Impact of adult attention deficit hyperactivity disorder and medication status on sleep/wake behavior and molecular circadian rhythms

Feb 14, 2019Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

How Adult ADHD and Medication Affect Sleep Patterns and Body Clock Rhythms

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

ADHD participants using medication show lower relative amplitudes of diurnal activity rhythms.

Patients with ADHD on medication exhibit lower sleep efficiency and increased nocturnal activity compared to controls and ADHD participants not using medication.
Circadian gene expression differences were observed, with altered levels of PER2 and CRY1 in ADHD individuals without medication compared to those with medication and controls.
CLOCK gene expression was modified in ADHD patients currently taking medication.
Changes in the timing of peak expression were noted in fibroblasts from the three groups.

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Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric condition that has been strongly associated with changes in sleep and circadian rhythms. Circadian rhythms are near 24-h cycles that are primarily generated by an endogenous circadian timekeeping system, encoded at the molecular level by a panel of clock genes. Stimulant and non-stimulant medication used in the management of ADHD has been shown to potentially impact on circadian processes and their behavioral outputs. In the current study, we have analyzed circadian rhythms in daily activity and sleep, and the circadian gene expression in a cohort of healthy controls (N = 22), ADHD participants not using ADHD-medication (N = 17), and participants with ADHD and current use of ADHD medication (N = 17). Rhythms of sleep/wake behavior were assessed via wrist-worn actigraphy, whilst rhythms of circadian gene expression were assessed ex-vivo in primary human-derived dermal fibroblast cultures. Behavioral data indicate that patients with ADHD using ADHD-medication have lower relative amplitudes of diurnal activity rhythms, lower sleep efficiency, more nocturnal activity but not more nocturnal wakenings than both controls and ADHD participants without medication. At the molecular level, there were alterations in the expression of PER2 and CRY1 between ADHD individuals with no medication compared to medicated ADHD patients or controls, whilst CLOCK expression was altered in patients with ADHD and current medication. Analysis of fibroblasts transfected with a BMAL1:luc reporter showed changes in the timing of the peak expression across the three groups. Taken together, these data support the contention that both ADHD and medication status impact on circadian processes.

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Impact of adult attention deficit hyperactivity disorder and medication status on sleep/wake behavior and molecular circadian rhythms

Abstract

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