ADHD +Insomnia: Delayed Sleep-Wake Phase and the Racing Brain at Night

If ADHD + insomnia feels like a brain that refuses to power down, you are not alone. Bedtime is often when focus runs out and the mind turns loud. This is not always "bad habits". ADHD and sleep problems can fuel each other in a loop.[3,4]

In this article, you'll learn:

• Why ADHD and sleep problems are bidirectional, not a character flaw

• What delayed sleep-wake phase looks like and why it shows up in ADHD

• Rule-outs that get missed, including restless legs and sleep apnea

• What clinicians track to separate insomnia from circadian delay

• Supports that help, including CBT-I and circadian rhythm strategies

🧠 Key takeaway: When sleep is off, ADHD symptoms usually get louder, and when ADHD is louder, sleep is harder to protect.[3,4]

The ADHD-sleep loop: why ADHD insomnia is not "just poor habits"

Poor sleep worsens inattention and impulsivity, and ADHD makes sleep harder

Sleep supports attention, inhibition, and emotional balance. When sleep is short or fragmented, most people become more distractible and reactive.[3] Those are already hard domains for ADHD brains, so poor sleep tends to magnify the daytime struggle.[3]

ADHD traits also make it easier for nights to unravel. Shifting attention, estimating time, and initiating routines can be hard. Quiet nighttime can invite scrolling or planning spirals that delay sleep.[4]

💡 Key takeaway: The goal is not more willpower. It is changing the conditions that keep the ADHD brain online at night.[4]

Common patterns: bedtime procrastination, "second wind," nighttime hyperfocus

Common patterns include:

• Bedtime procrastination: Difficulty initiating the steps of going to bed.

• Second wind: Feeling tired earlier, then alert late in the evening.

• Nighttime hyperfocus: Getting absorbed and noticing the clock much later.

Practical example: A student plans to wind down at 11. At 10:45, they start "just one thing" for tomorrow, fall into a research rabbit hole, and it is 1:30. The next day is rushed, caffeine increases, and bedtime shifts later again.

How common are sleep problems in ADHD?

Many children exceed sleep-problem thresholds (rates vary by informant and measure)

Parent and self-report studies consistently find more bedtime resistance, sleep-onset difficulties, and daytime sleepiness in youth with ADHD than in peers.[1] Objective measures like actigraphy and polysomnography sometimes show smaller or mixed differences, which is a reminder that the definition of "sleep problem" depends on the tool.[2]

Circadian delay and delayed sleep-wake patterns are frequently reported in ADHD

ADHD is often linked with an evening chronotype and later sleep timing.[5,6] In adults with ADHD, insomnia symptoms are also commonly reported in population studies.[14]

⏰ Key takeaway: In ADHD, sleep issues are not only insomnia symptoms. Timing problems, like circadian delay, are often part of the picture.[7]

Why delayed sleep-wake phase shows up so often

Night-owl rhythm plus difficulty initiating shutdown

Delayed Sleep-Wake Phase Disorder (DSWPD) is a circadian pattern where the natural sleep window is shifted later. People may sleep adequately when allowed to follow their preferred schedule, but struggle when required to fall asleep and wake earlier for school or work.[7]

ADHD can add extra friction. Eveningness is more common in adults with ADHD and higher ADHD traits.[5,6] And many people describe high pre-sleep cognitive arousal, like racing thoughts and mental replay. Research suggests pre-sleep arousal may help explain sleep initiation problems in relation to ADHD traits.[4]

🌙 Key takeaway: A delayed clock plus a racing brain can look like insomnia, but the best plan depends on which piece is leading.[4,7]

Morning impairment: sleep inertia, lateness, missed obligations

When you are forced to wake during your biological night, mornings can feel heavy. People often report strong sleep inertia and repeated lateness, which can snowball into stress and bedtime anxiety.[7]

Practical example: An adult falls asleep at 2:00 a.m. on weekends and wakes at 10:00 a.m. feeling okay. On weekdays, they try to sleep at 11:00 p.m., lie awake for hours, then wake at 6:30 a.m. exhausted. This can be a timing problem, not only insomnia.[7]

Rule-outs that commonly get missed

Restless legs, PLMs, sleep apnea, and parasomnias

A few conditions can mimic or worsen ADHD symptoms:

• Restless legs syndrome (RLS): An urge to move the legs, worse at night, that delays sleep. RLS co-occurs with ADHD more than expected by chance.[10]

