Why Sleep Can Be So Hard for Teens With ADHD—and the Routines That May Help

From parents.com

Experts weigh in on why kids with ADHD sleep less and with more disruptions to their sleep cycle 

KEY TAKEAWAYS

• Teens with ADHD often struggle with sleep, which can affect their focus, emotions, and relationships.
• Poor sleep can make ADHD symptoms worse, like impulsivity, irritability, and trouble concentrating.
• A consistent bedtime routine and limiting evening screen time can help kids with ADHD sleep better.

As many as 2 out of every 3 high school students aren’t getting enough sleep. And kids with attention deficit hyperactivity disorder (ADHD) are even more likely to have challenges getting appropriate shut-eye.

In fact, a recent study found that kids with ADHD sleep less at night and have poorer sleep quality than their peers without ADHD. These sleep issues impact their executive functioning skills, academics, and relationships with others.

“Think about how you feel when you are tired or sleep-deprived,” says Mary Beth DeWitt, PhD, chief of child psychology at Dayton Children’s Hospital. “It is harder to concentrate, and stay focused and you may be more irritable. With kids, it may also exacerbate ADHD, so kids may be more hyperactive, impulsive, and may even show aggression or irritability.”

                                                                                                                            Credit:    Getty Images

What Researchers Discovered About Sleep and ADHD

In this recent study, the research team investigated sleep physiology in 62 teens ages 13 to 17. Thirty-one had ADHD and 31 had no psychiatric diagnoses.

“This study showed that adolescents with ADHD tend to spend less time each night in slow-wave deep sleep, which is the deepest stage of sleep, and more time in stage 2 sleep,” says Mirjam Quinn, PhD, a licensed clinical child and adolescent psychologist and owner of a group psychology practice in Chicago, who is not affiliated with the study. “Sleep specialists think that stage 2 sleep is when our brain organizes our memories and experiences of the day.”

Slow-wave deep sleep, by comparison, is the deepest sleep stage, she says. “Your body uses this sleep stage to repair injuries, and you need it for your immune system to work. Slow-wave deep sleep is so important for our bodies that, for most people, this sleep stage is frontloaded, meaning that a lot of it happens at the beginning of our sleep session.”

When your teen doesn’t get adequate deep sleep, they may wake up in the morning feeling exhausted even if they logged “enough” hours of sleep, says Dr. Quinn. “So if an adolescent with ADHD has a brain that is so busy that it continues zipping along even at night, causing them to spend a lot of time in the lighter stages of sleep, and not enough time in the deep sleep stage, they are more likely to go through their day feeling tired and like they haven’t had enough rest.”

Researchers know that lack of sleep can cause neurocognitive impairments, but they don’t know whether sleep problems can explain the executive functioning difficulties that kids with ADHD have, she says. “But if their brain isn’t getting the rest and reset it needs at night, existing difficulties will be amplified.”

How Does This Change in Sleep Affect Kids With ADHD?

When teens don’t get enough sleep, it’s like their prefrontal cortex doesn’t have enough “juice” to fully show up and engage in executive functioning to the fullest of its ability, says Dr. Quinn. “So then [things like their] working memory, processing speed, emotion regulation, attention and concentration, and impulse inhibition—which are all things that a neurodivergent brain already has a harder time with anyway—start to suffer.”

In turn, this impacts their school life because it’s harder for them to tune out distractions and focus on their teacher, she adds. “It’s harder to inhibit the impulse to throw an eraser at your table mate instead of doing a worksheet; it’s harder to manage the frustration and boredom that go along with learning a new and difficult concept; and it’s harder to stay calm when your teacher does something that feels unfair.”

Lack of sleep will also make social interactions more difficult, she says. “It is harder to listen attentively to what your friend is saying—which requires working memory and attention—and it’s harder to stop doing something that you thought was funny but is making your friend mad (which requires impulse inhibition).”

To help make sense of this disruption kids experience when they miss sleep, Dr. Quinn suggests thinking about the last time you had a bad night’s sleep. “Chances are, you weren’t very productive at work that day, maybe forgot an appointment, and probably were cranky with your partner.”

Getting adequate sleep is critical, she says, because during deep sleep, the brain gets “washed” out by cerebrospinal fluid, which removes the toxic by-products of all the thinking and working it does during the day.

“I always think of sleep as a jolly man with a broom who comes through after a party and sweeps up all the confetti and cupcake wrappers,” she says. “If that jolly man doesn’t have enough time to do his work, there will be some [debris] left in the corner, and over time, that [debris] builds up and we start to trip over it.”

