Idiopathic Chronic Sleep Onset Insomnia in Attention‐Deficit/Hyperactivity Disorder: A Circadian Rhythm Sleep Disorder
Abstract
To investigate whether ADHD-related sleep-onset insomnia (SOI) is a circadian rhythm disorder, we compared actigraphic sleep estimates, the circadian rest-activity rhythm, and dim light melatonin onset (DLMO) in ADHD children having chronic idiopathic SOI with that in ADHD children without sleep problems. Participants were 87 psychotropic-medication-naïve children, aged 6 to 12 yrs, with rigorously diagnosed ADHD and SOI (ADHD-SOI) and 33 children with ADHD without SOI (ADHD-noSOI) referred from community mental health institutions and pediatric departments of non-academic hospitals in The Netherlands. Measurements were 1 wk, 24 h actigraphy recordings and salivary DLMO. The mean (+/-SD) sleep onset time was 21:38 +/- 0:54 h in ADHD-SOI, which was significantly (p < 0.001) later than that of 20:49 +/- 0:49 h in ADHD-noSOI. DLMO was significantly later in ADHD-SOI (20:32 +/- 0:55 h), compared with ADHD-noSOI (19:47 +/- 0:49 h; p < 0.001). Wake-up time in ADHD-SOI was later than in ADHD-noSOI (p = 0.002). There were no significant between-group differences in sleep maintenance, as estimated by number of wake bouts and activity level in the least active 5 h period, or inter- and intradaily rhythm variability. We conclude that children with ADHD and chronic idiopathic sleep-onset insomnia show a delayed sleep phase and delayed DLMO, compared with ADHD children without SOI.
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In children with ADHD, SOI is prevalent (87 of 110 children with ADHD had SOI).
“In this study, 87 of 110 children with ADHD had SOI, indicating that it is prevalent in ADHD.”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Van der Heijden et al. (2005)
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 Van der Heijden et al. 2005
A delayed pattern of melatonin secretion in children with ADHD compared with controls has been described.
“A delayed pattern of melatonin secretion in children with ADHD compared with controls has been described (Van der Heijden et al. 2005, 2007).”
From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Van der Heijden et al. 2005
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- Authors
- Van der Heijden, K. B., Smits, M. G., Someren, E. J. W. V., & Boudewijn Gunning, W.
- Affiliations
- Ziekenhuis Gelderse Vallei (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- Chronobiology International
- Publisher
- Informa UK Limited
- Published
- 2005-01
- Volume
- 22
- Issue
- 3
- Pages
- 559-570
- ISSN
- 0742-0528 (ISSN-L)
- 1525-6073
- OpenAlex
- W2050905237
- Cited by
- 269
- References
- 45
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 8 · 2023: 9 · 2022: 9 · 2021: 14 · 2020: 10 · 2019: 17 · 2018: 19 · 2017: 11 · 2016: 25 · 2015: 15 · 2014: 16 · 2013: 14 · 2012: 25
- FWCI
- 12.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Chronobiology International (publishedVersion)
- PubMed (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- attention deficit hyperactivity disorder, sleep onset insomnia, circadian rhythm sleep disorders, delayed sleep phase, dim light melatonin onset, circadian rest-activity rhythm, actigraphy, children, sleep timing, wake-up time
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Data Interpretation, Statistical, Environmental Monitoring, Humans, Sleep Initiation and Maintenance Disorders, Light, Melatonin, Sleep Disorders, Circadian Rhythm
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