• Periodic limb movements in sleep (PLMS): Polysomnographic studies suggest children with ADHD are more likely than controls to have PLMS.[9]

• Sleep-disordered breathing and obstructive sleep apnea: Sleep-disordered breathing is associated with ADHD symptoms in children, so screening matters.[8]

• Parasomnias: Sleepwalking or night terrors can disrupt sleep and raise safety concerns.[7]

🔎 Key takeaway: Rule-outs protect your time and your health. Treating the wrong problem can keep you stuck.[8,10]

Anxiety, depression, caffeine, alcohol or cannabis, and medication timing

Mood and anxiety conditions can raise pre-sleep arousal.[4] Caffeine, alcohol, and cannabis can also complicate sleep quality and sleep timing, so clinicians usually ask about timing and amount.

Medication timing matters too. In youth, stimulant medications are associated with longer sleep latency and shorter sleep duration on average, so clinicians often monitor sleep and coordinate adjustments with the prescriber.[11]

What a clinician will want to know (and what to track)

Sleep diary basics

A one to two week sleep diary helps identify whether this is mostly insomnia, mostly circadian delay, or both.[7] Track:

• Bedtime and lights-out time

• Estimated sleep onset time

• Night awakenings

• Wake time and out-of-bed time

• Naps

• Caffeine timing

• Alcohol or cannabis use

• Medication timing

• Screen use timing in the last hour

If you want a structured start, you can pair a diary with brief screeners like the Adult ADHD Self-Report Scale (ASRS) screener and the mental health screening tools.

"Red flag" symptoms that warrant sleep medicine evaluation

Consider a sleep medicine evaluation if you notice:

• Loud snoring, gasping, or witnessed breathing pauses[8]

• Severe daytime sleepiness or drowsy driving risk[7]

• Sleep behaviors with injury risk[7]

• Urge to move the legs that reliably delays sleep[10]

If you are unsure whether ADHD, insomnia, circadian delay, or a mix is driving the problem, a comprehensive evaluation can clarify next steps. ScienceWorks offers psychological assessments.

🩺 Key takeaway: Tracking turns "I never sleep" into patterns a clinician can treat.[7,12]

Supports that help (high-level, individualized, non-prescriptive)

Anchored wake time, light exposure, wind-down routine, screen boundaries

Many plans focus on a few levers:

• A more consistent wake time to stabilize circadian cues[7]

• Morning light exposure and dimmer evenings to support circadian rhythm alignment[7]

• Screen boundaries that limit hyperfocus triggers late at night[7]

For follow-through, executive function coaching can help build routines that match ADHD brains.

Evidence-based options: CBT-I, circadian interventions, med adjustments with a prescriber

If insomnia is prominent, CBT-I is a structured behavioral treatment that targets the behaviors and thought patterns that keep insomnia going.[12] CBT-I can be adapted for ADHD by simplifying steps, adding external supports, and planning for consistency.[12]

If circadian delay is prominent, clinical guidelines support circadian-based treatments for DSWPD, with timing and individual factors guiding what is appropriate.[7] Some studies in adults with ADHD suggest that morning bright light can advance circadian timing and may relate to symptom improvement, though this is individualized and best guided clinically.[13]

✅ Key takeaway: CBT-I helps when insomnia is the driver. Circadian supports help when timing is the driver. Many people need a blended plan.[7,12]

If you are in Tennessee and want support that integrates ADHD skills with sleep treatment, ScienceWorks offers specialized therapy and evidence-based insomnia services, including CBT-I for insomnia. You can also request a free consultation to talk through fit and options, including online therapy across Tennessee.

Clearing up common misconceptions

Misconception 1: "If I just go to bed earlier, I will fix it"

For delayed sleep-wake patterns, an earlier bedtime can increase time awake in bed and frustration. Addressing circadian timing is often more effective.[7]

Misconception 2: "It is always the stimulant medication"

Sleep changes can happen with stimulants, but sleep problems in ADHD also occur without medication. Other drivers like circadian delay or sleep disorders may be leading.[7,11]

Misconception 3: "Racing thoughts means I am doing sleep wrong"

Racing thoughts are a form of pre-sleep cognitive arousal. For many people with ADHD traits, the brain stays active when demands drop. This pattern can improve with targeted strategies.[4,12]

Conclusion

ADHD insomnia often sits at the intersection of arousal, timing, and executive functioning. When you can name the pattern, whether it is sleep-onset insomnia, delayed sleep-wake phase, a racing brain, or a rule-out like restless legs or sleep apnea, you can choose supports that match the problem.[7,8,10,12]

