Idiopathic Chronic Sleep Onset Insomnia in Attention‐Deficit/Hyperactivity Disorder: A Circadian Rhythm Sleep Disorder

Heijden, Kristiaan B. van der; Smits, Marcel G.; Someren, Eus J.W. Van; Gunning, W. Boudewijn

doi:10.1081/cbi-200062410

Cited by 238 publications

(142 citation statements)

References 38 publications

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“…142 Some patients with ADHD show a delayed sleep phase disorder. 143,144 In another study, a phase delay in the circadian rhythm of cortisol of adults with ADHD was found. 145 Other studies have observed a delay in the circadian rhythm of melatonin, as well as in the sleep-wake cycle, especially in ADHD patients who reported sleep onset insomnia.…”

Section: Attention Deficit Hyperactivity Disordermentioning

confidence: 99%

Circadian rhythms in cognitive performance: implications for neuropsychological assessment

Valdéz¹,

Ramírez²,

García³

2012

CPT

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Circadian variations have been found in human performance, including the efficiency to execute many tasks, such as sensory, motor, reaction time, time estimation, memory, verbal, arithmetic calculations, and simulated driving tasks. Performance increases during the day and decreases during the night. Circadian rhythms have been found in three basic neuropsychological processes (attention, working memory, and executive functions), which may explain oscillations in the performance of many tasks. The time course of circadian rhythms in cognitive performance may be modified significantly in patients with brain disorders, due to chronotype, age, alterations of the circadian rhythm, sleep deprivation, type of disorder, and medication. This review analyzes the recent results on circadian rhythms in cognitive performance, as well as the implications of these rhythms for the neuropsychological assessment of patients with brain disorders such as traumatic head injury, stroke, dementia, developmental disorders, and psychiatric disorders.

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Section: Attention Deficit Hyperactivity Disordermentioning

confidence: 99%

Circadian rhythms in cognitive performance: implications for neuropsychological assessment

Valdéz¹,

Ramírez²,

García³

2012

CPT

View full text Add to dashboard Cite

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“…8 Chronic sleep-onset insomnia has also been shown to be associated with childhood and adult ADHD. 9,10 ADHD is also associated with changes in diurnal preference towards greater eveningness. 4 The circadian clock is responsible for the generation of rhythms of behaviour and physiology on a near 24 period base, and has a key role in determining the rhythm of the sleep/wake cycle.…”

Section: Introductionmentioning

confidence: 99%

“…Abnormal rhythms of melatonin secretion has been associated with childhood and adult ADHD. 9,10 Cortisol circadian profiles have been reported to be either unaltered in ADHD 12 or altered in association primarily with the hyperactive subtype of ADHD. 13,14 The molecular basis of such circadian rhythm generation consists of positive and negative transcriptional/translational feedback loops of 'clock' genes and their protein products, and single-nucleotide polymorphism in clock genes have been associated with ADHD.…”

Section: Introductionmentioning

confidence: 99%

Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels

et al. 2011

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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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“…21 This observation is consistent with the demonstrated delay in evening increases of endogenous melatonin levels in nonmedicated children with ADHD. 22 An evening circadian tendency is associated with both parental reports of sleep-onset delay and PSGmeasured sleep-onset latency in children with ADHD. 21 Consistent with these findings, melatonin has demonstrated efficacy for improving sleep-onset latency and total sleep time in 2 studies in this population.…”

Section: Discussionmentioning

confidence: 99%

Eszopiclone for Insomnia Associated With Attention-Deficit/Hyperactivity Disorder

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Sleep disorders are common in children and adolescents and have a substantial negative impact on daily life and school performance. Long-term evaluations of the efficacy and safety of pharmacologic treatment options for sleep disorders are lacking in pediatric patients.WHAT THIS STUDY ADDS: These 2 studies provide the first evaluation of the effectiveness and safety of eszopiclone in children and adolescents with insomnia associated with ADHD. Data presented here encompass longer-term (up to 1 year) pediatric exposure to eszopiclone. abstract OBJECTIVE: To evaluate efficacy and safety of eszopiclone compared with placebo in children and adolescents with insomnia associated with attention-deficit/hyperactivity disorder (ADHD). METHODS:A 12-week, randomized, double-blind, placebo-controlled trial evaluated efficacy and safety of high-or low-dose eszopiclone (1 or 2 mg in children aged 6-11 years, 2 or 3 mg in children ages 12-17 years), given every evening, in 486 patients with ADHD-related insomnia. The primary efficacy variable was change in latency to persistent sleep from baseline to week 12, based on polysomnography. Key secondary measures were polysomnography-measured wake time after sleep onset, Clinical Global Impression Parent/Caregiver and Child scales, and the Conners' ADHD rating scales. The safety of eszopiclone was further studied over 1 year of open-label treatment in 55 patients who completed the double-blind study, and 249 patients with no previous eszopiclone exposure. RESULTS:Neither low-dose nor high-dose eszopiclone significantly reduced latency to persistent sleep compared with placebo after 12 weeks of treatment. Secondary outcomes were considered nonsignificant based on the hierarchical statistical analysis plan. The most frequent treatment-emergent adverse events over 12 weeks with eszopiclone were headache, dysgeusia, and dizziness. The study results demonstrated that eszopiclone was well tolerated over 1 year of treatment, with 11.2% of patients discontinuing open-label treatment because of an adverse event.CONCLUSIONS: Eszopiclone (up to 3 mg) failed to reduce latency to persistent sleep on polysomnography after 12 weeks in children aged 6 to 17 years with ADHD-related insomnia. Eszopiclone was well tolerated in the 1-year study.

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Idiopathic Chronic Sleep Onset Insomnia in Attention‐Deficit/Hyperactivity Disorder: A Circadian Rhythm Sleep Disorder

Cited by 238 publications

References 38 publications

Circadian rhythms in cognitive performance: implications for neuropsychological assessment

Circadian rhythms in cognitive performance: implications for neuropsychological assessment

Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels

Eszopiclone for Insomnia Associated With Attention-Deficit/Hyperactivity Disorder

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