If your teen or young adult has ADHD and bedtime is a constant battle, you’re not alone. Sleep difficulties are one of the most common, and most overlooked, parts of life with ADHD. Recent research suggests that sleep problems affect close to 70–80% of children and adults with ADHD.
Teenagers also need more sleep than adults, around 8–10 hours a night compared with 7–9 hours for adults. So when ADHD makes sleep harder, the gap between the sleep they need and the sleep they get can grow quickly.
Why is sleep harder with ADHD?
Like most things in this world, there isn’t one single cause for sleep struggles. For many teens and young adults with ADHD, it’s a mix of biology, behaviour and medication. However, there is usually one common pattern…
A delayed body clock.
The most common pattern is a delayed body clock. This means the signal that it’s time to sleep arrives later than it does for most people. A young person may not feel tired until late at night, however early they get into bed.
Behavioural contributors.
A few common patterns can push bedtime later:
- Procrastination, especially on tasks they’ve been avoiding all day
- Difficulty with transitions, such as moving from something enjoyable to winding down
- Hyperfocus on a preferred activity like gaming, scrolling, creating or studying, which makes it hard to stop
Physical and mental restlessness.
Even once they’re in bed, a busy mind or a restless body can make it hard to settle.
Medication timing and dosage.
ADHD medication can affect sleep depending on when it’s taken and the dose. If you suspect this is playing a part, speak with the prescribing doctor before making any changes.
Signs that sleep is affecting your teen or young adult
Not getting enough sleep affects everyone, but it can look especially like (or worsen) ADHD symptoms. Common signs include:
- Greater difficulty waking up and getting through morning routines
- Increased distractibility
- Reduced concentration and memory
- Emotional dysregulation
- Increased irritability
- Lower motivation
- Harder time with organisation and completing tasks
Because these overlap so much with ADHD itself, poor sleep can be easy to miss. Looking at sleep is often a helpful first step when daily routines, school, study or work feel harder than they should.
How occupational therapy can help
Occupational therapists look at how a person’s routines, environment and sensory needs affect everyday life, including sleep. Support is tailored to the young person, not a one-size-fits-all bedtime rule. An OT might help with:
- Transition strategies. Building practical ways to move from preferred activities to bedtime, so stopping feels more manageable.
- Sensory preferences. Identifying what helps the body and brain relax, such as dim lighting, calming movement, music or pressure-based sensory input.
- Evening routines that fit. Creating a wind-down routine that works with the young person’s natural patterns and the family’s lifestyle, so it’s realistic enough to stick.
- Morning routines. Problem-solving the barriers to getting up and out the door, especially when a delayed sleep pattern is part of the picture.
Next steps
If sleep is a struggle for your teen or young adult, you don’t have to figure it out alone. At OTHC Beyond, our occupational therapists support young people aged 15–25 to build routines and strategies that work for them.
Get in touch with OTHC Beyond to find out how we can help
This article is general information only and isn’t a substitute for medical advice. If you’re concerned about sleep or medication, please speak with your GP or prescriber.