Are Sleep Disorders More Common With ADHD?

According to Dr. Quinn, people with ADHD have higher rates of insomnia, have longer sleep onset latency (meaning, it takes them longer to fall asleep), and wake up more frequently during the night.

They also spend less time in REM sleep, which they need for emotion regulation and consolidating memory, she says. And, they may experience reduced sleep efficiency, meaning that a lower percentage of the time spent in bed is spent sleeping rather than tossing and turning.

Overall, experts estimate that 25% to 50% of kids with ADHD may have sleep-related problems, adds Dr. DeWitt. “Some studies suggest as many as 3 in 4 kids with ADHD have sleep problems...Some have suggested that the brain function that contributes to ADHD may also contribute to sleep-related conditions, such as circadian rhythm.”

Why Sleep Issues May Occur

According to Emily Bly, PhD, a licensed clinical psychologist and the CEO and clinical director at Psychology Partners Group, the reasons for the increased risk of sleep disorders could be multiple. “One is that neurobiology is at play. Levels of dopamine and norepinephrine differ for kids with ADHD and can often wreak havoc with sleep/wake cycles.”

A second common reason for sleep challenges relates to medication side effects, says Dr. Bly. “Stimulant medications are often challenging to regulate, particularly in the early phases where different medications may be in the trial period. Each child metabolizes ADHD medication slightly differently and it takes some time to adjust and become familiar with these patterns.”

Dr. Bly says for kids who metabolize these medications more slowly, their effect may be prolonged causing too much focus and alertness in the evening hours when parents want them to be winding down for bed.

“Also, it is common for there to be a ‘crash effect’ as medications leave the system leading to increased irritability and emotion regulation difficulties at night,” she says. “A third issue is the presence of co-occurring disorders like anxiety or depression for children with ADHD. These diagnoses can disrupt sleep onset or sleep maintenance and exacerbate the already challenging circumstances.”

How You Can Help Your Child With ADHD Sleep Better

According to Dr. DeWitt, behaviour change and a consistent sleep routine are the most effective ways to help your child sleep better. To further promote sleep and boost sleep efficiency, she also recommends:

• Limiting caffeine and electronics in the evening.
• Engaging in a predictable routine that involves quiet and calming activities.
• Allowing opportunities for your child to expend energy earlier in the evening, after school, or before dinner.
• Keeping sleep and wake times consistent across days and weeks.
• Using a white noise machine to assist with sleep onset associations.
• Getting help if things do not improve.

“These kiddos are sensitive to changes in routine so the more there is consistency in routines, the easier it will be for them to maintain a regular cadence,” says Dr. Bly. “If your child is struggling with sleep or any other related symptom, it is not your fault, and there is no glory in powering through.”

Sleep-oriented psychotherapy treatments for insomnia like CBT-I can do a lot to help get kids back on track with sleep and reduce volume levels to something that feels more manageable for kids and parents, she says.

https://www.parents.com/why-sleep-can-be-so-hard-for-teens-with-adhd-12032598

Could your teen’s phone habits be affecting their sleep and stress? Understanding the risks

From star-telegram.com

By Samantha Agate

Parents want to know how much their teenager’s phone is really disrupting sleep, mood and daily functioning. Experts on adolescent sleep and media use are pointing to specific ways screen time reshapes stress hormones, mental health and nightly routines. 

How Does Phone Use Affect Teen Sleep? 

Cellphone use before bed delays the natural drop in cortisol that teenagers need to fall asleep, according to Alice Hoagland, PhD, director of the Insomnia Clinic at the Rochester Regional Sleep Disorder Center.

“Cellphones will further delay an adolescent’s sleeping phase,” Hoagland said, per Rochester Regional Health. “The moment someone gets on a cellphone, they are essentially preventing their cortisol levels from naturally declining because they are becoming stimulated by the phone itself or the content on the phone.” A 2021 study also found teens who used social media more frequently had later bedtimes a year later, with problematic use linked to delayed sleep. Puberty already shifts melatonin release later in the day, so many teens do not feel tired until near midnight even though their bodies need about nine hours of sleep. 

What Is Problematic Media Use in Adolescents? 

Problematic media use is excessive or dysregulated screen use that starts interfering with a teen’s daily functioning, according to Sarah Domoff, assistant professor in the Department of Psychology at the University at Albany.

