Sleep and Circadian Rhythmicity in Adult ADHD and the Effect of Stimulants

J Atten Disord. 2017 Jan;21(1):14-26. doi: 10.1177/1087054713479663. Epub 2016 Jul 28.

Abstract

Objective: This review updates information on sleep and circadian rhythmicity in adult ADHD, especially circadian rhythmicity and the influence of stimulants.

Method: Investigations into sleep, chronotype, and circadian rhythm in adult ADHD were searched in the Cochrane Library, Embase, Medline, and PsycInfo databases.

Results: ADHD in adults is associated with longer objective sleep latency, irrespective of insomnia complaints. Sleep maintenance is disturbed and waking up time is delayed. Adult ADHD is associated with increased eveningness, delayed dim light melatonin onset (DLMO), and later waking up time. Stimulant treatment induces delay of nonparametric circadian parameters, whereas light therapy (LT) induces shifts toward morningness, which is associated with a reduction of ADHD symptoms.

Conclusion: Adult ADHD is associated with delayed circadian rhythmicity and analogous sleep characteristics, which are typical of a delayed sleep phase disorder. Stimulants induce delay of circadian rhythmicity.

Keywords: ADHD; circadian rhythm; psychostimulants; sleep.

Publication types

  • Review

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / physiopathology
  • Central Nervous System Stimulants / therapeutic use*
  • Circadian Rhythm / drug effects
  • Circadian Rhythm / physiology*
  • Female
  • Humans
  • Light
  • Male
  • Melatonin / metabolism
  • Phototherapy
  • Sleep / drug effects
  • Sleep / physiology
  • Sleep Initiation and Maintenance Disorders / etiology
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / physiopathology

Substances

  • Central Nervous System Stimulants
  • Melatonin