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CBT-i for ADHD · adolescents

Evidence-based sleep support for adolescents with ADHD

If sleep were easy, you’d already be sleeping. Lying awake. Delaying bedtime. Feeling exhausted but not sleepy. Waking unrefreshed, then starting the day already behind. If that cycle feels familiar, this program was built for you or your child.

Quick read — 60 seconds
The real problem isn’t sleep — it’s the mismatch

Standard sleep advice assumes a nervous system that can slow down on demand

ADHD changes how sleep pressure builds, how the circadian clock shifts, and how motivation and attention regulate in the evening. For ADHD nervous systems, that assumption fails — and more effort doesn’t fix the cycle. A different approach does.

The reframe: sleep is a regulation issue, not a compliance issue. Effective support works with ADHD traits, reduces strain instead of adding rules, supports autonomy rather than enforcing compliance, and stays structured but flexible. That’s where ADHD-adapted CBT-i — and the SIESTA model — comes in.

The cycle many families recognize
The solution

CBT-i adapted for ADHD — not a generic protocol

Rather than applying standard CBT-i, this service adapts sleep treatment to ADHD-specific patterns in attention, motivation, circadian rhythm, and executive functioning. The aim is not to control sleep, but to create conditions that allow the nervous system to settle more reliably over time.

What the program focuses on

Why this approach is different

Interventions support capacity — they don’t control behaviour.

A good fit if you or your child…

Not intended for

What working together is like

Clients often describe this program as relieving and validating. Sessions are structured but paced to attention and energy. A digital workbook is provided to both the adolescent and their parents, plus access to the STG Online Clinic. All appointments are virtual through secure video conferencing, Saskatchewan only.

Parent FAQ — quick answers

How is this different from regular sleep therapy?

CBT-i for ADHD is adapted for differences in circadian rhythm, motivation, arousal, and executive functioning — not built on rigid routines and consistency alone.

Is this just “sleep hygiene”?

No. While sleep hygiene may be discussed, the focus is understanding why sleep is difficult for a child with ADHD and creating individualized, realistic strategies that reduce strain rather than add pressure.

What difficulties does this help with?

Long sleep onset, delayed or irregular sleep timing, feeling tired but not sleepy at night, ADHD symptoms worsening with poor sleep, and anxious, restless, “wired” evenings.

Will this replace medication or medical care?

No. When medication is part of care, sleep patterns are discussed thoughtfully and coordinated with medical providers when appropriate.

Will my child have to follow strict rules?

No. Changes are introduced gradually, collaboratively, and only when they make sense for the child. The focus is feasibility, motivation, and nervous system regulation — not compliance.

What is my role as a parent or caregiver?

Caregivers are involved in assessment and planning, especially for younger clients: background information, brief screeners, and home support aligned with the child’s needs and autonomy. Collaborative, not punitive.

How long does this take?

It’s a structured, time-limited intervention. Exact length depends on age, needs, and pacing — it’s not open-ended therapy.

What if my child resists change?

That’s common. The model uses motivational interviewing, which respects ambivalence and avoids forcing change — kids identify their own goals and experiment at a pace they can tolerate.

What outcomes should we realistically expect?

Not perfect sleep — progress is measured by reduced strain and improved functioning: less exhaustion, more predictability, better daytime regulation and attention, and less stress and conflict around bedtime.

Teen FAQ

One thing to remember: your sleep problems are not because you’re lazy, broken, or doing it wrong. They make sense given how your brain works — and they can become easier with the right support.

Why is sleep so hard when I’m already exhausted?

With ADHD, being tired doesn’t always mean your brain is ready to sleep. ADHD affects how sleep pressure builds and how alert your brain stays in the evening — wiped out but still wired isn’t a failure; it’s how your nervous system works.

Is this just someone telling me to go to bed earlier?

No. It’s about understanding when your brain actually becomes ready for sleep and helping your system settle more naturally over time.

Do I have to stop using my phone at night?

Not automatically. We look at how evening activities affect your alertness and sleep timing, then decide together what’s worth changing — reducing friction, not removing enjoyment.

What if I don’t want to change anything right now?

That’s okay. This is choice-based change: we talk about what you want to be different and experiment at a pace you can tolerate.

Will this fix my sleep completely?

The goal isn’t perfect sleep. It’s feeling less exhausted, having more predictable sleep, waking with better focus and emotional control, and having fewer battles with your body at night.

What do sessions actually look like?

Structured but flexible. No lectures, no punishment, no pressure. We talk about what your sleep actually looks like, use simple tracking, learn how ADHD affects sleep, try small experiments, and build a plan that fits your real life.

Will my parents be involved?

That depends on your age and situation. Parents are usually involved in planning and support, but your autonomy is respected — you won’t be treated like someone who needs to be controlled.

What if I’ve tried sleep tips before and nothing worked?

Very common with ADHD — most sleep advice isn’t designed for ADHD brains. This program is built specifically around how ADHD affects sleep timing, motivation, and arousal.

What if I mess up or don’t follow the plan?

Nothing bad happens. There’s no failing here — sleep change isn’t linear, especially with ADHD. We expect variability and work with it, not against it.

Is this the right next step?

If sleep problems are amplifying ADHD-related challenges, targeted, ADHD-informed CBT-i can help interrupt the cycle. A consultation offers space to determine whether this SIESTA-based approach is the right fit.