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Other contributing factors to poor focus associated with ADHD include: Stress and cortisol imbalances (HPA axis dysregulation) Sleep deprivation or irregular circadian rhythms that can interfere with energy, motivation, and concentration, and can increase fatigue Blood sugar instability, which can worsen anxiety, brain fog, or irritability Micronutrient deficiencies, especially in magnesium, zinc, and B vitamins For women, hormonal fluctuations, like declining estrogen in perimenopause, can also worsen executive dysfunction and emotional reactivity (learn more about ADHD and hormones here)

A study by Abdulghani et al