ADHD versus sleep apnoea: How to tell the difference

Sleep apnoea is often underdiagnosed, but can have a big impact on ADHD. Learn what it is, what symptoms it shares with ADHD, how the two conditions differ, and what you can do if you notice symptoms of both.

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Daniel Atkinson
Medically reviewed by Daniel Atkinson GP Clinical Lead

Reading time: 5 min

Uploaded on: September 16, 2026

Sleep apnoea is one of the most underdiagnosed, yet very relevant, conditions linked to ADHD.  The two share similar symptoms, like inattention, irritability, and restlessness, which can lead to frequent misdiagnosis, especially in children, as sleep deprivation from apnoea can mimic ADHD.

Up to one-third of people with ADHD might also have sleep apnoea. And if you have both conditions, untreated sleep apnoea can worsen ADHD symptoms, while treating it can improve your focus and behaviour and may mean you could reduce your ADHD medication, if you’re taking it. This means a proper sleep study is a good idea to identify or separate the effects of each condition.

What is sleep apnoea?


Sleep apnoea is a potentially serious condition where your breathing repeatedly stops while you’re sleeping. Each pause ‘forces’ your brain to wake up to restart your breathing, and your sleep gets fragmented and shortened. So, the result is that you’re not getting enough restful, restorative sleep and often wake up feeling tired the next morning. 

It’s also (likely) more common than you might think. Around the world, it’s estimated that about 1 billion people aged between 30 and 69 have sleep apnoea.[1] 

It’s: 

  • more common in adults than in children 
  • more common in men than in women
  • and up to 9 in 10 people live with the condition without knowing that they have it.[2]

Symptoms of sleep apnoea

Symptoms of sleep apnoea that occur during sleep are more often noticed by a partner or family member than the person affected. These can include:

  • your breathing is stopping for 10 seconds or more at a time and starting again
  • waking up frequently
  • snoring loudly
  • short, sharp breaths, snorting or choking sounds

Symptoms that can occur during the day include:

  • fatigue
  • difficulty concentrating
  • mood swings
  • headaches, especially in the morning
  • dry mouth after waking up

Sleep apnoea causes

There are three main types of sleep apnoea, and the causes can differ by type:

  • Obstructive sleep apnoea (OSA). This is the most common type, and happens when muscles in your throat relax, allowing the tissue surrounding them to press on your windpipe. This causes your airways to become too narrow and makes it hard to get enough air.
  • Central sleep apnoea. This happens when the brain and the muscles that control breathing don’t communicate as effectively as they should while you sleep. 
  • Mixed/Complex sleep apnoea. This is a mix of both obstructive and central sleep apnoea.

Other potential factors linked to sleep apnoea include:

  • Obesity
  • Having other family members with sleep apnoea
  • Smoking
  • Drinking
  • Having a large neck
  • Having large tonsils
  • Being older
  • Having COPD (a condition which causes your airways to narrow and makes breathing more difficult)
  • Sleeping on your back

How sleep apnoea affects your overall health

Left untreated, sleep apnoea can lead to serious health issues. Some studies have identified a link between sleep apnoea and type 2 diabetes,[3] stroke,[4] and heart disease.[5] It’s not fully known why this happens, but one possible cause is obesity, which can be a risk factor for both sleep apnoea and stroke or heart disease.

But for type 2 diabetes, it’s an entirely different matter. Sleep deprivation due to sleep apnoea has been shown to raise blood sugar levels and increase the risk of type 2 diabetes even in people who aren’t overweight or obese. 

What the diabetes risk looks like in numbers 


Compared with people who get at least 7 hours of sleep a night, the risk of developing diabetes is: 

  • 2.5 times higher for those sleeping less than 5 hours
  • and around 1.7 times higher for those getting under 6 hours.[3]

What symptoms do ADHD and sleep apnoea share?


Even though they’re very different conditions, ADHD and sleep apnoea have some symptoms in common, which can make it difficult to tell one from the other.

Comparison table titled "What symptoms do ADHD and sleep apnoea share," outlining six shared symptoms—including daytime fatigue, concentration difficulties, emotional dysregulation, forgetfulness, restlessness, and impulsivity—and detailing how each manifests in both conditions.

How are ADHD and sleep apnoea different?

The short version: ADHD and sleep apnoea differ in:

Comparison table titled "How are ADHD and sleep apnoea different," contrasting the cause, symptom origin, age of onset, and outcome after treating sleep problems for both conditions.

The slightly longer version: The main difference between ADHD and sleep apnoea comes down to what’s causing them.

ADHD is a neurodevelopmental disorder, which means that the ADHD brain develops and functions differently from ‘neurotypical’ brains. Differences in how various parts of the brain connect and communicate with each other usually affect executive functions like attention, planning, and impulse control. 

Symptoms of ADHD always begin in childhood and can persist into adulthood (though the way they appear can change over time). It isn’t caused by poor sleep, though many people with ADHD can struggle with sleep, which can worsen symptoms.

Sleep apnoea, on the other hand, is a disorder where breathing stops and starts during sleep, causing oxygen deprivation and fragmented sleep. As a result, your brain cannot enter the necessary deeper stages of rest it needs to recover properly. This leads to daytime fatigue, which can mimic ADHD symptoms like inattention, irritability, or hyperactivity.

But with sleep apnoea, these issues resolve once the sleep problem is treated.

Sleep apnoea also more commonly affects adults (between 9% and 38%)[8] than children (1% to 5%).[9] And unlike ADHD, when symptoms always start in childhood, it can develop later in life.

Read more about:


References

  1. Benjafield, A.V., et al. (2019). Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. The Lancet Respiratory Medicine, 7(8), pp.687–698. 
  2. Johns Hopkins Medicine (n.d.). Obstructive Sleep Apnea. 
  3. Pandey, A., et al. (2010). Sleep Apnea and Diabetes: Insights into the Emerging Epidemic. Current Diabetes Reports, 11(1), pp.35–40.  
  4. Laavanya Dharmakulaseelan and Boulos, M.I. (2024). Sleep Apnea and Stroke: A Narrative Review. CHEST Journal. 166(4), pp. 857-866. 
  5. Girardin. J.-L., et al. (2008). Obstructive Sleep Apnea and Cardiovascular Disease: Role of the Metabolic Syndrome and Its Components. Journal of Clinical Sleep Medicine : JCSM : official publication of the American Academy of Sleep Medicine, 4(3), p.261. 
  6. Goldstein, A.N. and Walker, M.P. (2014). The Role of Sleep in Emotional Brain Function. Annual Review of Clinical Psychology, 10(1), pp.679–708. 
  7. Hirotsu, C., Tufik, S. and Andersen, M.L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science, 8(3), pp.143–152.  
  8. Senaratna, C.V., et al. (2017). Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Medicine Reviews, 34, pp.70–81. 
  9. Nixon, G. M. and Davey, M. J. (2015). Sleep apnoea in the child, Australian Family Physician, 44(6), pp. 352–355.  

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Reading time: 5 min

Uploaded on: September 16, 2026

Dr Daniel
Medically reviewed by Daniel Atkinson GP Clinical Lead Registered with GMC (4624794) September 16, 2026 Meet Daniel Atkinson
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Written by Focused Content Team
Last updated on September 24, 2026
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