Emotion-Regulation Difficulties Heighten Insomnia Risk in Adults with ADHD

A recent investigation published in the *Journal of Affective Disorders* examined whether adults with Attention-Deficit/Hyperactivity Disorder (ADHD) who struggle to manage their emotions are more likely to experience insomnia. Using an online survey administered with the Norwegian ADHD Association, researchers collected data from 1,414 participants (ages 16-74, mean ? 40) who self-reported an ADHD diagnosis or strong ADHD symptoms. The sample was 81 % female. Participants completed the Difficulties in Emotion Regulation Scale, the Bergen Insomnia Scale, the Adult ADHD Self-Report Scale, and questionnaires on depression, anxiety, chronotype, education, employment, substance use, and stimulant medication use.

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• Insomnia prevalence: 76 % of respondents met insomnia criteria; the figure fell to 60 % under the strictest diagnostic thresholds.

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• Emotion-regulation link: Higher scores on the emotion-regulation difficulty scale correlated with more severe insomnia symptoms, even after adjusting for depression, anxiety, ADHD medication, and overall ADHD severity.

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• Strategic coping: Participants reporting limited access to effective coping strategies exhibited the strongest sleep disturbances, indicating that the inability to calm down—not merely feeling upset—drives insomnia.

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• Age effect: The association was markedly stronger in emerging adults under 30, suggesting heightened vulnerability during periods of increased independence and self-management.

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• Chronotype: Evening preference (“night owl” status) was common but did not modify the emotion-regulation-insomnia relationship.

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The findings underscore emotional coping as a distinct target for improving sleep among adults with ADHD. Since up to 67 % of adults with ADHD report insomnia—far above the 24 % prevalence in the general population—addressing emotion-regulation deficits could reduce daytime fatigue, functional impairment, and overall quality-of-life disruptions.

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Lead author Lin Sørensen, licensed clinical psychologist and professor at the University of Bergen’s Department of Clinical and Biological Psychology, emphasized that emotional distress appears to be a major contributor to the high insomnia rates observed in ADHD. She noted that the relationship persisted after controlling for depression, suggesting a unique pathway linking emotion regulation to sleep. Sørensen also highlighted the bidirectional nature of the association, acknowledging that poor sleep may further impair emotional control.

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The study’s cross-sectional design precludes causal inference, and reliance on self-reported ADHD diagnoses and sleep symptoms limits diagnostic certainty. The overwhelmingly female sample (? 81 %) may not reflect the broader adult ADHD population, especially given gender-related differences in employment and sick-leave status that could influence stress and sleep. Objective sleep measures (e.g., polysomnography) were not employed, raising concerns about measurement accuracy.

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• “One of the main research focuses in our group is the role of emotion regulation in mental health, including among adults with ADHD,” — Lin Sørensen, Licensed Clinical Psychologist, University of Bergen

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• “We were surprised to find that the association between emotion regulation difficulties and sleep problems was stronger among younger than older adults with ADHD, as we had expected the opposite pattern,” — Lin Sørensen

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• “We expected evening preference to play a role because it is common in ADHD and is often associated with poorer self-regulation and more sleep problems, but this was not the case,” — Lin Sørensen

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• “Difficulties regulating strong and intense emotions may make it more challenging to fall asleep and remain asleep throughout the night,” — Lin Sørensen

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• “Our study was cross-sectional, and therefore cannot establish the direction of the observed associations,” — Lin Sørensen

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The authors call for longitudinal research with clinically verified ADHD diagnoses and objective sleep assessments to clarify causality and explore mechanisms across the 24-hour ADHD experience. A more gender-balanced cohort would also help determine whether findings generalize beyond the predominantly female sample.

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