References

1. Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Psychiatry. 2009. 48(9):894-908. https://doi.org/10.1097/CHI.0b013e3181ac09c9

2. De Crescenzo F, Armando M, Mazzone L, Ciliberto M, Sciannamea M, Figueroa C, et al. The use of actigraphy in the monitoring of sleep and activity in ADHD: a meta-analysis. Sleep Med Rev. 2016. 26:9-20. https://doi.org/10.1016/j.smrv.2015.04.002

3. Lowe CJ, Safati A, Hall PA. The neurocognitive consequences of sleep restriction: a meta-analytic review. Neurosci Biobehav Rev. 2017. 80:586-604. https://doi.org/10.1016/j.neubiorev.2017.07.010

4. Smullen D, Kolodny T, Bagshaw AP, Mevorach C, et al. Pre-sleep arousal as a possible mechanism driving sleep problems in relation to ADHD traits. Sci Rep. 2025. 15:24554. https://doi.org/10.1038/s41598-025-09866-3

5. Baird AL, Coogan AN, Siddiqui A, Donev RM, Thome J. Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels. Mol Psychiatry. 2012. 17(10):988-995. https://doi.org/10.1038/mp.2011.149

6. McGowan NM, Voinescu BI, Coogan AN. Sleep quality, chronotype and social jetlag differentially associate with symptoms of attention deficit hyperactivity disorder in adults. Chronobiol Int. 2016. 33(8):988-996. https://doi.org/10.1080/07420528.2016.1208214

7. Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM, et al. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder, delayed sleep-wake phase disorder, non-24-hour sleep-wake rhythm disorder, and irregular sleep-wake rhythm disorder. J Clin Sleep Med. 2015. 11(10):1199-1236. https://doi.org/10.5664/jcsm.5100

8. Sedky K, Bennett DS, Carvalho KS. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev. 2014. 18(4):349-356. https://doi.org/10.1016/j.smrv.2013.12.003

9. Sadeh A, Pergamin L, Bar-Haim Y. Sleep in children with attention-deficit hyperactivity disorder: a meta-analysis of polysomnographic studies. Sleep Med Rev. 2006. 10(6):381-398. https://doi.org/10.1016/j.smrv.2006.03.004

10. Migueis DP, Lopes MC, Casella E, Soares PV, Soster L, Spruyt K. Attention deficit hyperactivity disorder and restless leg syndrome across the lifespan: a systematic review and meta-analysis. Sleep Med Rev. 2023. 69:101770. https://doi.org/10.1016/j.smrv.2023.101770

11. Kidwell KM, Van Dyk TR, Lundahl A, Nelson TD. Stimulant medications and sleep for youth with ADHD: a meta-analysis. Pediatrics. 2015. 136(6):1144-1153. https://doi.org/10.1542/peds.2015-1708

12. Jernelöv S, Larsson Y, Llenas M, Nasri B, Kaldo V. Effects and clinical feasibility of a behavioral treatment for sleep problems in adult attention deficit hyperactivity disorder (ADHD): a pragmatic within-group pilot evaluation. BMC Psychiatry. 2019. 19(1):226. https://doi.org/10.1186/s12888-019-2216-2

13. Fargason RE, Hollar D, Schmidt MH, et al. Correcting delayed circadian phase with bright light therapy predicts improvement in attention-deficit/hyperactivity disorder symptoms: a pilot study. J Psychiatr Res. 2017. 91:105-110. https://doi.org/10.1016/j.jpsychires.2017.03.004

14. Wynchank D, Ten Have M, Bijlenga D, Penninx BW, Beekman AT, Lamers F, et al. The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study. J Clin Sleep Med. 2018. 14(3):349-357. https://doi.org/10.5664/jcsm.6976

About ScienceWorks

ScienceWorks is led by Dr. Kiesa Kelly - a clinical psychologist. She provides specialized therapy and psychological assessment services for adults, adolescents, and children, including evaluations for ADHD and related concerns.

Her approach emphasizes evidence-based care and practical skills that help clients translate insight into daily routines. At ScienceWorks, she supports clients who are navigating attention challenges, anxiety, and sleep-related concerns, with a focus on realistic, sustainable change.

Disclaimer

This article is for informational purposes only and does not constitute medical or mental health advice. If you have symptoms of a sleep disorder or are concerned about your safety, talk with a qualified clinician or seek urgent care.