Sleep and the Neurodivergent Brain
Sleep challenges are nearly universal for neurodivergent adults. Whether it’s racing thoughts at bedtime, bursts of creative energy at night, or a nervous system that resists “shutting down,” these struggles often ripple through mood, concentration, work, and relationships. Importantly, these patterns are not signs of weakness or laziness—they are deeply tied to how the ADHD and autistic brain regulates arousal and rest.
The encouraging news? Recent research is offering both clarity and hope. Not only do we better understand why neurodivergent adults face these issues, but therapies such as Cognitive Behavioral Therapy for Insomnia (CBT-I) are showing strong effectiveness when adapted to these unique needs.
What the Latest Research Reveals
Higher insomnia vulnerability in ADHD ADHD is closely linked to circadian rhythm differences and heightened arousal, making sleep initiation particularly challenging. A 2025 study found that adults with ADHD, especially women and those with higher symptom severity, were significantly more prone to insomnia when under stress (Uygur et al., 2025).
A vicious cycle of exhaustion and attention struggles Insomnia exacerbates ADHD symptoms like distractibility, impulsivity, and emotional reactivity—and those same symptoms make it harder to maintain sleep routines. This creates a feedback loop: the more tired you are, the harder it is to regulate attention and emotion, which in turn worsens sleep.
Links with mood and mental health Insomnia in ADHD and autism is tightly connected to depression and anxiety (Demirkan et al., 2025). Sleep loss increases emotional lability, reduces resilience, and makes sensory regulation harder. For autistic adults, hyperarousal at night compounds the challenge, while in ADHD, late-night “second winds” collide with the body’s natural sleep signals.
Why Sleep Struggles Are Common in Adults
Circadian rhythm differences and evening chronotypes Many adults with ADHD or autism produce melatonin later than neurotypical peers. This “delayed sleep phase” makes it biologically difficult to fall asleep before midnight, even when exhausted. A 2024 study from the Netherlands Sleep Registry confirmed this delayed pattern in nearly 30% of ADHD adults (PMCID: PMC12273136). Evening-type chronotypes are significantly more prevalent in ADHD, which often conflicts with conventional work and school schedules (PMCID: PMC10784417).
Sensory sensitivity Autistic adults often describe how small discomforts—like light seeping through curtains or the feel of fabric—can prevent relaxation. While others filter these sensations out, the autistic brain often remains on high alert.
Executive function hurdles ADHD can make following through on sleep routines difficult, even with strong intentions. Hyperfocus may keep someone working late into the night, while fatigue in planning skills derails consistency.
The Role of Chronodisruption and Social Jetlag Beyond internal differences, environmental factors can compound sleep issues. Chronodisruption—disruption of natural circadian rhythms due to lifestyle or environmental cues—is a growing concern in modern life. For neurodivergent individuals, the impact is magnified. The phenomenon of social jetlag (misalignment between biological sleep-wake cycles and social obligations) can erode daily functioning and emotional resilience over time.
How Therapy Can Help
CBT-I as a gold standard Cognitive Behavioral Therapy for Insomnia is considered the first-line treatment for chronic insomnia in adults (Jernelöv, 2019). It is structured, skill-based, and often more effective than medication over the long term.
Adaptations for ADHD and autism A systematic review (Cullen et al., 2025) found CBT-I effective when tailored for neurodivergent populations. Adaptations include shorter modules, visual aids, reminders, and sensory accommodations. These small adjustments make CBT-I not only accessible but sustainable.
Group and peer approaches Pilot studies show that group-based CBT-I can also reduce insomnia in ADHD (Ishii, 2021). Sharing experiences helps normalize struggles and builds accountability.
Beyond “sleep hygiene” Generic advice like “no screens before bed” rarely works alone. Neurodivergent adults often need more structured experiments, therapeutic accountability, and personalized accommodations such as weighted blankets or circadian lighting.
Emerging options: ACT for Insomnia For some, Acceptance and Commitment Therapy (ACT) may be a useful alternative or complement to CBT-I. ACT emphasizes values-based behavioral flexibility and acceptance, rather than symptom control, and shows promise in promoting restful attitudes and consistent sleep behavior.
Practical Therapy-Infused Strategies
Sleep Education & Tracking Sleep diaries reveal patterns and provide concrete data. Many clients feel empowered seeing their progress visually mapped.
Stimulus Control Relearn to associate bed with rest. If awake for 20 minutes, step out and return only when drowsy.
Sleep Restriction (Building Pressure) Limiting time in bed to match actual sleep duration harnesses natural sleep drive and resets efficiency.
Cognitive Restructuring Replace catastrophic thoughts (“I’ll never fall asleep”) with compassionate alternatives (“Even partial rest restores me”).
Relaxation & Sensory Supports Incorporate weighted blankets, guided imagery, or dim lighting. These aren’t optional extras—they’re powerful therapeutic tools.
Relapse Prevention Plan for disruptions: travel, stress, or schedule shifts. Therapists help build routines that keep sleep stable during change.
Why This Matters for Neurodivergent Adults Without support, sleep difficulties can spiral into worsening mental health, higher sensory overwhelm, and reduced daily functioning. But with tailored therapy, rest becomes more accessible and restorative.
Therapy also helps process the shame many carry about “failing” at sleep. Reframing insomnia as a nervous system challenge—not a personal flaw—can be life-changing.
References Uygur, H., et al. (2025). Sleep reactivity, ADHD symptoms, and insomnia severity in adults with ADHD. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2024.1528979
Cullen, M., et al. (2025). Effectiveness of CBT-I in individuals with neurodevelopmental conditions: A systematic review. Journal of Sleep Research. https://pubmed.ncbi.nlm.nih.gov/40180888/
Jernelöv, S. (2019). Effects of ADHD-adapted CBT-I on adult insomnia: A randomized controlled trial. BMC Psychiatry, 19(1), 282. https://doi.org/10.1186/s12888-019-2216-2
Ishii, P. (2021). Group CBT-I pilot for adults with ADHD and insomnia. Frontiers in Psychiatry, 12, 10899906. https://pmc.ncbi.nlm.nih.gov/articles/PMC10899906/
Demirkan, A. K., et al. (2025). ADHD symptoms, sleep disturbances, and mood in students. BMJ Mental Health.
Netherlands Institute of Neuroscience (2024). Evening chronotypes in ADHD: Results from the Netherlands Sleep Registry. PMCID: PMC12273136
Parker, J. et al. (2024). Chronotype alignment and academic performance in ADHD students. PMCID: PMC10784417
University of Southampton & Netherlands Institute of Neuroscience (2025). Insomnia and reduced quality of life in adults with ADHD. BMJ Mental Health.
Contextual Consulting. (2024). ACT for insomnia: Emerging clinical applications. https://contextualconsulting.co.uk/mental-health/act-for-insomnia
