ADHD in Teens: Why Sleep Should Be Part of the Conversation

We often ask teens with ADHD about focus, impulsivity, and school performance.

But how often do we ask about sleep?

A 2023 systematic review and meta analysis found that adolescents with ADHD consistently reported poorer sleep, including shorter sleep duration, more daytime sleepiness, and greater overall sleep disturbances than their peers. The authors concluded that sleep should be a routine part of ADHD assessment, not an afterthought.

The challenge is that poor sleep and ADHD can amplify each other.

A teen who’s exhausted may struggle even more with attention, emotional regulation, motivation, and executive functioning. Those difficulties can then make it harder to stick to routines that support healthy sleep, creating a cycle that’s difficult to break.

As therapists, we don’t need to become sleep specialists. But we can become better at asking questions like:

How long does it usually take you to fall asleep?

Do you wake up feeling rested?

Are you tired during the school day?

Has your sleep changed since your ADHD symptoms became more noticeable?

These conversations can reveal an important part of the clinical picture that’s easy to overlook.

When we assess ADHD without assessing sleep, we may miss a factor that’s contributing to a teen’s daily functioning, mood, and quality of life.

Learn more here: https://acamh.onlinelibrary.wiley.com/doi/full/10.1002/jcv2.12151