How do you treat ADHD when someone also has insomnia?

Treating ADHD in someone with insomnia requires a careful, individualized approach because ADHD medications — especially stimulants — can sometimes worsen sleep if not timed correctly. First, clinicians typically review sleep hygiene and underlying causes: irregular sleep schedules, caffeine use, nighttime screen exposure, or anxiety can all contribute. Optimizing these behaviors is often the first step. When medication is needed for ADHD, providers consider timing and type. Stimulants taken too late in the day can worsen insomnia, so morning dosing or using short-acting formulations may help. Non-stimulant ADHD medications, like atomoxetine or certain extended-release options, may be preferred if stimulants disrupt sleep. Sometimes, lower doses or splitting doses is useful. Behavioral strategies such as CBT for insomnia, relaxation exercises, and structured routines for winding down can be combined with ADHD treatment. Treating both conditions together — ADHD symptoms during the day and insomnia at night — often leads to better overall functioning. Throughout treatment, clinicians monitor both ADHD symptoms and sleep patterns, adjusting medications or strategies as needed. The goal is to improve attention, focus, and daily functioning without worsening sleep, so a coordinated, flexible plan is key.