Sleep doesn’t always come easily for people with attention deficit hyperactivity disorder (ADHD). From an early age, many people with ADHD struggle to fall asleep, stay asleep, or feel rested upon waking. These problems are among the most common complaints, yet the reasons behind them remain puzzling. Even with years of research, the exact reasons behind the strong ties between ADHD and poor sleep remain unclear, especially when it comes to their long-term impact on mental and physical health.
ADHD and sleep: a complex relationship
Many people with ADHD tend to fall asleep and wake up later than others, but the reasons behind this pattern may be more complex than simply being a “night owl”. Recent research suggests that these delays in sleep timing may stem from difficulties falling asleep—one of the key symptoms of insomnia—rather than a true preference for staying up late. This highlights the importance of understanding not just how people with ADHD sleep but also why they experience specific sleep problems.
Sleep problems may also vary depending on the type of ADHD symptoms a person experiences. While inattention, hyperactivity, and impulsivity are all linked to insomnia, how these symptoms relate to sleep on a day-to-day basis can differ. For instance, in young people with more severe ADHD, a poor night’s sleep is often followed by more hyperactive behavior the next day. Interestingly, this isn’t the case for impulsivity, suggesting that lack of sleep may intensify hyperactivity, but doesn’t seem to have the same effect on impulsive behavior.
The link between ADHD symptoms and sleep doesn’t seem to go both ways. For people with ADHD, being more hyperactive or impulsive during the day doesn’t usually mean they’ll sleep worse that night. But in people with other mental health conditions, like depression or anxiety, those same behaviors can actually lead to poorer sleep. This suggests that the way sleep and symptoms affect each other may work differently in ADHD compared to other mental health problems.
Broader health implications
Sleep problems in ADHD not only impact mental health—they can also take a toll on physical health. Poor sleep is a well-known risk factor for cardiometabolic conditions that are common in people with ADHD. Recent findings from the TIMESPAN consortium confirm this link, showing that adults with ADHD are significantly more likely to develop a range of cardiometabolic conditions—including obesity, type 2 diabetes, and heart disease—compared to those without ADHD.
Recent research shows that physical health tends to be worse in people with ADHD who also struggle with sleep disorders. Poor sleep not only complicates management of ADHD symptoms but may also raise the risk of developing other health problems. For example, people with ADHD who have conditions like delayed sleep-phase disorder or obstructive sleep apnea are more likely to develop heart-related diseases compared to those with healthier sleep. This highlights that treating sleep problems in ADHD is important for both mental and physical well-being.
Looking ahead
As research continues to unravel the connections between ADHD, sleep, and overall health, it’s clear that sleep plays a critical role in the well-being of people with ADHD. By prioritizing sleep health in both research and clinical settings, we can move toward more effective interventions that address the full spectrum of challenges faced by those with ADHD.
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Article was provided by Dina Sarsembayeva and the UMCG team