ADHD, chronotype, and circadian preference in a multi‐site sample of college students

Jul 12, 2023Journal of sleep research

ADHD and daily activity patterns in college students from multiple locations

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Abstract

In a sample of 4751 college students, 47.2% of those with attention-deficit/hyperactivity disorder predominantly inattentive presentation identified as evening types.

Students with attention-deficit/hyperactivity disorder predominantly inattentive presentation had higher rates of evening chronotype compared to those without elevated symptoms.
41.5% of students with attention-deficit/hyperactivity disorder combined presentation also identified as evening types, versus 28.5% among those without elevated symptoms.
Inattentive symptoms were more strongly linked to eveningness preference than hyperactive-impulsive symptoms.
Greater preference for eveningness was associated with a stronger link between attention-deficit/hyperactivity disorder inattention and depressive symptoms, but not with anxiety symptoms.

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Attention-deficit/hyperactivity disorder and an evening chronotype are both common among college students, and there is growing interest in understanding the possible link between attention-deficit/hyperactivity disorder and circadian function. However, mixed findings have been reported, and many of the existing studies have used small samples that were unable to examine chronotype across attention-deficit/hyperactivity disorder presentations. Participants were 4751 students (73% female; 80% White), aged 18-29 years (M = 19.28, SD = 1.50), from five universities who completed measures assessing attention-deficit/hyperactivity disorder, depressive and anxiety symptoms, as well as the Morningness-Eveningness Questionnaire to assess chronotype (categorical) and circadian preference (dimensional). Participants with either attention-deficit/hyperactivity disorder predominantly inattentive presentation or attention-deficit/hyperactivity disorder combined presentation had higher rates of being an evening type (47.2% and 41.5%, respectively) than participants without elevated attention-deficit/hyperactivity disorder (28.5%), and participants with attention-deficit/hyperactivity disorder predominantly inattentive presentation also had higher rates of being an evening type than participants with attention-deficit/hyperactivity disorder predominantly hyperactive-impulsive presentation (30.7%). Dimensional analyses indicated that attention-deficit/hyperactivity disorder inattentive symptoms were more strongly associated than hyperactive-impulsive symptoms with eveningness preference. Finally, greater eveningness preference strengthened the association between attention-deficit/hyperactivity disorder inattention and depressive symptoms but not anxiety symptoms. This is the largest study to document that college students with elevated attention-deficit/hyperactivity disorder symptoms are more likely to be evening types than other college students, and inattentive symptoms in particular are associated with later circadian preference.

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ADHD, chronotype, and circadian preference in a multi‐site sample of college students

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