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

Molecular Psychiatry volume 17, pages 988–995 (2012)Cite this article

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Abstract

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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Acknowledgements

We acknowledge financial support from the Welsh Office for Research and Development and NARSAD. We also acknowledge technical assistance from Dr Sarah Forbes-Robertson.

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Author notes

  1. A L Baird and A N Coogan: These authors contributed equally to the study.

Authors and Affiliations

  1. Department of Neuroscience and Molecular Psychiatry, Institute of Life Science, School of Medicine, Swansea University,

    A L Baird, A Siddiqui, R M Donev & J Thome

  2. Swansea, UK

    A L Baird, A Siddiqui, R M Donev & J Thome

  3. Department of Psychology, National University of Ireland, Maynooth, Republic of Ireland

    A N Coogan

  4. Department of Psychiatry, University of Rostock,

    J Thome

  5. Rostock, Germany

    J Thome

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  1. A L Baird
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Correspondence to A N Coogan.

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Competing interests

JT has received financial support from various pharmaceutical companies, including AstraZeneca, Bristol-Meyer Squibb, Janssen, Lilly, Lundbeck, MEDICE, Merz, Novartis, Pfizer and Servier, some of which manufacture medication used in the treatment of ADHD. The other authors declare no conflict of interest.

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Baird, A., Coogan, A., Siddiqui, A. et al. Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels. Mol Psychiatry 17, 988–995 (2012). https://doi.org/10.1038/mp.2011.149

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