Delayed circadian rhythm in adults with attention-deficit/hyperactivity disorder and chronic sleep-onset insomnia.
BACKGROUND
Previous studies suggest circadian rhythm disturbances in children with attention-deficit/hyperactivity disorder (ADHD) and sleep-onset insomnia (SOI). We investigate here sleep and rhythms in activity and melatonin in adults with ADHD.


METHODS
Sleep logs and actigraphy data were collected during 1 week in 40 adults with ADHD, of whom 31 reported SOI. Salivary melatonin levels were assessed during 1 night. Sleep measures, circadian activity variables, and dim light melatonin onset were compared between groups of ADHD adults with and without SOI and with matched healthy control subjects.


RESULTS
Compared with control subjects, both groups of ADHD adults had longer sleep-onset latency and lower sleep efficiency. Adults with ADHD and SOI showed a delayed start and end of their sleep period and a delayed melatonin onset compared with adults with ADHD without SOI (p = .006; p = .023; p = .02) and compared with healthy control subjects (p = .014; p = .019; p = .000). Adults with ADHD and SOI also showed an attenuated 24-hour amplitude in their rest-activity pattern, in contrast to those without SOI, who showed a higher day-to-day stability.


CONCLUSIONS
These findings demonstrate diurnal rhythm deviations during everyday life in the majority of adults with ADHD that have SOI and suggest that potential benefits of rhythm-improving measures should be evaluated.
Van Veen
Maaike M
MM
PsyQ Psycho-Medical Programs, Program Adult ADHD, The Hague, The Netherlands. m.vanveen@psyq.nl
Kooij
J J Sandra
JJ
Boonstra
A Marije
AM
Gordijn
Marijke C M
MC
Van Someren
Eus J W
EJ
D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D016009:Chi-Square Distribution; D002940:Circadian Rhythm / Q000502:physiology*; D006801:Humans; D008550:Melatonin / Q000032:analysis; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000503:physiopathology*; D011795:Surveys and Questionnaires
D008550:Melatonin