Sleep, circadian, and mental health in neurodivergent neurotypes: lived experience perspective on the research landscape and roadmaps.

Neurodivergent neurotypes refer to brains that function differently from what is considered the societal standard or "stereotypical" norm, and include autism and attention deficit hyperactivity disorder (ADHD). Currently, global estimates suggest that 15 per cent to 20 per cent of the global population is neurodivergent. Autistic people and those with ADHD often experience mental health problems and a heightened likelihood of anxiety and depression. Epidemiological evidence shows that sleep and circadian rhythm disruption, such as low self-reported sleep quality, insomnia symptoms, and delayed sleep-wake phase disorder, are common in autistic people and those with ADHD. Despite scientific advancements, a comprehensive framework integrating sleep and circadian factors associated with mental health problems in neurodivergent neurotypes remains undeveloped. This perspective, written by people with lived experience of neurodivergent neurotypes, examines mental health problems, particularly anxiety, depression, and suicide risk, in autistic people and those with ADHD; sleep and circadian rhythm disruption in these neurotypes; and the growing epidemiological evidence linking sleep, circadian, and mental health problems in these neurotypes compared to people with neurotypical development. Our perspective advocates for an integrated biopsychosocial model that accounts for the interplay between sleep, circadian rhythms, and mental health in neurodivergent neurotypes. Moreover, it identifies gaps and future research avenues, and the need for personalized behavioral interventions to improve their sleep, circadian, and mental health problems. Co-production of research is advocated as a method to ensure that people with neurodivergent neurotypes are included as equal partners in the entire research process, as a means to best support their sleep, circadian, and mental health.