Is It ADHD or a Sleep Problem?

Tired attention can pass for ADHD attention

You lose your place in meetings, forget why you walked into a room and snap at people you love. It is easy to read that as a focus problem you have always had. Sometimes it is. Sometimes the brain is simply running on too little rest.

Because the day-to-day signs overlap, the most useful first question is often not whether it is ADHD, but how you have been sleeping and for how long.

What short or broken sleep does to focus

The National Heart, Lung, and Blood Institute (NHLBI) explains that getting enough quality sleep at the right times helps you function well throughout the day. It uses the term sleep deficiency for the opposite.

According to NHLBI, sleep deficiency can cause problems with learning, focusing and reacting. People may have trouble making decisions, solving problems, remembering things, managing their emotions and behavior, and coping with change. They may take longer to finish tasks and make more mistakes.

NHLBI also describes microsleep: brief moments of sleep while you are normally awake, which you may not notice. During a lecture or a long meeting, you might miss part of what was said without realizing you dozed. And some people who are short on sleep do not recognize it, because they still feel they are functioning well.

The Centers for Disease Control and Prevention (CDC) recommends seven or more hours of sleep a day for adults aged 18 to 60. Quality counts as much as quantity. The CDC lists trouble falling asleep, waking repeatedly during the night, and feeling sleepy even after enough sleep as signs of poor sleep quality.

Sleep disorders that can look like ADHD

The CDC states that there is no single test for ADHD and that sleep disorders are among the problems that can have symptoms similar to it. The CDC names these as common sleep disorders:

• Insomnia.
• Sleep apnea, in which, as NHLBI explains, breathing stops and restarts many times during sleep. Untreated, it can lead to problems concentrating, making decisions, remembering things or controlling behavior.
• Restless legs syndrome.
• Narcolepsy.

Why ADHD and sleep problems often travel together

This does not have to be one or the other. The National Institute of Mental Health (NIMH) notes that sleep problems are especially common in adults with ADHD.

The connection can run in both directions. The CDC explains that ADHD can make it hard to stay consistent with healthy habits, including good sleep, especially when stress and demands are high. Meanwhile, a night of poor sleep can make existing attention problems feel worse the next day. Sorting out which came first takes patience and a look at the bigger picture.

Raise sleep with your doctor

Sleep disorders are medical conditions, and a doctor is the right person to check for them. NHLBI suggests talking with your healthcare provider if someone tells you that you snore or gasp for air during sleep, or if you have excessive daytime sleepiness. A few steps can make that appointment more useful:

1. 1Notice the signsWrite down when you have trouble falling or staying asleep, when you feel drowsy in the day, and whether a partner has noticed snoring or pauses in breathing.
2. 2Keep a sleep diaryThe CDC suggests recording when you go to bed, wake in the night, wake in the morning and nap, along with exercise, alcohol or caffeine, and any medications you take.
3. 3Ask about testingYour provider can run tests, including sleep studies, to tell whether you have a sleep disorder. NHLBI notes that sleep apnea is often diagnosed with a sleep study.
4. 4Mention attention concernsTell your doctor that focus is part of the worry. That helps them decide whether a separate ADHD evaluation makes sense alongside any sleep care.

How an ADHD evaluation weighs sleep

NIMH explains that for adults, ADHD symptoms must have begun before age 12, so an evaluator looks back at childhood, school and work as well as at how you feel now. If focus trouble began around the time sleep changed, such as after a new baby, shift work or a change in health, that timing is useful to share.

The CDC says a medical and psychological exam may be needed to rule out other health problems that can cause symptoms like ADHD or that are often present with it, including sleep problems. NIMH adds that adults may be asked about their mood and current and past medical conditions. Bring any results from a sleep study or notes from your doctor.

If you are in crisis or thinking about harming yourself, call or text 988, or call 911. Locascio Wellness does not provide emergency services.

How we can help

Locascio Wellness offers an ADHD evaluation by secure video for adults who are physically located in Pennsylvania, West Virginia or Arizona. It ends with the findings explained in plain language, time for questions, and a written report, which at the moment is usually ready about a month after the first evaluation appointment. An ADHD evaluation is not a sleep study, so please see your doctor about sleep as well.

Evaluations are private-pay, not billed to insurance, and a sliding scale is available; see what evaluations cost. To start, use the short evaluation request form or book a free 15-minute consultation on our booking page.

Therapy is a separate service. Therapists on our team offer ADHD therapy and, if worry or stress is part of what keeps you up at night, anxiety therapy, both by video. Better rest and clearer answers are both realistic goals, and you can work toward them at the same time.