“Problematic media use includes excessive or dis-regulated use of screens, including social media or other forms of digital media such as gaming,” Domoff told Campus Insights Media. She said the behaviour crosses into concerning territory when it disrupts sleep, school performance or relationships. Design choices on many apps actively push teens to keep scrolling. “Even though someone only wanted to be on the phone for 15 minutes to watch one short video, all of a sudden, it’s 45-60 minutes later and they are still ‘going down the rabbit hole’ of watching videos,” Hoagland said.

Can Social Media Affect a Teen’s Mental Health? 

A 2025 CDC study of nearly 2,000 U.S. teenagers found those who logged four or more hours a day of recreational screen time were more likely to report anxiety and depression symptoms, poorer sleep and less physical activity than peers with lower screen use. 

The study also linked heavier non-schoolwork screen use to irregular sleep routines, weight concerns and weaker peer support. Domoff cautioned that the picture is not entirely negative. “It’s very complicated, the relationship between social media use and mental health,” she told Campus Insights Media. Positive engagement, like building connections or learning new skills, can benefit some youth, while social comparison and triggering content can worsen mental health concerns for others, she said.

 How Can Parents Talk to Teens About Phone Use? 

Start with curiosity rather than confrontation, Yann Poncin, MD, a child psychiatrist, told Yale Medicine. He suggested asking teens what they think, such as, “It seems like you’re on the phone so much that I don’t see you just doing homework like you used to do, so I’m just worried how healthy this is for you in terms of getting your stuff done. What do you think about that?”

Linda Mayes, MD, chair of the Yale Child Study Center, compared the approach to how families once handled TV. “Research showed that watching TV in and of itself wasn’t bad, but it began to have potentially negative effects on kids’ behaviour when it was used as a babysitter,” Mayes said. She recommended asking teens how social media is working for them rather than banning it outright, so they feel comfortable coming to a parent when something goes wrong. Hoagland offered a simple night-time fix. “Keep the phone away from the bedside is a good way of avoiding that situation,” she said.

https://www.star-telegram.com/entertainment/article316803194.html

What Is CBT-I? The Gold Standard Insomnia Treatment Doctors Recommend Before Sleep Medication

From amp.miamiherald.com

If you have ever spent hours staring at the ceiling wondering why sleep will not come, CBT-I may be the answer sleep specialists wish more people knew about. Short for cognitive behavioural therapy for insomnia, it is the first-line treatment for chronic sleep problems and increasingly the go-to method for millennials and Gen Z who are tired of relying on pills, gummies and wearables that never quite deliver on their promises.

Interest has surged thanks to books like Matt Walker’s “Why We Sleep,” the health-tracking boom and a growing awareness that sleep medications treat symptoms rather than causes. The American Academy of Sleep Medicine and the American College of Physicians both recommend CBT-I over pharmaceuticals for chronic insomnia, and the U.S. Department of Veterans Affairs calls it the gold standard for sleep disorder treatment.

           CBT-I is the gold standard for insomnia treatment. Thos Robinson

How CBT-I works

According to Stanford Medicine, CBT-I guides patients through a series of changes in sleep-related behaviours. It targets three factors that keep insomnia going. Those factors are conditioned arousal, ineffective habits people develop to try to sleep better and the sleep-related worry that builds up around bedtime itself.

The therapy has five components, which are sleep hygiene, relaxation and stress reduction, stimulus control therapy, sleep restriction and cognitive therapy. It was formally developed at the end of the 20th century, and in 2016 the American College of Physicians recommended it as the initial treatment for chronic insomnia in adults.

Dr. Meredith Broderick, a neurologist and board-certified sleep and behavioural sleep medicine specialist, told SELF that CBT-I addresses the unproductive behaviours people develop over time to cope with insomnia. That includes spending too long in bed, avoiding activities out of fear of not sleeping and resting excessively during the day.

Why it works better than most sleep medication

“It’s so successful because it’s considered to be a behavioral intervention,” Dr. Amoha Bajaj, a clinical and health psychologist, told SELF.

Rather than adding another product or ritual to a bedtime routine, CBT-I rewires how you think and feel about sleep. The tradeoff is effort. “CBT-I works. It’s one of the most studied, one of the most effective treatments in all of medicine, but I can’t do it for you. You have to do it,” Broderick told SELF.

The numbers make the case. According to Psychiatric Times, 70% to 80% of people who complete a course of CBT-I achieve a therapeutic response, and roughly 40% reach clinical remission. A course typically runs six to eight weekly sessions with no prolonged maintenance required. Meta-analytic data shows clinically significant effects at one year, and follow-up from a randomized controlled trial found persisting benefits after 10 years.

