Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels
Open accessAbstract
Attention-deficit hyperactivity disorder (ADHD) in adults is associated with impaired sleep, and it has been postulated that this impairment may contribute to the psychopathology of this common condition. One key driver of sleep/wake cycles is the circadian system, which at the molecular level consists of a series of transcriptional feedback loops of clock genes, which in turn produce endocrine, physiological and behavioural outputs with a near 24 h periodicity. We set out to examine circadian rhythms at the behavioural, endocrine and molecular levels in ADHD. Adults with ADHD as well as age- and sex-matched controls were recruited. Circadian rhythms were measured by means of actigraphy for the determination of gross motor patterns, by self-sampling of oral mucosa for assessment of rhythmic expression of the clock genes BMAL1 and PER2, and by estimation of salivary cortisol and melatonin levels. Actigraphic analysis revealed significant diurnal and nocturnal hyperactivity in the ADHD group, as well as a significant shorter period of best fit for the locomotor circadian rhythm in ADHD. BMAL1 and PER2 showed circadian rhythmicity in controls with this being lost in the ADHD group. Cortisol rhythms were significantly phase delayed in the ADHD group. These findings indicate that adult ADHD is accompanied by significant changes in the circadian system, which in turn may lead to decreased sleep duration and quality in the condition. Further, modulation of circadian rhythms may represent a novel therapeutic avenue in the management of ADHD.
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In adults with ADHD, a loss of circadian gene expression rhythms in the oral mucosa accompanies delays in cortisol rhythm and reduced-amplitude melatonin rhythms.
“In adults with ADHD, a loss of circadian gene expression rhythms in the oral mucosa accompanies delays in cortisol rhythm and reduced-amplitude melatonin rhythms89.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [89]
In 13 adults with ADHD, the period of the actigraphic rest/activity rhythm differed significantly from 24 h.
“Baird et al. (2012) report that in 13 adults with ADHD there was loss of rhythmic expression of the clock genes PERIOD 2 (PER2 ) and BMAL1 in oral mucosa, and the period of the actigraphic rest/activity rhythm differed significantly from 24 h.”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Baird et al. (2012)
In 13 adults with ADHD, there is loss of rhythmic expression of the clock genes PER2 and BMAL1 in oral mucosa.
“Baird et al. (2012) report that in 13 adults with ADHD there was loss of rhythmic expression of the clock genes PERIOD 2 (PER2 ) and BMAL1 in oral mucosa, and the period of the actigraphic rest/activity rhythm differed significantly from 24 h.”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Baird et al. (2012)
In 13 adults with ADHD, there is a significant delay of the cortisol diurnal rhythm relative to wakening time.
“Baird et al. (2012) report a significant delay of the cortisol diurnal rhythm relative to wakening time in a sample of 13 adults with ADHD with 6 samples taken across 24 h.”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Baird et al. (2012)
In adults with ADHD, there is a blunted melatonin rhythm.
“In their study, Baird et al. (2012) noted a blunted melatonin rhythm in adults with ADHD, but also noted more nocturnal light exposure in the ADHD group which may have contributed to acute suppression of melatonin secretion.”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Baird et al. (2012)
There is evidence to suggest that ADHD may be associated with disturbances of the circadian rhythm.
“There is evidence to suggest that ADHD may be associated with disturbances of the circadian rhythm.”
From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Baird et al. 2012
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- Authors
- Baird, A. L., Coogan, A. N., Siddiqui, A., Donev, R. M., & Thome, J.
- Affiliations
- Swansea University (GB)
- National University of Ireland, Maynooth (IE)
- Corresponding author
- Coogan, A N
- Venue
- Molecular Psychiatry
- Published
- 2011-11-22
- Volume
- 17
- Issue
- 10
- Pages
- 988-995
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- OpenAlex
- W2138292762
- Cited by
- 224
- References
- 30
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 12 · 2023: 12 · 2022: 12 · 2021: 19 · 2020: 20 · 2019: 18 · 2018: 18 · 2017: 20 · 2016: 10 · 2015: 14 · 2014: 19 · 2013: 15 · 2012: 12
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Molecular Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Maynooth University ePrints and eTheses Archive (Maynooth University) (acceptedVersion)
- Funders
- Office of Research and Development
- National Alliance for Research on Schizophrenia and Depression
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- adult ADHD, circadian rhythm, sleep disorders, clock genes, Bmal1, Per2, salivary cortisol, melatonin, actigraphy, circadian period, circadian rhythm therapy
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Circadian Rhythm, Endocrine System, Female, Humans, Hydrocortisone, Male, Melatonin, Middle Aged, Psychometrics, Surveys and Questionnaires, Retrospective Studies, Saliva, Time Factors, Case-Control Studies, Statistics, Nonparametric, Diagnostic and Statistical Manual of Mental Disorders, Young Adult, Actigraphy, ARNTL Transcription Factors, Period Circadian Proteins, Self Report
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