Evening circadian preference is associated with sleep problems and daytime sleepiness in adolescents with ADHD

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.