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ADHD as a circadian rhythm disorder: evidence and implications for chronotherapy (2025)

149 points bookofjoe 4 hours ago 112 comments

falcor84 3 hours ago | parent

There seems to be almost nothing new here. I see that the main studies the they cite are actually from the 2010s:

https://www.bmj.com/content/350/bmj.h68.abstract

https://www.sciencedirect.com/science/article/abs/pii/S13899...

I'd be curious to see if there's been any larger scale follow up on this since.

pazimzadeh 2 hours ago | parent

well it's a review article

falcor84 2 hours ago | parent

I'm used to reviews of recent work, not of work from a decade ago

bbor 3 hours ago | parent

Oh cool so now people will be told to go to sleep earlier and get more sun before you can prove that you deserve actual treatment. Fun...

gchamonlive 3 hours ago | parent

Another way to look at this is how many people need more sun and regular sleep and instead are doing unnecessary treatments?

btilly 2 hours ago | parent

That is doubly important given that one of the effects of the medications, is to disrupt sleep.

gregoryl 2 hours ago | parent

Roughly, zero. Stimulants are not a fun dependency, come with a bucket list of side effects and downsides, and only mitigate one aspect of ADHD.

gchamonlive 2 hours ago | parent

ADHD treats with Lisdexamfetamine. Amfetamines, I repeat. People use this to study, to get high at parties, to be functional at work, so I really doubt there aren't patients out there abusing these drugs with valid prescriptions.

jplusequalt 2 hours ago | parent

Yes, some people will abuse their prescriptions.

But the majority will not. Treating ADHD through stimulants usually has fantastic outcomes for patients.

gchamonlive 2 hours ago | parent

So it isn't roughly zero, and this minority is what's being discussed here.

jplusequalt 2 hours ago | parent

No, but if you're trying to argue that sleep therapy would be more effective for this group than non-stimulant form of medication, you need to prove this.

Sleepy therapy (CBT-I) may be the best supported treatment for insomnia, but it's still quite shit. ~50% of people will see little to no improvement after going through therapy.

gchamonlive 1 hour ago | parent

I'm not arguing anything, I'm questioning

jplusequalt 2 hours ago | parent

Any psychiatrist worth a damn already considers these things.

"ADHD" symptoms can manifest for a variety of reasons, and that's why good ADHD testing involves multiple exams alongside the traditional ADHD ones to help figure out what actual issues are present.

Also, comorbidities make this all the more complicated. Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.

gchamonlive 2 hours ago | parent

> Any psychiatrist worth a damn already considers these things.

Protocols however are always changing depending on new findings. Not saying this is the case, but not considering something unknown at the time doesn't make a doctor not worth a damn.

> Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.

if that was the case the treatment wouldn't be unecessary, like I specifically wrote in the comment you are replying to.

ctolsen 2 hours ago | parent

ADHD is highly treatable with medication, and any other intervention is at best mild mitigation. So how many? Amongst people with ADHD, basically nobody.

Sun and proper sleep is certainly helpful for people with ADHD but the likelihood of them getting that is vastly increased if they’re medicated correctly.

whimsicalism 1 hour ago | parent

Just an FYI, in circles similar to HN, people will respond very negatively to anyone suggesting anything that might hint at tightening amphetamine prescriptions.

gchamonlive 1 hour ago | parent

I'm counting on it, I find it deliciously ironic how much there's little interest here in the actual wellbeing of people. The logical hoops people go through here is hilarious.

whimsicalism 1 hour ago | parent

tbh as a non-user, I think stimulants are likely life improving for many (potentially most) people. what i dislike/chafe at is the insinuation that stimulants only work for people with diagnosed ADHD or only have non-recreational effects for people with ADHD. the latter especially seems to rapidly have become a folk wisdom.

gchamonlive 1 hour ago | parent

Sure, there's always the middle ground, but there's always the extreme, people abusing amfetamines because a regular human being isn't made to work 12 hours a day 7 days a week, or because after the third pill it's not kicking anymore.

And people should drop the cynicism that just because there are doctors around everyone is well cared for. Just look at the opioid crisis in the US, fuelled by respectable doctors chasing financial incentives.

mplemay 3 hours ago | parent

Be me. Too AHDH to even open the article, let alone read the article before moving to the next HN post.

baoooooooooooo 3 hours ago | parent

> walk in

> see this title

> oh man that would explain a lot

Ok after reading a chunk of this the correlation is pretty wild. Having the data it’s quite striking. Sleep intervention as a form of ADHD treatment has always seemed reasonable to me but this gives a lot more clarity to the approach and mechanisms.

