ADHD and sleep problems in adults
Very common: up to 8 in 10. Studies find insomnia in 43 to 80% of adults with ADHD. But for many, the problem isn’t bedtime habits. Their body clock runs late, which changes the fix.
On this page
Is poor sleep part of ADHD?
Very often. Three studies found insomnia in 43 to 80% of adults with ADHD. In the general public it’s 31 to 56%.
Insomnia here means you’re unhappy with how much or how well you sleep. A review also puts a late body clock at 73 to 78% of children and adults with ADHD.
| Problem | How common with ADHD | What it feels like |
|---|---|---|
| Insomnia | 43 to 80% in three studies | Hard to get to sleep or stay asleep, then tired in the day. |
| Late body clock (delayed sleep phase) | 73 to 78%, children and adults | Sleep starts late and ends late. |
| Sleep loss from ADHD medicine | In trials, 11% on slow release methylphenidate and 10 to 19% on lisdexamfetamine | Trouble sleeping that started with the medicine. |
Sources: Wynchank 2017; Bijlenga 2019; Van Veen 2010; NHS
Poor sleep can blur focus on its own. The NHS lists finding it hard to concentrate as an insomnia symptom.
Start a sleep diary to see which row fits you.
Why can’t I fall asleep with ADHD?
For many, it’s timing. In a study of 40 adults with ADHD, those who struggled to drop off started and ended sleep later. Their melatonin, the hormone that rises before sleep, also rose later.
That’s a late body clock. It’s like your body lives in a time zone to the west of your watch.
At 11pm your watch says bed, but your body isn’t ready. So going to bed earlier may just mean lying awake longer. The NHS says to only go to bed when you’re sleepy.
| Your nights | Could be | Next step |
|---|---|---|
| Sleep starts late and ends late | Late body clock | Fixed wake time. Morning light may help. |
| Lie awake or wake in the night, tired in the day | Insomnia | NHS sleep habits, then CBT for insomnia (a talking therapy) from a GP. |
| Trouble began with a new ADHD medicine or dose | Medicine side effect | Ask your prescriber about timing. |
| Loud snoring, gasping or choking in your sleep | Sleep apnoea | See a GP. |
| A strong urge to move your legs at night | Restless legs | See a GP. It can be linked to low iron. |
Sources: NHS insomnia; NHS sleep apnoea; NHS restless legs; NHS methylphenidate; Van Veen 2010
Restless legs? See blood tests for restless legs.
Can ADHD medicine cause sleep problems?
Yes, for some people. The NHS lists trouble sleeping as a common side effect of methylphenidate, in more than 1 in 100 people.
Its tip: if you can’t sleep, try taking the last dose more than 6 hours before bedtime. That advice is for methylphenidate. Ask your prescriber about other medicines.
NICE tells specialists to watch your sleep, for example with a sleep diary, and adjust the medicine to suit. So bring your diary to your review.
Never stop or change a prescribed medicine without your prescriber. If you stop methylphenidate suddenly, you may get withdrawal symptoms, such as depression.
How to sleep better with ADHD
Six NHS sleep habits to start this week
- Get up at the same time every day, even after a bad night.
- Only go to bed when you’re sleepy.
- Have no tea, coffee or alcohol for at least 6 hours before bed.
- Relax for at least 1 hour before bed, for example with a bath or a book.
- Keep your bedroom dark and quiet, and put screens away before bed.
- Don’t nap during the day.
Sources: NHS insomnia; NHS ADHD in adults
Morning light may help a late clock.
One small pilot had no comparison group. In it, 30 minutes in front of a bright light box each morning for 2 weeks moved the body clock 31 minutes earlier. Bigger shifts were linked to fewer ADHD symptoms.
It didn’t add sleep time in the people tracked. More on using daylight in our body clock guide.
Melatonin is prescription only in the UK. In one trial it moved the body clock earlier, but sleep times didn’t follow. The researchers said coaching on habits was needed too.
Habits not enough? A GP may offer CBT for insomnia, a talking therapy that changes the thoughts and habits that keep you awake. See how CBT for insomnia works.
Why am I tired all the time with ADHD?
Start with your sleep. Adults need 7 to 9 hours on average. The NHS says you probably aren’t getting enough if you’re constantly tired in the day.
Better sleep may help your ADHD too. In 92 adults with ADHD and insomnia, those whose insomnia cleared had a bigger fall in ADHD symptoms over 6 months. That study can’t prove one caused the other.
Also think about sleep apnoea, where breathing stops and starts in your sleep. It can leave you very tired and make it hard to concentrate.
What a GP may do about poor sleep
- 1
Find the cause
Asks what’s keeping you awake.
- 2
CBT for insomnia
Face to face, or an online self-help course.
- 3
Sleep clinic
If you have signs of sleep apnoea or another sleep disorder.
- 4
Sleeping pills, rarely
For a few days, or weeks at most, if insomnia is very bad and other treatments haven’t worked.
Source: NHS insomnia
Still tired after a full night? See still tired after sleep and sleep apnoea and blood tests.
When to speak to a GP
Book an appointment if:
- Changing your sleep habits hasn’t helped, or you’ve had trouble sleeping for months.
- Poor sleep makes daily life hard to cope with.
- Your breathing stops and starts, or you gasp or choke in your sleep, or you always feel very tired in the day.
- Restless legs are stopping you sleep.
- Your sleep got worse on ADHD medicine. Tell your prescriber.
On methylphenidate, call 999 or go to A&E if you have chest pains, fits, signs of a stroke or thoughts about harming yourself or others.
Call 999 if your lips, mouth, throat or tongue suddenly swell or you struggle to breathe.
Not diagnosed yet? If ADHD signs affect your work, studies or relationships, the NHS says to see a GP. See ADHD signs and blood tests.