ADHD, circadian rhythms and seasonality

Wynchank, Dora; Bijlenga, Denise; Lamers, Femke; Bron, Tannetje I.; Winthorst, Wim H.; Vogel, Suzan W.N.; Penninx, Brenda W. J. H.; Beekman, Aartjan T.F.; Kooij, J. J. Sandra

doi:10.1016/j.jpsychires.2016.06.018

Cited by 24 publications

(16 citation statements)

References 72 publications

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“…Bron et al (2016) report in another retrospective cohort of adults at risk for anxiety or depression there is an increased risk of late chronotype and delayed sleep phase in those scoring highly on the ADHD screener. An increased risk for delayed sleep was also noted in a cohort study by Wynchank et al (2016).…”

Section: Sleep-onset Insomnia and Delayed Sleep Phase Disorder In Adhdmentioning

confidence: 57%

A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

Coogan

McGowan

2017

ADHD Atten Def Hyp Disord

153

126

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Reports of sleep disturbances in attention deficit hyperactivity disorder (ADHD) are common in both children and adults; however, the aetiology of such disturbances is poorly understood. One potentially important mechanism which may be implicated in disrupted sleep in ADHD is the circadian clock, a known key regulator of the sleep/wake cycle. In this systematic review, we analyse the evidence for circadian rhythm changes associated with ADHD, as well as assessing evidence for therapeutic approaches involving the circadian clock in ADHD. We identify 62 relevant studies involving a total of 4462 ADHD patients. We find consistent evidence indicating that ADHD is associated with more eveningness/later chronotype and with phase delay of circadian phase markers such as dim light melatonin onset and delayed sleep onset. We find that there is evidence that melatonin treatment may be efficacious in addressing ADHD-related sleep problems, although there are few studies to date addressing other chronotherapeutic approaches in ADHD. There are only a small number of genetic association studies which report linkages between polymorphisms in circadian clock genes and ADHD symptoms. In conclusion, we find that there is consistent evidence for circadian rhythm disruption in ADHD and that such disruption may present a therapeutic target that future ADHD research might concentrate explicitly on.

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Section: Sleep-onset Insomnia and Delayed Sleep Phase Disorder In Adhdmentioning

confidence: 57%

A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

Coogan

McGowan

2017

ADHD Atten Def Hyp Disord

153

126

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“…20 One recent meta-analysis confirmed these conclusions. 21 Of note, the study of Wynchank et al 7 found that worsening of ADHD symptoms in autumn and/or winter may be attributed the association between ADHD and seasonal affective disorder (SAD) commonly seen in adult patients with ADHD. However, the prevalence of SAD is much lower in children as compared with adults.…”

Section: Discussionmentioning

confidence: 99%

“…6 Moreover, it was noted that seasonal and circadian rhythm instabilities can significantly influence ADHD symptoms. 7 Symptoms of ADHD can negatively impact an individual's health and quality of life (QoL) and impair function in multiple settings. 8 Furthermore, this disorder creates significant difficulties in education, social performance, and personal relationships.…”

Section: Introductionmentioning

confidence: 99%

Effect of Demographic Factors on Quality of Life in Children with ADHD under Atomoxetine Treatment: 1-Year Follow-up

Ragab

Eid

Badr

2020

Journal of Child Science

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Attention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children and adolescents. Symptoms of ADHD and its treatment can impact an individual's quality of life (QoL). The present study aimed to evaluate the effect of atomoxetine treatment, demographic characteristics, and seasonal variation on QoL in children with a recent diagnosis of ADHD and their parents. The present study included a cohort of 200 children diagnosed with ADHD. In addition to the recruited children, one of their parents was included in the study. ADHD symptoms were assessed using Conners' Parent Rating Scale. QoL of the participants was assessed with the PedsQL, while parents' QoL was evaluated using the World Health Organization Quality of Life questionnaire (WHOQOL-Bref). There was significant improvement in pediatric and parental QoL after treatment with atomoxetine. Significant factors related to better QoL in the participants included spring season, above average Conner's score, male sex, and rural residence. However, after using multivariate regression analysis, only patients' sex and Conner's score were significant predictors of pediatric QoL at the end of treatment with atomoxetine. Medical treatment significantly improved QoL in children with ADHD and their parents. Level of improvement was affected by patients' sex and ADHD severity.

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“…Recent evidence also suggests their efficacy in the treatment of obesity [ 47 , 48 , 73 ]. Importantly, these treatments were chosen because they are thought to directly modulate two key pathophysiological mechanisms of ADHD—namely a dysregulation of the dopaminergic [ 37 ] and circadian systems [ 57 , 58 ]—that potentially link ADHD to co-morbid depression and obesity [ 38 , 39 , 59 , 60 ]. Taking the neurobiological evidence into account, it seems reasonable that these non-pharmacological treatments might be specifically useful in the treatment and prevention of depression and obesity in adolescents and young adults with ADHD.…”

Section: Discussionmentioning

confidence: 99%

“…BLT is thought to modulate the circadian (CIRCA) system dysfunctions [ 57 , 58 ]—another key pathophysiological mechanism possibly linking ADHD to co-morbid symptoms of depression and obesity [ 59 – 62 ]. Following the idea of a shared CIRCA dysregulation possibly associated with the striatal dopaminergic system [ 63 ] that can be modulated by BLT, therapeutic effects of this intervention on ADHD symptoms as well as co-morbid depression and obesity can be expected.…”

Section: Introductionmentioning

confidence: 99%

Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial

Mayer

Hees

Medda

et al. 2018

Trials

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BackgroundThe risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day–night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD.MethodsThis trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 – < 30 years, will be screened at the four study centers. To establish effect sizes, the sample size was planned at the liberal significance level of α = 0.10 (two-sided) and the power of 1-β = 80% in order to find medium effects. Secondary outcomes measures including change in obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up.DiscussionThis is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and obesity, a larger scale confirmatory phase-III trial may be warranted.Trial registrationGerman Clinical Trials Register, DRKS00011666. Registered on 9 February 2017. ClinicalTrials.gov, NCT03371810. Registered on 13 December 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-017-2426-1) contains supplementary material, which is available to authorized users.

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ADHD, circadian rhythms and seasonality

Cited by 24 publications

References 72 publications

A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

Effect of Demographic Factors on Quality of Life in Children with ADHD under Atomoxetine Treatment: 1-Year Follow-up

Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial

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