Neurofeedback is a non-invasive, brain-based therapy. Here at Smart TMS, we are starting to introduce neurofeedback therapy for ADHD as an evidence-based treatment option. Often, traditional interventions for ADHD, such as medication, can come with a wide range of side effects, and the long-term effectiveness in addressing core symptoms remains unclear. Recent research into ADHD and patient wellbeing suggests a greater focus on long-term behavioural change may be impactful. Both neurofeedback treatment and good sleep hygiene consider this factor. So, let’s look at how neurofeedback for ADHD can work together with healthy sleep habits to provide long-term relief of ADHD symptoms.
ADHD is increasingly understood as a disorder of self-regulation, affecting attention, emotional regulation, motivation, impulse control, amongst other symptoms. Sleep plays a central role in all of these domains, with sleep and ADHD being very closely linked. It is well-documented that co-morbidity is high between ADHD and sleep disorders, with up to 83% of adults diagnosed with ADHD reporting problems with sleep (Gruber, 2012).
People with ADHD may struggle to sleep due to hyperactivity symptoms and racing thoughts. This lack of sleep may then worsen inattentiveness and impulsivity, creating a negative cycle that can be difficult to break (Becker, 2020). Evidence for the impact of sleep on ADHD symptoms is strong, with worsening effects reported in both adults and children (Lazzarro et al., 2024).
A new study (Pignall et al., 2025) has suggested that lapses in attention seen in adults with ADHD are linked to the presence of “sleep spindles” during wakefulness. Sleep spindles are a pattern of brain waves that occur during deep sleep and contribute to more restorative sleep quality. This suggests that the brain could be entering more sleep-like states whilst people are awake, potentially accounting for the inattention and cognitive errors associated with ADHD. This further supports the role of EEG neurofeedback and brain training therapy for ADHD as viable long-term treatment approaches.
Neurofeedback therapy is a non-invasive treatment that teaches the brain to switch into healthier brain states or levels of brain activity. It does this by rewarding the brain when it adopts more regulated patterns. These patterns are consolidated over several sessions and can often lead to lasting behavioural change.
For individuals experiencing ADHD symptoms, neurofeedback treatment for ADHD involves rewarding improved focus and relaxed states. During everyday activities, this can translate to reduced hyperactivity and an improved ability to maintain attention.
One way we can teach the brain to do this is through training Slow Cortical Potentials (SCPs), a term used to describe slow shifts in electrical brain activity. Surface-negative SCPs are associated with increased excitability, readiness to respond, and concentration, whilst surface-positive SCPs are linked to reduced excitation and relaxation.
The aim of SCP neurofeedback therapy is to help the brain adopt these different states more effectively, allowing individuals to transition more easily between concentration and relaxation. In day-to-day life, this may appear as reduced signs of inattention, impulsivity, and hyperactivity.
Research supports neurofeedback for ADHD symptoms using the SCP method as an effective treatment approach. For instance, in 2017, researchers used SCP neurofeedback on a group of 150 children with ADHD and found improvements in symptoms such as inattention and impulsivity (Strehl et al., 2017).
Neurofeedback treatment can also directly support sleep improvement. To do this, we look at the sensorimotor rhythm (SMR), a level of brain activity associated with restful sleep and sleep spindle activity.
During neurofeedback therapy, we train the brain to activate this frequency and increase the availability of sleep spindles. This can improve both sleep quality and sleep onset. Improved sleep may then lead to better daytime attention, emotional regulation, and cognitive performance. Therefore, treating sleep through neurofeedback for ADHD may also indirectly reduce ADHD symptoms.
Patients receiving ADHD neurofeedback treatment may benefit from a combination of SCP and SMR training methods, depending on which symptoms are most prominent and how they affect daily functioning.
Some forms of brain training therapy allow us to directly target how the brain regulates ADHD symptoms, whilst others improve symptoms indirectly through enhanced sleep quality. This demonstrates how personalised neurofeedback therapy can be tailored to the individual needs of each patient.
When developing sustainable interventions for ADHD, sleep and circadian rhythm regulation are often underestimated. Many traditional ADHD treatment approaches focus primarily on attention, executive functioning, and behavioural strategies. However, long-term outcomes frequently depend on addressing the biological foundations that support brain regulation — particularly sleep.
Integrating neurofeedback sleep protocols, Slow Cortical Potential (SCP) training, and circadian rhythm or sleep hygiene strategies may provide a more stable, resilient, and sustainable pathway for ADHD treatment without medication.
This approach is relevant for both clinicians designing treatment plans and families seeking long-term improvement rather than short-term symptom management.
At Smart TMS, we are committed to providing evidence-based, non-invasive treatments that support long-term brain health and wellbeing. As part of this approach, we now offer neurofeedback therapy for ADHD in selected clinics across the UK. Our personalised neurofeedback treatment programmes are designed to help individuals improve attention, emotional regulation, sleep quality, and overall cognitive functioning through targeted brain training techniques. By combining advances in EEG neurofeedback, sleep-focused interventions, and tailored treatment planning, Smart TMS aims to provide sustainable support for both adults and children living with ADHD symptoms.
Written by Isabel, London TMS practitioner & Nikki, Birmingham TMS Practitioner