Insomnia and Neurodivergence: What to Know

Sleep problems cut across neurotypes. If you live with ADHD, autism, OCD, anxiety, or trauma—and especially if more than one applies—you’re statistically more likely to wrestle with nights that are too long, too short, or simply too alert. When it’s chronic, insomnia and neurodivergence can feed each other: a wired mind at night, foggy days, and a bed that feels like anything but a cue for sleep (1, 2).

This article is a practical, science‑informed guide to help you sort patterns, spot red flags, and plan next steps. You’ll learn what’s universal about insomnia, what’s unique in ADHD and autism, where circadian timing fits in, and how CBT‑I and related therapies are adapted at ScienceWorks—so you can decide whether it’s time to book a sleep consultation with Ryan Robertson.

💤 Key Takeaway: CBT‑I (cognitive behavioral therapy for insomnia) is the first‑line treatment for chronic insomnia in adults and works well even when anxiety, trauma, OCD, ADHD, or autism are part of the picture (1, 3, 4).

Insomnia and Neurodivergence: A Universal Human Experience

Occasional bad nights are normal—stress, travel, illness, or a crying baby can derail sleep. Insomnia disorder becomes likely when difficulty falling asleep, staying asleep, or waking too early persists ≥3 nights/week for ≥3 months, causes daytime impairment, and occurs despite adequate opportunity to sleep (5, 6). If you snore loudly, stop breathing at night, have uncomfortable “need to move” sensations in your legs, or feel excessively sleepy during the day, a medical sleep evaluation is also important.

🧭 Key Takeaway: If poor sleep is chronic and impairing, it’s time for structured help—starting with a thorough insomnia assessment and a brief trial of CBT‑I strategies (3, 5).

When should you seek further evaluation?

• You’ve had sleep trouble most nights for 3 months or longer (5).

• You feel sleepy when driving or at work/school.

• Your bed has become a place of frustration rather than a cue for sleep—classic conditioning that CBT‑I reverses (1, 7, 8).

• You suspect a circadian rhythm sleep‑wake disorder (e.g., a very late body clock) or symptoms of sleep apnea or restless legs (5).

• Nightmares or trauma memories are a factor—effective options exist such as Imagery Rehearsal Therapy (IRT), often combined with CBT‑I (9, 10).

🕯️ Key Takeaway: Nightmares are treatable; IRT reduces nightmare frequency and improves sleep quality, and can be paired with CBT‑I when needed (9, 10).

What Makes Insomnia in Neurodivergence Unique?

While insomnia follows the same diagnostic rules across neurotypes, certain maintaining mechanisms are more common in ADHD and autism:

• Hyperarousal and safety behaviors: Worry about sleep can drive counter‑productive coping—extra time in bed, long naps, clock‑watching, seeking reassurance—that keeps insomnia going (7, 11, 12).

• Executive function friction: Initiating bedtime, task‑switching from engaging activities, and “closing the tabs” can be harder—especially when the brain finally feels focused at night.

• Circadian delay: Many folks have a naturally late chronotype (the “night‑owl” pattern). In ADHD, delayed melatonin onset and delayed sleep‑wake phase are common (13, 14).

• Sensory sensitivity: In autism, tactile or auditory hypersensitivity can amplify bedtime discomfort and awakenings (15, 16).

• Co‑occurring conditions: Anxiety, OCD (including sleep‑focused OCD), trauma, and medical issues can all complicate the picture and should be addressed in parallel (3, 9).

🧠 Key Takeaway: Effective care targets the right mechanism—bed–sleep conditioning, circadian timing, executive‑function barriers, sensory load, anxiety/OCD, or trauma—often in combination.

Understanding Insomnia and ADHD

Recurring patterns we see clinically and in research:

• Bedtime initiation delays (a.k.a. “revenge bedtime procrastination”): reduced self‑regulation late in the day → scrolling, gaming, or hyperfocus past bedtime (17, 18).

• Late body clock vs. insomnia: many ADHDers have delayed DLMO (melatonin onset), making it easier to fall asleep later; this is a circadian issue that needs light/behavioral timing, not just sleep hygiene (13, 14).

• After‑hours hyperfocus: difficulty task‑switching from preferred activities, leading to inconsistent sleep windows and conditioned alertness in bed.

• Variable wake times and napping undermining sleep drive; CBT‑I’s sleep restriction consolidates sleep and stabilizes timing (1, 8, 19).

