Restless Minds: How ADHD Impacts Sleep and What to Do

Why ADHD and Sleep Are So Deeply Connected

ADHD and sleep are locked in a complex relationship affecting up to 70% of children with ADHD. If your child lies in bed with racing thoughts, struggles to fall asleep, or wakes up exhausted, you’re not imagining it—and it’s not your fault.

Here’s what you need to know about ADHD and sleep:

• It’s bidirectional: Poor sleep worsens ADHD symptoms, and ADHD makes it harder to sleep.
• It’s neurobiological: The ADHD brain struggles with the two key processes that regulate sleep (sleep pressure and circadian rhythm).
• It’s treatable: Targeted, brain-based interventions work far better than basic “sleep hygiene” advice.
• It’s common: Children with ADHD often sleep less and wake more than their peers.

For families living with ADHD, the exhausting cycle of a racing mind at night isn’t a character flaw or bad parenting—it’s a neurobiological difference.

The good news is that when we understand why this happens, we can break the cycle. Improving sleep doesn’t just help your child rest; it can reduce ADHD symptoms, improve focus and emotional regulation, and bring peace to your family.

I’m Dr. Roseann Capanna-Hodge, and for over 30 years, I’ve helped families with ADHD and sleep challenges using science-backed, brain-first approaches. In this guide, I’ll share what research tells us about ADHD and sleep and the practical strategies that help families move from “tired but wired” to truly rested.

The Vicious Cycle of ADHD and Sleep: Why It Happens and How to Break It

We had this sweet little kid once, Elfie, a bright 5-year-old who took hours to fall asleep, then woke before sunrise. For her, bedtime became battles, and preschool days were fidgety and tearful. After an ADHD diagnosis, it finally made sense—this was brain-based, not bad behavior—and the family could act.

When your child can’t sleep night after night, it’s easy to wonder if you’re doing something wrong. Here’s the truth: this isn’t about effort or willpower. ADHD and sleep challenges stem from neurobiological differences that create a stubborn loop. You’re not alone—and understanding the “why” is the first step toward calming the brain and restoring real rest.

The Science Behind the Struggle: Sleep Processes and the ADHD Brain

Sleep is regulated by two key processes: Process S (sleep pressure), which builds the longer you’re awake, and Process C (circadian rhythm), your internal 24-hour clock. In the ADHD brain, these processes are often out of sync.

The circadian rhythm frequently runs late, a neurobiological difference known as delayed sleep phase syndrome. This makes many with ADHD natural “night owls,” as their brains aren’t ready for sleep when the rest of the household is winding down.

Several external factors can also disrupt sleep:

• Stimulant medications can be a paradox. While they can delay sleep onset for some, for others, they calm the racing thoughts that prevent sleep. Finding the right timing and dosage with your doctor is crucial.
• Caffeine can fuel an already racing mind, disrupting the natural buildup of sleep pressure and pushing bedtime later.
• Daytime napping can backfire by reducing nighttime sleep pressure, making it even harder for an ADHD brain to fall asleep.

This interplay of neurobiology and external factors means that these challenges require a targeted approach, not generic advice (Wajszilber et al., 2018).

Beyond Bedtime Battles: How Poor Sleep Worsens ADHD Symptoms

When sleep is disrupted, it’s not just about feeling groggy. For those with ADHD, poor sleep amplifies every symptom. Executive functions like planning, focus, and emotional control become even more impaired.

• Attention and Memory: Even one night of poor sleep makes it harder to sustain attention and impacts working memory. This affects everything from following instructions to remembering homework.
• Emotional Regulation: Lack of sleep worsens irritability and moodiness. For children with ADHD, this can lead to explosive outbursts and heightened frustration, creating a stressful cycle for the whole family.
• Hyperactivity: Surprisingly, sleep deprivation in children can increase hyperactivity—a paradoxical response as the brain tries to stay awake. What looks like worsening ADHD is often severe sleep deprivation in disguise.

Research shows children with ADHD and sleep issues sleep 30-60 minutes less per night and wake more often, leading to impaired academic performance (Ruiz-Herrera et al., 2021) and higher family stress.

Remember: behavior is communication. When your child is melting down or bouncing off the walls late at night, they might be signaling severe sleep deprivation, not defiance.

