0028 Are ADHD Symptoms Associated with Circadian Phase Preference or Melatonin Onset Phase in Youth on a Fixed Sleep Schedule?

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Abstract Introduction Research indicates that attention-deficit/hyperactivity disorder (ADHD) may be associated with later circadian rhythms, particularly an evening phase preference. It remains unclear whether biological circadian parameters index ADHD symptoms. Here we investigated preliminary associations of ADHD symptoms in early adolescents with circadian phase preference, dim-light-melatonin onset (DLMO) phase, and phase angle to sleep onset. Methods We analyzed data from 50 adolescents in R01HD103655 with complete data on all measures (28F; age: 12.3±1.2yrs, range: 10-15yrs). ADHD symptoms were assessed with the Conners-3 Parent and age/sex-adjusted t-scores revealed a range of inattention (59.29±14.75, range=40-90) and hyperactivity/impulsivity (61.83 ±16.82, range=41-90) symptoms. Participants were off psychostimulants or exogenous melatonin and completed at least five nights of sleep stabilization (10h time-in-bed aligned to family-optimal risetime) prior to at-home DLMO collection. Each wore light-blocking glasses and provided one sample every 30 minutes for 4.5 hours extending 1 hour past bedtime—10 samples in total. DLMO phase was determined by interpolation (4 pg/mL threshold), and phase angle to sleep onset was calculated as the average actigraphy-estimated sleep onset of the 5 nights before DLMO – DLMO phase. We measured child self-reported phase preference (eveningness[low]-morningness[high]; 29.16±5.08; range: 12-38) and puberty status (categories 1-5; mode=3, range=1-4) using measures previously established by our group. Results More mature pubertal category and older age were associated with greater self-reported eveningness (r(46)=-.38, p<.01; r(47)=-.41, p<.01). No associations were found between puberty category or age and DLMO phase (|r|’s≤.011, p’s ≥.90,) or phase angle (|r|’s≤.02, p’s>.88). Higher inattention t-scores were marginally associated with eveningness (r(45)=-.27, p=.07) but did not index DLMO phase or phase angle (|r|’s≤.01, p’s>.81). There were no associations of circadian variables and hyperactivity/impulsivity (|r|’s≤.06, p’s≥.68). Conclusion Despite perceptions of later circadian rhythms in ADHD, we found weak evidence linking ADHD symptoms with delayed circadian rhythms. Higher inattention symptoms were associated with a trend towards self-reported eveningness, however, neither inattention nor hyperactivity/impulsivity, was linked to biological DLMO phase or the phase angle of melatonin to sleep onset. These results indicate that altered circadian timing may not be a stable phenotype of ADHD when youth are placed on a stabilized sleep schedule. Support (if any) R01HD103655 (JMS); P20GM139743 (MAC).

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