For me, the seasonal aspect of it aligns with their blue light findings (both driving symptoms and aligning with improvement under the intervention of having a grow-LED garden setup on my desk), and in a second maybe related matter we’ve found using blue light blocking glasses an hour before bed to be the most impactful single intervention around sleep quality and onset (the ones that are like orange laser safety glasses, not the mildly reflective desk-work glasses)

TeMPOraL 3 hours ago | parent

> walk in

> see this title

> think authors are reversing causation hard

-- signed, a deep Night Owl

alterom 2 hours ago | parent

Indeed.

The following (informally described) symptoms are well-known consequences of ADHD:

- Delayed Sleep Phase [1]

- Staying Up Late [2]

- Revenge Bedtime Procrastination [3]

Newsflash, getting a full night's sleep helps alleviate ADHD symptoms, while being perpetually sleep-deprived wrecks us.

But there are reasons why we stay up late. Simply forcing us to sleep doesn't address those reasons.

Which is why I wrote about it so much, and keep spamming these links even though it feels so darn obvious. Not to the authors of the study, it appears.

[1] https://romankogan.net/adhd/#Delayed%20Sleep%20Phase

[2] https://romankogan.net/adhd/#Staying%20Up%20Late

[3] https://romankogan.net/adhd/#Revenge%20Bedtime

parpfish 2 hours ago | parent

going to bed early feels like i'm a child being punished.

staying up late rocks. its the funnest. why would i give that up? just to pay attention better at work? no thanks.

CoastalCoder 2 hours ago | parent

> staying up late rocks. its the funnest. why would i give that up? just to pay attention better at work? no thanks.

You may eventually find yourself in a situation where the tradeoff is worth it.

E.g., you have a family to feed, and your ability hold a well-paying job hinges on your performance.

alterom 2 hours ago | parent

There's only one little problem with that reasoning, my friend...

sigh

ADHD PEOPLE ARE NOT MOTIVATED BY REWARD[1]

We literally can't do the things we want and need to do [2].

We know full well the trade-off is worth it. It's just that we can't have it.

Sincerely,

--an AuDHDer

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3010326/

[2] https://add.org/demand-avoidance/

autoexec 55 minutes ago | parent

> ADHD PEOPLE ARE NOT MOTIVATED BY REWARD

I'm not sure that's an entirely fair way to frame that. ADHD people can be highly motivated by reward, but being motivated isn't enough to consistently navigate the path from wanting something to getting something. Reward can make you want something more, and even try harder for it, but ADHD means that sometimes no matter how much you want something and how hard you try it just doesn't happen.

theshackleford 2 hours ago | parent

> E.g., you have a family to feed, and your ability hold a well-paying job hinges on your performance.

I can do all of these things anyway. Of course, this does present the potential reality that were I able to sleep like people, I could be even more successful, but after a near death experience, then disability, I've learned to be happy with where I am.

casualscience 1 hour ago | parent

It's hard to interface with society this way. I'm the same as you and have waxed and waned many times. There are periods where I'm all about being social and living a normal life. There are other times where I'm just down to only sleep when I'm dead tired (as opposed to using drugs to keep me in normal rhythm). There are tradeoffs

alterom 1 hour ago | parent

Consistent inconsistency is the part of the ADHD package.

It's not that there aren't tradeoffs, it's that we don't get to choose these tradeoffs (as in: the cost of choosing is huge and nonzero).

autoexec 1 hour ago | parent

A delayed sleep/wake cycle is only relevant in the context of a society where people are forced on an unnatural sleep schedule. You could get a full 9 hours of high quality sleep every single night and still be considered to have a delayed sleep/wake cycle disorder.

Some people are just night owls. A large percentage of night owls have ADHD. I think they can linked without it meaning that people with ADHD have to learn to get up at 5AM.

Keep staying up late if that's what feels natural for you, but it's probably worth making sure that you're still getting enough sleep and that you don't have other issues (like sleep apnea) keeping you from getting the quality of sleep you need. There's a lot of other health issues associated with sleep disorders and sleep problems will tank people's ability to focus even when they have non-ADHD brains.

hatthew 2 hours ago | parent

Lots of the things on this site are normal things that everyone experiences to some degree ...right?

alterom 2 hours ago | parent

>Lots of the things on this site are normal things that everyone experiences to some degree ...right?

