Adolescence is a developmental period characterized by disruptions in sleep and changes in circadian preferences. Although adolescents with attention-deficit/hyperactivity disorder (ADHD) are at even higher risk of sleep disruption than their peers, no study has examined whether circadian preference is associated with sleep problems and daytime sleepiness in adolescents with ADHD. This study provides an initial test of the hypothesis that greater evening preference would be associated with more sleep problems and daytime sleepiness in adolescents diagnosed with ADHD. Participants were 80 adolescents (69% male), aged 13-17 years, with ADHD. Adolescents completed measures assessing circadian preference, pubertal development, anxiety/depressive symptoms and weeknight sleep duration. Both adolescents and parents completed measures of sleep problems and daytime sleepiness. In regression analyses controlling for a number of other variables (i.e., age, sex, pubertal development, ADHD medication use, and ADHD, oppositional defiant disorder and internalizing symptom severity), greater evening preference was associated with both adolescent- and parent-reported sleep problems and daytime sleepiness. Greater evening preference remained significantly associated with each of these sleep problems and daytime sleepiness when also controlling for weeknight sleep duration. This is the first study to demonstrate that evening circadian preference is associated with both sleep problems and daytime sleepiness in adolescents with ADHD. The results indicate that it is important to consider circadian function as research examining sleep in adolescents with ADHD continues to advance.
Keywords: attention-deficit/hyperactivity disorder; chronotype; circadian rhythm; morningness-eveningness; sleep duration; sleepiness.
© 2019 European Sleep Research Society.
Conflict of interest statement
Nighttime media use in adolescents with ADHD: links to sleep problems and internalizing symptoms.Sleep Med. 2018 Nov;51:171-178. doi: 10.1016/j.sleep.2018.06.021. Epub 2018 Jul 29. Sleep Med. 2018. PMID: 30223187 Free PMC article.
Sleep and daytime sleepiness in adolescents with and without ADHD: differences across ratings, daily diary, and actigraphy.J Child Psychol Psychiatry. 2019 Sep;60(9):1021-1031. doi: 10.1111/jcpp.13061. Epub 2019 Apr 29. J Child Psychol Psychiatry. 2019. PMID: 31032953
Featured Article: Technology Use and Sleep in Adolescents With and Without Attention-Deficit/Hyperactivity Disorder.J Pediatr Psychol. 2019 Jun 1;44(5):517-526. doi: 10.1093/jpepsy/jsy101. J Pediatr Psychol. 2019. PMID: 30615174
Excessive daytime sleepiness in patients with ADHD--diagnostic and management strategies.Curr Psychiatry Rep. 2015 Aug;17(8):608. doi: 10.1007/s11920-015-0608-7. Curr Psychiatry Rep. 2015. PMID: 26122671 Review.
Chronotype-related differences in childhood and adolescent aggression and antisocial behavior--a review of the literature.Chronobiol Int. 2014 Feb;31(1):1-16. doi: 10.3109/07420528.2013.829846. Epub 2013 Oct 22. Chronobiol Int. 2014. PMID: 24147657 Review.