Research also links CBT-I to better mental health. In one study of patients with both depression and insomnia, people who received CBT-I saw as much improvement in their depression symptoms as those who received depression treatment directly.

CBT-I practices you can try tonight

You do not need to enroll in a formal program to borrow from the toolkit. A few of the most effective habits are worth trying on their own.

• Wake up at the same time every day. Consistency anchors the circadian rhythm and is essentially non-negotiable.
• Focus on a wind-down time rather than a bedtime. Do not force yourself into bed when you are not sleepy. Wind down earlier and let sleep come naturally.
• Schedule “worry time.” If anxious thoughts flood in at night, put dedicated time on your calendar during daylight hours to process them, when your brain has more capacity to handle stress.
• Be careful with sleep trackers. The rise of wearables has produced a new problem called orthosomnia, in which anxiety over achieving perfect sleep data actually creates insomnia.

Broderick also notes that many people seeking out CBT-I do not actually meet the clinical definition of chronic insomnia, which is difficulty falling or staying asleep at least three days a week for more than three months. For those who do qualify and commit to the full protocol, the payoff can outlast a lifetime of prescriptions.

This article was created by content specialists using various tools, including AI.

https://amp.miamiherald.com/living/article316775065.html 

Is ‘Always On’ Culture Ruining Your Health? What Happens to Your Body When You Don’t Take Time Off

From mensjournal.com

By Tom Ward

In a world obsessed with doing more, experts say downtime is the key to peak performance 

I’ve been feeling a bit burned out lately. In general, there’s just a lot going on. I’m not talking about what’s on the news, but in my career and life. I’m training for two half marathons while also trying to improve my bouldering. I’m busier than ever with work, which is great (*grimace face*), my weekends are fully booked up with other people’s weddings and birthdays, and on top of it all, my car’s about to give up the ghost. 

In Britain, we have a saying, ‘Keep calm and carry on’. I suppose the idea is to embrace stoicism. Stiff upper lip, and all that. To me, it sounds like a great way to have a heart attack, aneurysm, or both. Because, in a world that tells us we always need to be on, always need to be optimising, need to be earning and investing, getting up at 3 a.m. to work out, carving out time with our loved ones, studying and more, there’s very little time for you to, you know, sit with yourself and be happy.

I’m desperately in need of this. And maybe you are too, which is why I reached out to athletes, creatives, and experts to ask why burnout can feel inevitable, how it’s impacted them, and what we can all do about it.

Are We Doomed to Overwork?

Lewis Moses is an ultra runner and the director of Run Through coaching. As an athlete and a self-employed businessperson, he knows that it can be difficult to close the laptop at the end of the day. 

“It’s easy to stay glued to the desk and just keep going; there’s no natural cut-off point, so the days blur together,” he says.

Worryingly, Moses has found that overworking has been detrimental to his health.

“When you’re burned out, the first things to slip are training and your wellbeing,” he says. “I’ve been there. You stop thinking clearly and start reacting instead of leading.”

Occasionally, the stress of balancing two careers has been so much that Moses says he’s been forced to stop and rethink how his week was structured. That extra run he was squeezing in was helping because his head was stuck on emails. And that extra hour at the desk wasn’t making him more productive, just more tired. 

The Spillover Effect of Constant Stress

It’s something I can relate to; checking emails at 11 p.m. isn’t getting a head start on the next day’s work; it’s robbing yourself of your downtime, and almost ensuring you won’t be able to sleep because you’ll be up sweating inconsequential details that definitely could have waited until morning. And with the general lack of sleep and never being able to turn your brain off, you’re not able to show up the way you’re meant to. “On the personal side, you carry the stress home without meaning to; you’re shorter with people, or you’re half-listening because your brain’s still churning through tomorrow’s to-do list,” says Moses. Again, it’s something I can relate to. Instead of keeping work in my 9-5, it takes over my life to the point where it’s rare if I can enjoy a day off without thinking about it.

There might be another way. As a multi-hyphenate author, model, psychotherapist, and fitness instructor, Eloise Skinner says doing what she loves now is less stressful than when she was stuck in a corporate role in a past career. 

“It was easier to feel exhausted because the work had a single focus,” she says. “Having lots of different careers allows for a frequent switch in focus. If I feel overwhelmed or stressed, I can usually switch into doing something completely different, which gives a bit of perspective and space.”

So how can we make the change?

Why Do Humans Need Downtime?

                                                                                          J.A. Bracchi / Getty Images

Speaking with her psychotherapist hat on, Skinner says that there are huge benefits to making ourselves take some downtime. “On a mental level, it can allow us to reduce our stress and anxiety levels, providing us with space to find perspective and new ways to look at problems or challenges,” she says. 

