Later (“evening”) circadian preference is associated with poorer executive, academic, and attentional functioning in adolescents with and without ADHD

Jul 20, 2024Journal of child psychology and psychiatry, and allied disciplines

Evening sleep patterns are linked to weaker thinking, school, and attention skills in teens with and without ADHD

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Abstract

Greater eveningness is uniquely associated with poorer academic, executive, and attentional functioning in adolescents.

Adolescents with greater eveningness tend to have later bedtimes and wake times.
Sleep quality is linked to several academic and functioning outcomes, while sleep duration shows no significant association.
The relationship between eveningness and functioning persists even after accounting for sleep duration, sleep quality, and other factors.
ADHD status does not alter the impact of on functioning outcomes.

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BACKGROUND: Adolescents vary considerably in their circadian phase preference; those with greater "eveningness" (also known as "night owls") have later bedtimes, wake times, and peak arousal compared to those with greater "morningness." Prior research suggests that (a) greater eveningness is associated with worse academic, executive, and attentional functioning; and (b) adolescents with attention-deficit/hyperactivity disorder (ADHD) tend to be high in eveningness and to have deficits in these school-related constructs. However, few studies have examined alongside two potential confounds-sleep duration and sleep quality-as predictors of daytime functioning, or whether the strength of associations differs across adolescents with and without ADHD.

METHODS: Participants were 302 adolescents (M = 13.17 years; 44.7% female; 81.8% White); approximately half (52%) had ADHD. A multi-method, multi-informant design was used. Specifically, adolescents reported on their circadian preference, school night sleep duration, and sleep quality. Adolescents provided ratings of their academic motivation (intrinsic, extrinsic, and amotivation) and were administered standardized achievement tests in reading and math. Adolescents and parents completed ratings of daily life (behavioral, emotion, and cognitive regulation), and they and teachers also provided ratings of ADHD inattentive symptoms. age

RESULTS: Above and beyond sleep duration, sleep quality, and covariates (sex, family income, pubertal development, medication use), greater eveningness was uniquely associated with poorer academic, executive, and attentional functioning across most measures. Sleep quality was uniquely associated with a handful of outcomes, and sleep duration was not significantly uniquely associated with any outcome in the regression analyses. ADHD status did not moderate effects.

CONCLUSIONS: This study provides compelling evidence that poorer academic, executive, and attentional functioning are more closely associated with greater eveningness than with sleep duration or quality in adolescents. Findings suggest that targeting circadian preference may be important to reduce these problems in adolescents, especially in clinical samples such as ADHD for whom academic, executive, and attentional difficulties are exceptionally common.

Key numbers

0.26

Increase in Inattention Symptoms

Effect size of eveningness on inattention symptoms.

−0.18

Decrease in Academic Motivation

Effect size of morningness on academic motivation.

β = −0.85

Lower Math Fluency Scores

's impact on math fluency performance.

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Later (“evening”) circadian preference is associated with poorer executive, academic, and attentional functioning in adolescents with and without ADHD

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