Why Do People with ADHD Traits Experience Depression and Lower Quality of Life? Study Sheds Light - Video

A new study published in BMJ Mental Health found that insomnia, or sleep disturbances, that happen due to ADHD's impulsivity could be the reason why adults with ADHD symptoms experience a reduced quality of life. The research provides compelling evidence that heightened cognitive activity before sleep may be a key factor in the poor sleep quality.

ADHD, a neurodevelopmental disorder affecting approximately 2.5% of adults, is often accompanied by chronic sleep difficulties. Up to 90% of people with ADHD report problems such as insomnia and excessive daytime sleepiness. While the link between ADHD and sleep issues has been well documented, the mechanisms behind this connection have remained largely unclear.

To explore the potential mediating role of pre-sleep arousal, researchers collected data from two independent groups—104 online participants and 96 in-person respondents recruited a year later to replicate the initial findings. Participants completed self-report questionnaires that measured ADHD traits, levels of pre-sleep arousal, and overall sleep quality. The study adhered to strict ethical protocols, with all participants providing informed consent and the freedom to withdraw at any time.

The results revealed a strong correlation between ADHD-like traits and poor sleep quality, primarily driven by elevated levels of cognitive arousal before bedtime. Cognitive arousal refers to racing thoughts, worry, or mental overactivity that occurs prior to falling asleep. Researchers found that this mental restlessness had a far greater impact on sleep quality than physical signs of arousal, such as a racing heart—by up to ten times. These findings have important clinical implications.

“There needs to be more research to understand this complex interplay. By improving our understanding, we could uncover treatment options that improve the quality of life of people with ADHD. For instance, targeting insomnia complaints in individuals with higher ADHD traits, with cognitive behavioral therapy for insomnia (CBT-I) or sleep restriction therapy may help improve their quality of life,” said study co-author Samuele Cortese, a professor at the University of Southampton.

The study underscores the complexity of ADHD and associated sleep problems and highlights the need for integrated treatment approaches.

Reference: Siddhi Nair, Neha Deshpande, Catherine Hill, Samuele Cortese, Eus J W Van Someren, Sarah Laxhmi Chellappa - Associations of ADHD traits, sleep/circadian factors, depression and quality of life: BMJ Mental Health 2025;28:e301625.