• Safety behaviors like waking to check the clock or “trying harder to sleep,” which ironically make sleep less likely (7, 11).

• What helps: A tailored blend of stimulus control (re‑pair bed with sleep), sleep‑window consolidation, consistent out‑of‑bed anchor time, morning bright‑light exposure, and small exec‑function supports (timers, shutdown routines, app blockers). Chronotherapy trials show that timed low‑dose melatonin and morning bright light can advance circadian timing in ADHD (13, 20).

⏰ Key Takeaway: A consistent wake‑time anchor beats a perfect bedtime. Protect morning light, limit evening light, and let your sleep drive rebuild.

Understanding Insomnia and Autism

Common, converging patterns:

• Sensory load at night: tactile, auditory, or temperature sensitivities make the bed/environment feel “too much,” increasing awakenings (15, 16).

• Difficulty with transitions: shifting from stimulating evening routines to sleep may require predictable, low‑demand steps and longer wind‑down.

• High rates of insomnia and other sleep issues across the lifespan; insomnia often co‑occurs with anxiety or medical concerns (2).

• Conditioned arousal in bed: especially when the bed is used for screens/activation; stimulus control helps rebuild the bed‑sleep link (7).

• Circadian contributions: some autistic adults also show delayed sleep timing; circadian assessment can prevent mislabeling night‑owl patterns as “insomnia.”

• What helps: sensory‑friendly adjustments (weighted or breathable bedding as clinically appropriate, sound dampening, predictable cues), scaffolded routines, circadian‑aware timing, and standard CBT‑I components adapted for communication preferences and processing speed (3, 7, 15, 16).

🎧 Key Takeaway: For autistic sleepers, optimize the sensory environment first, then add CBT‑I tools—both matter.

Next Steps

1) Get individualized guidance. If this feels familiar, start with a targeted consult to map your pattern and pick the smallest effective changes. You can work with Ryan Robertson, TLPC‑MHSP, NCC (adults, teens, couples, families) or explore Therapy at ScienceWorks to find the best fit.

2) What CBT‑I looks like at ScienceWorks. We use evidence‑based CBT‑I as a foundation and combine it, when indicated, with:

• Stimulus control (backed by decades of research) to recondition the bed as a cue for sleep only (7).

• Sleep‑window consolidation (sleep restriction therapy) to rebuild sleep drive and enhance continuity—carefully titrated and monitored (1, 8).

• Circadian alignment via morning light and evening light management; when appropriate, we coordinate with your medical provider on timed melatonin for delayed schedules (13, 20).

• Executive‑function supports that make plans doable: shutdown rituals, environmental prompts, and Executive Function Coaching for skill‑building.

• Co‑occurring care: When OCD or trauma contribute, we integrate OCD treatment approaches (ERP or I‑CBT) and trauma therapies; for persistent nightmares, we add Imagery Rehearsal Therapy. Learn more about our Trauma treatment and how it interfaces with sleep care (9, 10).

• Measurement‑based care using sleep diaries or actigraphy to track progress and adjust—paired with options for Psychological Assessments when diagnostic clarity would help.

  
  

3) Ready to take action?

• Book a sleep consultation with Ryan to review your sleep diary, clarify ADHD/autism‑related barriers, and outline a week‑by‑week plan.

• Prefer to start general and decide later? Use Contact to schedule a free consultation and explore fit.

🧩 Key Takeaway: Sustainable sleep change comes from matching tools to mechanisms—conditioning, circadian, executive‑function, sensory, and co‑occurring factors—then iterating with data.

About the Author

Kiesa Kelly, PhD, HSP is a licensed clinical psychologist and Chief Clinical Officer at ScienceWorks Behavioral Healthcare. She specializes in compassionate, affirming care for OCD, trauma, insomnia, and autistic & ADHD neurotypes, with advanced training in CBT‑I, EMDR, ERP, and I‑CBT. (See Kiesa Kelly, PhD.)

A former university professor with a neuropsychology concentration, Dr. Kelly brings measurement‑based care and practical science to every treatment plan—helping clients match methods to mechanisms for sustainable change.

Disclaimer

This article is for educational purposes only and does not constitute medical advice. Sleep and mental health conditions vary; individual results may differ. Consult a qualified clinician for personalized recommendations.

References and Citations

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