title: Attention-deficit hyperactivity disorder symptoms add risk to circadian rhythm sleep problems in depression and anxiety.
abstract: Comorbid ADHD symptoms may partly account for circadian rhythm disturbances in depression and anxiety disorders.
  
  
  
  Self-reported sleep characteristics of 2090 participants in the Netherlands Study of Depression and Anxiety were assessed using the Munich Chronotype Questionnaire. We defined 3 groups: healthy controls (HC), persons with lifetime depression and/or anxiety disorders (LDA), and those with both LDA and high ADHD symptoms (LDA+ADHD), using the Conner's Adult ADHD Rating Scale.
  
  
  
  Sleep characteristics were least favorable in the LDA+ADHD group. Important group differences between LDA+ADHD, LDA and HC were found for extremely late chronotype (12% vs. 5% vs. 3%; p<.001), sleep duration <6h (15% vs. 5% vs. 4%; p<.001), and for an indication of the Delayed Sleep Phase Syndrome (DSPS; 16% vs. 8% vs. 5%; p<.001). After adjustment for covariates, including depression and anxiety, presence of ADHD symptoms increased the odds ratio for late chronotype (OR=2.6; p=.003), indication of DSPS (OR=2.4; p=.002), and sleep duration <6h (OR=2.7; p=.007).
  
  
  
  ADHD conceptually overlaps with symptom presentation of depression and anxiety. We used a cross-sectional study design, and used self reported sleep characteristics.
  
  
  
  High ADHD symptoms were associated with an increased rate of circadian rhythm sleep disturbances in an already at-risk population of people with depression and/or anxiety disorders. Circadian rhythm sleep disorders, as often seen in ADHD are not entirely due to any comorbid depression and/or anxiety disorder. Adequate treatment of such sleep problems is needed and may prevent serious health conditions in the long term.
authors.affiliation: PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands. Electronic address: annet.bron4@psyq.nl.
authors.forename: T I
authors.initials: TI
authors.lastname: Bron
authors.affiliation: PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Bijlenga
authors.affiliation: PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands; Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: J J S
authors.initials: JJ
authors.lastname: Kooij
authors.affiliation: PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands.
authors.forename: S W N
authors.initials: SW
authors.lastname: Vogel
authors.affiliation: PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Wynchank
authors.affiliation: Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: A T F
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: B W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003866:Depressive Disorder / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D012306:Risk; D012307:Risk Factors; D020178:Sleep Disorders, Circadian Rhythm / Q000209:etiology*
keywords: ADHD symptoms; Anxiety; Chronotype; Circadian rhythm disturbances; Depression; Sleep problems