I’m with her there; an actual holiday, like over the December break, often does wonders for my mind. Things that seemed important in late November are often forgotten about by January.

“I think we need downtime because the brain simply isn’t built to run flat-out all the time; it needs space to process and reset, the same way your legs need a rest day after a hard session,” says Moses. 

He adds that, when he actually wants to switch off, he’ll go for a run with others, so that rather than being alone with his problem-obsessed brain, he has space for a normal, human conversation. It works wonders. 

“Being ‘always on’ doesn’t make you sharper; it blunts you,” he says. “You get more reactive, less logical, and worse at the very things you’re working so hard to be good at.”

What the Research Says

As for studies on the benefits of downtime, a 2018 article in the journal Nature found that downtime can be supportive for brain health, providing our brain with space and time to consolidate memories and process information. Again, it’s all about that new perspective.

What’s more, a 2016 study from Florida Gulf Coast University seems to confirm this, suggesting that taking time off from physical activity allows us to spend more time in deep, internal thought. 

Meanwhile, a 2022 study analysis confirmed that micro-breaks are “efficient in preserving high levels of vigour and alleviating fatigue.”

On the physical side, Skinner says that downtime allows us to relax, reducing the physiological impact of stress or anxiety like insomnia, muscle tension, and even digestive issues. 

“When we’re constantly responding to emails, notifications, meetings and deadlines, we’re keeping our brain’s executive control network switched on,” says Scott Capelin, founder of inLIFE Wellness. 

During periods of rest, however, another network called the default mode network (DMN) becomes more active. This network is involved in memory consolidation, self-reflection, problem solving, and creative insight. 

“Many of our best ideas don’t happen while we’re staring at a screen,” adds Capelin. “They arrive during a walk, in the shower, or while driving home.”

In other words, being always ‘on’ keeps our stress response activated. And, as Capelin explains, while short bursts of stress can improve performance, chronic activation elevates cortisol and can impair our mood, decision-making, creativity and relationships. 

“People often assume they’ll get more done by working longer, but cognitive performance actually declines when the brain isn’t given opportunities to recover,” he says, adding that one of the biggest casualties of constant busyness is creativity. 

How Can I Find Balance?

If all of the above is setting off alarm bells in your head, it’s probably time to slow down, reassess, and ask yourself how you can take your foot off the gas somewhat moving forward. Capelin has some tips:

Plan Your Week, Not Just Your Day

Before the week begins, block out periods that are intentionally unscheduled. If every hour has a task attached to it, your brain never gets the chance to recover.

Create Small “Buffer Zones”

Leave 10 to 15 minutes between meetings or appointments instead of running back-to-back all day. Those small gaps reduce mental fatigue and improve focus for the next task.

Accept That Not Everything Deserves Your Attention

Many people carry around an endless list of low-value tasks. Ask yourself: ‘If this wasn’t on my list already, would I choose to do it today?’ If the answer is no, it probably isn’t essential.

Schedule Device-Free Time

Even 30 to 60 minutes without notifications, email, or social media allows your brain to shift out of reactive mode. You don’t have to meditate. Reading, walking, gardening, or simply sitting quietly can provide the same restorative effect.

Revisit Your Long-Term Goals Regularly

Many people become busy chasing commitments that no longer align with what’s most important to them. A monthly review helps eliminate obligations that create activity without creating progress.

Practice Letting Small Things Go

Some people benefit from deliberately leaving a non-essential email unanswered until tomorrow or allowing a minor task to remain unfinished. It can feel uncomfortable initially, but it teaches your brain that not everything is urgent. Over time, this reduces the constant sense of pressure that keeps many people mentally switched on.

Ultimately, he says that downtime isn’t the opposite of productivity; it’s one of the conditions that makes sustained productivity possible. 

“The goal isn’t to do less, it’s to recover well enough that the time you do spend working is more focused, creative and effective.”

Of course, if it were that easy, you wouldn’t be reading this article. Feeling guilty about taking time off is a real thing, but one we should try to overcome. “If we really struggle to justify taking time out, it can help to plan some downtime that feels structured and organised,” says Skinner. 

Try planning a weekend away, then you still have the structure your brain likes, but you’ve applied it to something restorative—not just clearing out your email inbox. 

“Scheduling downtime can be the first step to unwinding tension about always needing to be working,” says Skinner. 

And don’t we all deserve a bit more of that?

https://www.mensjournal.com/health/why-downtime-beats-burnout-expert-guide