A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

  • Andrew N. CooganEmail author
  • Niall M. McGowan
Review Article


Reports of sleep disturbances in attention deficit hyperactivity disorder (ADHD) are common in both children and adults; however, the aetiology of such disturbances is poorly understood. One potentially important mechanism which may be implicated in disrupted sleep in ADHD is the circadian clock, a known key regulator of the sleep/wake cycle. In this systematic review, we analyse the evidence for circadian rhythm changes associated with ADHD, as well as assessing evidence for therapeutic approaches involving the circadian clock in ADHD. We identify 62 relevant studies involving a total of 4462 ADHD patients. We find consistent evidence indicating that ADHD is associated with more eveningness/later chronotype and with phase delay of circadian phase markers such as dim light melatonin onset and delayed sleep onset. We find that there is evidence that melatonin treatment may be efficacious in addressing ADHD-related sleep problems, although there are few studies to date addressing other chronotherapeutic approaches in ADHD. There are only a small number of genetic association studies which report linkages between polymorphisms in circadian clock genes and ADHD symptoms. In conclusion, we find that there is consistent evidence for circadian rhythm disruption in ADHD and that such disruption may present a therapeutic target that future ADHD research might concentrate explicitly on.


ADHD Circadian Sleep Melatonin clock gene 



Attention deficit hyperactivity disorder


Bipolar disorder


Composite scale of morningness


Dim light melatonin onset


Delayed sleep phase disorder


Interdaily stability


Intradaily variability


Morningness–eveningness questionnaire


Munich chronotype questionnaire






Sleep-onset insomnia


Randomised control trial


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by the authors.


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© Springer-Verlag Wien 2017

Authors and Affiliations

  1. 1.Department of PsychologyMaynooth University, National University of IrelandMaynoothIreland

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