Why ‘Sleep Hygiene’ Isn’t Enough for ADHD and sleep Issues

If you’ve tried all the standard sleep advice—dark rooms, regular schedules, no screens—and are still facing bedtime battles, you haven’t failed. The problem is that basic sleep hygiene alone is often insufficient for the ADHD brain.

While these principles are a good starting point, the ADHD brain is wired differently. It craves novelty and struggles with the consistency that sleep hygiene demands. A racing mind won’t magically quiet down just because the lights are dimmed.

Furthermore, the ADHD brain’s challenges with executive functions make it difficult to initiate and maintain sleep routines. Basic sleep hygiene doesn’t address core neurobiological issues like a delayed circadian rhythm or the mental restlessness that is a hallmark of ADHD.

When standard advice fails, it leads to frustration for both parents and children. This is why ADHD and sleep issues require a more targeted, structured, and compassionate approach that works with the brain’s differences, not against them.

The Gold Standard Solution for ADHD and sleep: Cognitive Behavioral Therapy for Insomnia (CBT-I)

When basic advice isn’t enough, Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold-standard treatment. It’s not just talk therapy; it’s a structured, evidence-based program that addresses the thoughts and behaviors that perpetuate sleeplessness, making it highly effective for ADHD and sleep challenges.

CBT-I provides tools to quiet a racing mind, break unhelpful habits, and realign the body’s internal clock. Its core components include:

• Stimulus Control: Re-associating the bed with sleep, not wakefulness.
• Sleep Restriction: Temporarily limiting time in bed to build sleep pressure.
• Cognitive Restructuring: Challenging negative thoughts and worries about sleep.
• Relaxation Training: Using techniques to calm the body and mind.
• Sleep Hygiene Education: Providing customized, foundational sleep advice.

Worried your child can’t handle traditional therapy? You’re not alone. Effective CBT-I for ADHD must be adapted. At Dr. Roseann, our programs use shorter, more frequent virtual sessions and digital tools to support executive functions and maintain engagement. This accessible, brain-based approach empowers families to take control of their sleep, leading to restful nights and calmer, more focused days.

Dr. Roseann’s Therapist Tip

In my 30+ years of clinical practice, I’ve learned that most sleep problems in kids with ADHD aren’t ‘willful’—they’re rooted in a nervous system that has trouble shifting out of high alert.

What I tell parents:

Create a predictable wind-down routine that signals to the brain it’s safe to slow down—dim lights, lower noise, and guide your child through a simple, rhythmic activity like drawing, stretching, or reading.

Try this today:

Pick one calming cue (a soft lamp, a weighted blanket, or slow breathing) and use it consistently for three nights in a row.

Why it works:

These sensory-based signals help the brain transition into parasympathetic mode, making it easier to fall asleep and stay asleep.

Remember: Your child isn’t fighting sleep—they’re fighting a dysregulated brain. Slow the body first, and the mind will follow.

Practical, Brain-Based Strategies to Improve Sleep

Beyond CBT-I, several practical strategies can significantly improve ADHD and sleep by calming the brain and regulating the body’s rhythms.

• Reset the Internal Clock: Actively manage your child’s circadian rhythm. The most powerful tools are a consistent wake-up time (even on weekends) and morning light exposure within the first hour of waking. This anchors the internal clock and signals that the day has begun. In the evening, reducing bright light exposure helps the natural rise of melatonin.
• Consider Melatonin Carefully: Research shows melatonin can help children with ADHD fall asleep faster and sleep longer. However, it’s not a sedative; it’s a timing hormone. Always consult a healthcare professional to determine the right dose and timing for your child.
• Use Behavioral Interventions: Evidence shows that for children with ADHD, behavioral interventions effectively reduce sleep disturbances and can even decrease ADHD symptoms (Larsson et al., 2023). These strategies empower parents with tools for consistent routines, managing resistance, and teaching calming techniques.
• Try Weighted Blankets: For some children, the deep pressure from a weighted blanket can be very soothing, helping to calm a restless body and mind before sleep.

At our center, our brain-based ADHD programs integrate these strategies into comprehensive plans. Available in Ridgefield CT, throughout Connecticut, and worldwide, we focus on root causes to deliver rapid, effective results. Let’s calm the brain first, and restful sleep will follow.