Sleep and Biological Rhythms

, Volume 17, Issue 1, pp 11–18 | Cite as

ADHD symptoms in adults with delayed sleep phase disorder

  • Mark A. SnitselaarEmail author
  • Marcel G. Smits
  • Jan Spijker
Original Article


The aims of the study are to investigate the prevalence of ADHD in delayed sleep phase disorder (DSPD) patients and to explore the relationship between circadian phase and ADHD symptoms, using the dim light melatonin onset (DLMO), and to compare this relationship with patients with sleep problems other than DSPD. 353 adult patients with sleep problems were assessed for self-reported ADHD symptoms using ADHD rating scale, self-reported sleep disorders using Holland Sleep Disorders Questionnaire (HSDQ), and circadian rhythmicity using salivary DLMO. From the 353 patients with sleep problems, 63 were designated as DSPD and 107 (30.3%) reported probable ADHD. Probable ADHD was reported by 47.6% of the DSPD patients and by 26.9% of the non-DSPD patients (p = 0.059). The DSPD group showed significant higher total ADHD-RS scores (p = 0.011). In the probable ADHD group more patients were designated as DSPD (28%) compared to the non-ADHD group (13.6% [χ2 = 10.402, p = 0.001]). Also 20 min later, DLMO (22:46 h) was found (p = 0.017) and more positive HSDQ scores on insomnia, parasomnia, hypersomnia, and sleep-related breathing disorders were reported in the probable ADHD group than in the non-probable ADHD group (χ2 resp. 16.07; p < 0.001, 9.245; p = 0.002, 19.391; p < 0.00 and 5.865; p = 0.059). The data suggest a high prevalence of probable ADHD in DSPD patients and increased prevalence of DSPD and other sleep disorders in patients with probable ADHD. Consequence is that awareness of these findings might help with treatment of both DSPD and ADHD.


ADHD Circadian rhythm Delayed sleep phase disorder DSPD Sleep Sleep disorders 



The authors received no financial support for the research, authorship, and/or publication of this article. Also no off-label or investigational use.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

The study protocol was approved by the local ethics committee of St. Radboud University Nijmegen. No clinical trial registration number available.


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Copyright information

© Japanese Society of Sleep Research 2018

Authors and Affiliations

  1. 1.Pro Persona Mental Health CareEdeThe Netherlands
  2. 2.Center for Sleep–Wake Disturbances and ChronobiologyGelderse Vallei HospitalEdeThe Netherlands
  3. 3.Pro Persona Mental Health CareNijmegenThe Netherlands
  4. 4.Radboud UniversityNijmegenThe Netherlands

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