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Idiopathic chronic sleep onset insomnia in attention-deficit/hyperactivity disorder: a circadian rhythm sleep

Kristiaan B Van der Heijden1, Marcel G Smits, Eus J W Van Someren

  • 1Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.

Chronobiology International
|August 4, 2005
PubMed

Insights

Children with Attention Deficit Hyperactivity Disorder (ADHD) and sleep-onset insomnia (SOI) exhibit a delayed sleep phase and later dim light melatonin onset (DLMO), suggesting a circadian rhythm component. This impacts sleep patterns in ADHD patients.

Area of Science:

  • Chronobiology
  • Pediatric Neurology
  • Sleep Medicine

Background:

  • Attention Deficit Hyperactivity Disorder (ADHD) is frequently associated with sleep disturbances.
  • Sleep-onset insomnia (SOI) is a common complaint in children with ADHD.
  • The underlying mechanisms of ADHD-related SOI, particularly its potential link to circadian rhythm disorders, require further investigation.

Purpose of the Study:

  • To determine if ADHD-related chronic idiopathic sleep-onset insomnia (SOI) is associated with a circadian rhythm disorder.
  • To compare actigraphic sleep estimates, circadian rest-activity rhythm, and dim light melatonin onset (DLMO) between ADHD children with and without SOI.

Main Methods:

  • Utilized actigraphy for sleep estimates and circadian rhythm assessment over one week.
  • Measured salivary dim light melatonin onset (DLMO) in participants.
  • Compared data from 87 medication-naïve children with ADHD and SOI (ADHD-SOI) to 33 children with ADHD without SOI (ADHD-noSOI), aged 6-12 years.

Main Results:

  • Children with ADHD-SOI demonstrated significantly later sleep onset times (21:38 vs. 20:49) compared to ADHD-noSOI.
  • Dim light melatonin onset (DLMO) was significantly delayed in ADHD-SOI (20:32) versus ADHD-noSOI (19:47).
  • Later wake-up times were observed in ADHD-SOI, with no significant differences in sleep maintenance or rhythm variability between groups.

Conclusions:

  • Children with ADHD and chronic idiopathic SOI exhibit a delayed sleep phase.
  • A delayed DLMO in ADHD-SOI children suggests a potential underlying circadian rhythm delay.
  • These findings indicate that ADHD-related SOI may be characterized by circadian rhythm alterations.

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