Everyone may experience some of those things some of the time, particularly if they are overwhelmed, overworked, overstressed, etc.

ADHD is experiencing most of these most of the time - as in all the time - for your entire life.

As an analogy: everyone may experience toe pain sometimes if and when they stub their toe on kitchen table leg.

But if it hurts like that all the time, for your entire life - you'd get it checked out, right? There are solid chances something is different about your body.

Now multiply that by 100.

To reword this: say, each relatable entry on that page is a 2% likelihood of ADHD.

If you relate to 100 of them, the chances you're not ADHD drop to 13%.

I've got enough people through an official diagnosis this way that this page, in itself, is a decent enough diagnostic tool.

hatthew 20 minutes ago | parent

How much do you think ADHD is a specific mental condition that one either has or doesn't have, versus a set of common symptoms that can have many causes? I wonder which direction a causal relationship between sleep and ADHD might be.

autoexec 1 hour ago | parent

> Newsflash, getting a full night's sleep helps alleviate ADHD symptoms, while being perpetually sleep-deprived wrecks us.

being perpetually sleep-deprived wrecks everyone. If you've got ADHD getting the sleep you need won't cure it, but it will make it easier to manage. If you don't have ADHD, but a lot of the symptoms fit for you, getting sleep might those all go away.

oliyoung 2 hours ago | parent

Almost my exact response.

And the cruel tragedy is that it becomes this self-reinforcing cycle.

Sleep bad > "Bad" ADHD day > Harder to fall asleep. Rinse. Repeat.

CoastalCoder 2 hours ago | parent

Then add in the use of powerful stimulants (e.g. Adderall) to power through a workday, only to have that cause insomnia that night, and a wrecked sleep schedule for the following 3 days.

autoexec 47 minutes ago | parent

Caffeine too, and forgetting to take medications on time and taking them later in the day.

Nevermark 2 hours ago | parent

I had great success reflecting 80,000 lumens of work lights off my living rooms ceiling during winter for a couple years.

At a new home, I remodeled four rooms to have three bands wide of LED lighting surrounding the ceilings, hidden from below by cove molding. It is an actual sunny day, with an “an actual” sunny sky inside. Winter, midnight, eclipse? Not a concern.

Having all that intense light reflecting off entire ceilings creates soft diffuse lighting, no shadows, even though it is extremely bright.

Helped a lot with waking up and avoiding depression, all year round.

On the sleep treatment, anything that can help sleep is good, my body has always operated well on a 30 hour day, which means terribly almost all the time, by default. But I do a lot of things that help, so my sleep is pretty good most of the time.

I would see sleep aids as a pretty narrow interventions relative to my ADHD.

Correlation would be nowhere near equivalence.

conception 2 hours ago | parent

This sounds amazing- do you have part list or pics/write up?

Nevermark 2 hours ago | parent

I had a contractor and an electrician! There is some significant power draw.

It’s been five years, so I expect the best components are different, more efficient and cheaper.

In winter, the lights can be considered part of my heating system. In summer, windows get opened. If I did it again, I would have some little fans up there expelling air from the cove directly outside.

But that is fine tuning. I am really happy. (When the lights are on. /h)

brailsafe 2 hours ago | parent

The 30 hour day feeling resonates. If I have no external schedule or I'm just living as I see fit, I end up gravitating to 3am bed, ~12pm wake sorta schedule. The only real problem is that it's functionally incompatible with jobs and many other services, even fully remote

hax0ron3 2 hours ago | parent

Same. For me it's more like 4-6 am bed.

I also work best in long bursts of up to 12 hours, with days of full rest in between bursts. I don't do well with a five days a week 9-5 work schedule.

And timeline urgency / time pressure tends to do well at putting me into deep flow state, whereas it can be hard for me to get into flow state for work otherwise.

casualscience 2 hours ago | parent

Live on East Coast, take a west coast remote job. 9am Meeting is noon.

