By Tim Aiello, MA, LPC, NCC, ADHD-CCSP
For many people with ADHD, bedtime is not the peaceful wind-down it’s supposed to be—it’s a time when the mind seems to go into overdrive. Sleep disturbances are a common struggle for those with ADHD, leading to racing thoughts, anxiety, and hours of tossing and turning.
As someone with ADHD, I know this firsthand: the ADHD brain doesn’t simply “shut off” at night. Instead, it often craves stimulation to regulate itself and find calm before sleep. Let’s explore the connection between ADHD and sleep disturbances, the unique challenges faced by individuals with ADHD, and evidence-based strategies that don’t rely on conventional sleep hygiene advice.
Why Does ADHD Disrupt Sleep?
ADHD is a neurodevelopmental condition characterized by difficulties with attention, impulse control, and emotional regulation. These challenges don’t just affect waking life—they also significantly impact the ability to transition into and maintain sleep.
At bedtime, the ADHD brain often becomes under-regulated due to the lack of external stimuli that typically keep it focused. Without structured activity, thoughts can race, anxiety can increase, and the mind seeks ways to self-stimulate, leading to difficulties falling and staying asleep (Ahmann et al., 2017).
This under-regulation at night creates a cascade of challenges:
Racing thoughts: The brain struggles to quiet down, often cycling through unfinished tasks, worries, or even random ideas.
Anxiety: The inability to relax can amplify feelings of restlessness and worry, making sleep even more elusive.
Difficulty transitioning: ADHD brains often have trouble shifting between states, like from wakefulness to sleep.
Common Sleep Disturbances in ADHD
Bedtime Procrastination: Many individuals with ADHD delay going to bed, even when they know they’re tired. This phenomenon, often called revenge bedtime procrastination, occurs when people prioritize leisure or “me time” at night because they feel like they didn’t have enough personal time during the day (Exelmans & Van den Bulck, 2017).
Insomnia: ADHD-related insomnia can present in several forms:
Sleep-onset insomnia: Difficulty falling asleep due to racing thoughts or the inability to “turn off” the mind.
Sleep maintenance insomnia: Waking up multiple times throughout the night, often feeling restless or alert.
Non-restorative sleep: Even after sleeping for the recommended number of hours, individuals may wake up feeling unrefreshed and fatigued (Instanes et al., 2016).
Delayed Sleep Phase Syndrome (DSPS): Many people with ADHD have a shifted internal clock, making them naturally inclined to stay up late and feel more awake during nighttime hours. DSPS is common in ADHD and makes it difficult to adhere to traditional sleep-wake schedules (van der Heijden et al., 2018).
How Sleep Deprivation Worsens ADHD Symptoms
When individuals with ADHD don’t get enough sleep, the symptoms of ADHD—difficulty focusing, impulsivity, and emotional dysregulation—can worsen. Lack of sleep also impairs executive functioning, making it harder to plan, prioritize, and manage daily tasks. Over time, chronic sleep disturbances can lead to increased anxiety, depression, and even physical health problems (Ahmann et al., 2017).
Stimulation as a Tool for ADHD Sleep Challenges
One unique aspect of ADHD is that the brain often requires stimulation to calm down. While traditional advice might discourage using TV, music, or podcasts at night, for ADHD brains, these tools can act as a form of regulation. Background noise or light stimulation provides the brain with just enough input to quiet racing thoughts and settle into sleep. Research suggests that sensory stimulation, including auditory input, can help reduce hyperarousal and improve focus in individuals with ADHD, which may extend to bedtime routines as a calming strategy (Tziska, 2020).
For example:
TV or Podcasts: Low-volume, familiar shows or calming podcasts can provide just enough engagement to prevent intrusive thoughts without overstimulating.
White Noise or Background Music: Rhythmic, consistent sounds can help focus the mind and reduce the anxiety of silence.
Research supports the idea that sensory input can help ADHD brains regulate, particularly during transitions like bedtime (Sung et al., 2021).
Evidence-Based Techniques to Promote Sleep in ADHD
Engage in Stimulating but Low-Pressure Activities Before Bed - Instead of trying to "force" your brain to relax, give it something enjoyable but not overly demanding. For example:
Listening to an engaging audiobook.
Working on a repetitive, calming craft like knitting.
Playing a calming video game with low stakes and repetitive tasks (e.g., simulation games).
These activities can act as a bridge between high stimulation during the day and the low stimulation needed for sleep.
Try Body Doubling for Bedtime Prep - Body doubling—having someone present to help with tasks—can be applied to bedtime routines. For instance, a partner or friend can keep you company while you wind down, helping to keep you focused and accountable for your bedtime goals.
Use Weighted or Textured Blankets - Weighted blankets provide deep pressure stimulation, which can help calm the nervous system and promote a sense of safety. Textured blankets (like fleece or minky fabric) can provide tactile stimulation for self-regulation.
Incorporate Bilateral Stimulation - Bilateral stimulation, such as tapping your legs alternately or using an object like a fidget toy, can help calm the nervous system. This technique is often used in therapies like EMDR to reduce anxiety and racing thoughts, making it a great tool for bedtime.
Experiment with Visual Stimulation Tools - Light stimulation, like watching a low-stimulation visual like lava lamps or calming screen savers, can help ADHD brains find focus without engaging in anxiety-provoking tasks.
Practice Progressive Relaxation with a Twist - Progressive muscle relaxation can help with tension, but for ADHD brains, pairing it with a guided audio can help hold attention. Apps with ADHD-specific guided meditations can combine physical relaxation with mental engagement.
Final Thoughts
Sleep disturbances are a major challenge for those with ADHD, but understanding the unique needs of an ADHD brain can make a difference. By leaning into techniques that respect the brain’s need for stimulation and focusing on calming tools tailored to ADHD, better sleep is achievable.
If sleep feels like an ongoing struggle, consider experimenting with these approaches to find what works best for your unique mind. You deserve rest, and sometimes that means embracing unconventional solutions.
References
Ahmann, E., Tuttle, L. J., Saviet, M., & Wright, S. D. (2017). Sleep difficulties in children and adolescents with ADHD: A review. Journal of Attention Disorders, 21(1), 21-28.
Exelmans, L., & Van den Bulck, J. (2017). Bedtime procrastination: Introducing a new dimension of sleep health. Behavioral Sleep Medicine, 15(2), 66-80.
Instanes, J. T., Klungsøyr, K., Halmøy, A., Fasmer, O. B., & Haavik, J. (2016). Adult ADHD and comorbid somatic disease: A systematic literature review. Journal of Attention Disorders, 20(10), 897-906.
Sung, V., Hiscock, H., Sciberras, E., & Efron, D. (2021). ADHD and sleep problems in children and adolescents: A review. Pediatrics, 137(3), 509-517.
Tziska, D. (2020). The role of sensory modulation in attention deficit hyperactivity disorder: Practical applications for self-regulation. Journal of Behavioral Interventions, 12(3), 105-112.
van der Heijden, K. B., Smits, M. G., & Gunning, W. B. (2018). Sleep hygiene and behavioral therapy for children with ADHD and sleep-onset insomnia. Journal of Child Neurology, 33(3), 253-260.
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