Does ADHD Cause Insomnia? (Science-Backed Answer)

Not only is insomnia more common in people with ADHD, but sleep problems can also mimic or exacerbate ADHD symptoms, leading to a vicious cycle (1).

In general, insomnia is more common in adults, and that appears to apply to those with ADHD as well.

We’re going to look at a summary of current research on ADHD and insomnia in this short post to understand it better.

Research on ADHD and Insomnia

There are a few studies that have looked at if sleep problems are more common in those with ADHD.

Let’s start by looking at children with this disorder.

A study of just under 11,000 Australian preschool children found that (2):

Children with moderate or severe sleep problems were 12.06 times more likely to have diagnoses of attention-deficit disorder and ADHD and had significantly more conduct and emotional problems and inappropriate behaviors

While that’s only a single study, it certainly does look like ADHD puts even children at higher risk of developing insomnia symptoms.

Another longitudinal analysis used data from the UK-based Twin Study in order to see how ADHD and sleep quality are linked as children age (3).

The results are shown in the graph below. People with a remitted ADHD diagnosis had no significant difference in sleep problems than the general population. However, children with persistent ADHD diagnoses and people with late-onset ADHD both experienced more sleep problems.

The researchers attributed most of this risk increase to psychiatric comorbidities that are common in those with ADHD.

One final study looked more closely at children with ADHD and sleep problems and found a few interesting things (4):

• Sleep problems were temporary for most subjects, but persistent for about 10% of children with ADHD
• Greater ADHD symptom severity correlated to higher risk of persistent sleep problems
• The best predictor of sleep problems in these children were comorbidities with other clinical disorders (e.g. anxiety, depression, etc.) that are common with ADHD

SummaryMost research does suggest that people with ADHD are more likely to experience insomnia. This applies to both children and adults. However, if ADHD symptoms decline or even remit, the sleep problems associated with them also appear to remit.

Why Does ADHD Cause Insomnia Symptoms?

We won’t spend much time on this because it’s such a nuanced topic.

But long story short is that there are many possible mechanisms that explain how ADHD and insomnia may occur in someone, and it’s still not fully known how common each cause is.

The diagram from one analysis shows why it’s so hard to get to the bottom of this (5):

ADHD might directly cause sleep problems, or sleep problems may trigger ADHD (or similar) symptoms.

Alternatively, a common underlying condition could cause both types of issues, or comorbidities could cause a negative cycle making ADHD and sleep problems worse.

Finally, there’s also evidence that insomnia can be a side effect of certain medications that are often used to treat ADHD like adderall, amphetamine salts, or dasotraline (6).

SummaryIn short, there are many ways that ADHD can lead to sleep problems and insomnia to some degree. Genetics, comorbidities, and even medication can all play a role.

How Is Insomnia in ADHD Patients Treated?

Ultimately, insomnia in ADHD patients should be treated by a doctor. It’s important to identify the most likely causes of the problems to be treated.

In general, normal treatments like sleep hygiene education and cognitive behavioral therapy are still options that are often prescribed.

One study found that using sleep hygiene and melatonin in children with ADHD and initial insomnia was helpful (7):

The effect size of the combined sleep hygiene and melatonin intervention from baseline to 90 days' posttrial was 1.7, with a mean decrease in initial insomnia of 60 minutes. However, the researchers noted that the improved sleep quality had no significant effect on ADHD symptoms.

Another study looking at just using melatonin in children with ADHD and insomnia found similar results (8).

Finally, there is ongoing research into alternative treatment methods. One of the most promising ones is using weighted blankets.

A randomized study had patients use a weighted blanket for 4 weeks and found (9):

Weighted chain blankets are an effective and safe intervention for insomnia in patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, or attention deficit hyperactivity disorder, also improving daytime symptoms and levels of activity.

Treatments like weighted blankets that are relatively well-accepted and have low risk of side effects are ideal. Even though they won’t be fully effective in all people with ADHD, it’s an easy and relatively cheap thing to try.

References

1. Sleep problems and their effect in ADHD
2. Adverse associations of sleep problems in Australian preschoolers: national population study
3. ADHD and Sleep Quality: Longitudinal Analyses From Childhood to Early Adulthood in a Twin Cohort
4. A prospective study of sleep problems in children with ADHD
5. Associations of sleep disturbance with ADHD: implications for treatment
6. Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia
7. Sleep Hygiene and Melatonin Treatment for Children and Adolescents With ADHD and Initial Insomnia
8. Effect of Melatonin on Sleep, Behavior, and Cognition in ADHD and Chronic Sleep-Onset Insomnia
9. A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders