to engage the vagus nerve
These strategies help shift the nervous system out of a sympathetic fight-or-flight state and into ventral vagal regulation, making sleep more accessible.
2. Embrace a Non-Traditional Sleep Schedule
Many autistic and AuDHD adults feel guilty about having an “off” sleep schedule that doesn’t match societal norms. But research shows that forcing oneself into a conventional 9-to-5 sleep schedule can actually backfire, especially for those with Delayed Sleep Phase Syndrome (Barclay & Gregory, 2013).
Instead of trying to sleep at a neurotypical time, consider:
✔ Adjusting work or school hours (if possible) to accommodate natural sleep rhythms
✔ Taking naps strategically instead of forcing full nights of sleep
✔ Gradual bedtime shifts in 15-minute increments rather than forcing an unrealistic schedule change
3. Reduce Dopamine-Seeking at Night (Without Frustration)
Since ADHD brains are dopamine-seeking machines, the temptation to engage in high-stimulation activities before bed (e.g., scrolling on social media, gaming, deep-diving into special interests) is strong. Rather than trying to eliminate these behaviors, work on gradually reducing stimulation intensity before bed:
✔ Use blue-light-blocking glasses rather than eliminating screens entirely
✔ Slowly transition from high-stimulation activities to lower ones (e.g., from gaming to reading about gaming)
✔ Engage in “dopamine bridging”—give the brain a less stimulating but still interesting activity to transition into sleep mode
4. Address Rumination and Overthinking Before Bed
For AuDHD adults, rumination and overthinking can keep the brain too activated for sleep. Cognitive Behavioral Therapy (CBT) techniques, combined with Polyvagal Theory (PVT) regulation strategies, can help manage bedtime anxiety:
✔ Try a “brain dump” journal before bed to externalize racing thoughts
✔ Use self-talk reframes: "I don’t need to solve this tonight"
✔ Engage in progressive muscle relaxation to reduce hyperarousal
Final Thoughts: Honoring Your Neurodivergent Sleep Needs
Autistic and AuDHD adults often struggle with sleep due to a combination of autonomic dysregulation, sensory sensitivities, and ADHD-related sleep phase delays. Instead of trying to force neurotypical sleep hygiene rules, it's more effective to honor the neurodivergent nervous system with Polyvagal-informed and dopamine-conscious strategies.
By working with your nervous system instead of against it, you can build a sleep routine that feels supportive, not stressful—and that’s the key to unlocking truly restful sleep.
References
Barclay, N. L., & Gregory, A. M. (2013). Quantitative genetic research on sleep: A review of normal and pathological sleep phenotypes. Sleep Medicine, 14(5), 391-398.
Cohen, S., Conduit, R., Lockley, S. W., Rajaratnam, S. M., & Cornish, K. M. (2014). The relationship between sleep and autism spectrum disorder. Neuroscience & Biobehavioral Reviews, 47, 10-22.
Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation.
Richdale, A. L., & Schreck, K. A. (2009). Sleep problems in autism spectrum disorders. Research in Autism Spectrum Disorders, 3(3), 101-111.
Comments