Altered circadian profiles in attention-deficit/hyperactivity disorder: an integrative review and theoretical
Lindita Imeraj1, Edmund Sonuga-Barke, Inge Antrop
1Ghent University Hospital, Department of Psychiatry and Medical Psychology, Child and Adolescent Psychiatry Research Unit, 0K12F, De Pintelaan 185, 9000 Ghent, Belgium. lindita.imeraj@ugent.be
Abstract:
Disruptions in the sleep-wake cycle and the circadian system have been found in a wide range of psychiatric disorders and are generally correlated with clinical severity and diminished quality of life. Emerging evidence suggests similar disturbances may be found in attention-deficit/hyperactivity disorder (ADHD). Here we review the available literature on across the day fluctuations in ADHD-related processes in terms of; (i) time of day effects on behavior and activity; (ii) morningness-eveningness chronotypology; (iii) sleep/wake rhythms; and (iv) rhythmicity in neuroendocrine and neurophysiological responsiveness. On this basis, we propose a neurobiological framework to guide future study, which sees circadian effects in ADHD, along with other aspects of ADHD arousal-related deficits (e.g., cognitive energetic deficits), as being the result of dysregulated locus coeruleus function. Based on this perspective specific recommendations for future research are presented.
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