I did this for several years. It works great

mjburgess 2 hours ago | parent

I can confirm this effect. One winter I left 2x300w living room lights on perm, and it had a dramatic effect. The only issue is that its nice to turn lights off at night, and if you do that, now you're in habit-dependent territory.

landrew_ 2 hours ago | parent

one thing i've been paying the adhd tax on is automating / making habits lower activation energy. smart bulbs / blinds are a great thing for me especially when i am already in bed and have too much executive dysfunction to walk 3 feet to the light switch / shade

baoooooooooooo 2 hours ago | parent

Ah on the 30 hour day: I had some success living a 28 hour day for a few months, which has the nice property of meaning your awake hours are identical week to week making it at least somewhat possible to interface with polite circadian society.

6x 28 hour days pack cleanly into a 7-day week, so all Mondays you wake at the same time, then all Tuesdays you wake 4 hours later and so on. It was one of the most productive times of my life but ultimately left my partner feeling unhappy and lonely.

Fuck it we do our best with 24 hour days…

Nevermark 1 hour ago | parent

Your comment prompted the epiphany that I am a natural 4-cycle per 5-day person.

That's enough synchronization that I am going to give some thought to what the crossovers times with "normals" will be, and may try it.

Synchronizing across M-F, then adjusting between Friday evening and Monday morning, to repeat.

RobRivera 35 minutes ago | parent

>open the door

>get on the floor

>walk the dinosaur

Aboutplants 3 hours ago | parent

Disruptions to sleep aggravates underlying issues, mentally or physically.

psygn89 3 hours ago | parent

I am lucky I don't have disruptive sleep issues, but my brain still feels slightly foggy and my battery feels 75% charged in the morning. I imagine if I had disruptive sleep issues I might as well be toast. Or maybe I'm just not aware of disruptions in my sleep...

toast0 3 hours ago | parent

What's wrong with being toast? :P

My sleep issues are at least manageable.

anon291 2 hours ago | parent

I was like you. A year ago, I was tired as hell despite sleeping (well, not enough, but I've never slept 'enough'). A few people said sleep apnea but i was not overweight and didn't snore. I tried the test anyway, and it turns out I wasn't breathing. I used an oral appliance and a year later, it's gone and I feel better.

Also, without doing anything my triglycerides, LDL cholesterol and blood sugar which had gone way out of whack, went back to normal.

I started using my oral appliance on a Monday. That Friday I was so energetic I ran 12 miles in one go. I hardly ever run or even practice that much, but I was just so wired that I couldn't help it. It was an amazing feeling. I highly suggest sleep apnea treatment even if you don't think it sounds like you.

omnicognate 58 minutes ago | parent

If you haven't had a sleep study to check for sleep apnoea you should get one. It's very common, anyone can have it and the only way to check properly is a sleep study. You can have sleep apnoea without being a snorer and you can sleep next to someone without them being aware of it. It's extremely bad for your health and very treatable.

tombert 2 hours ago | parent

I still have problems, but my life categorically improved once I got diagnosed and treated for obstructive sleep apnea. I focus on things much better, I'm better at juggling tasks, and I'm just nicer to people, or at least my fuse is considerably longer than it used to be. Also I'm sure my wife is grateful that I'm not snoring or gasping for breath every night.

I would highly encourage anyone who can get a sleep study done to do it. Most insurance companies will at least cover the sleep study and sleep sleep apnea can lead to a lot of considerably-more-expensive issues later down the line. It's not very invasive anymore, all they had to do was have me sleep with a pulse oximeter for a few nights and apparently that was enough.

skupig 3 hours ago | parent

I've been using a smart switch to fade in a light (one of the "sun-like" full-spectrum ones) over my head in the morning and it's been really effective for regulating my circadian rhythm. Even with little sleep, I will naturally wake up in the morning at a much more regular time.

neckardt 3 hours ago | parent

If the light turns on too quickly for me it’s super jarring and I hide under the covers. Did you find one that goes bright over the course of 30m or something? Or can you handle the quick increase in brightness?

servo_sausage 2 hours ago | parent

I do the same with a lifx bulb, it can be set up to fade and colour shift over any duration you like.

ThrowawayP 2 hours ago | parent

Google for "wake-up light". Philips is the brand I'm familiar with but there are others.

skupig 2 hours ago | parent

It's a controllable dimmer switch that I fade in over the course of an hour or so using a Home Assistant script.

al_borland 2 hours ago | parent

I have a sunrise alarm clock, I think from Phillips. If I set the alarm for 8am, the light will start turning on at 7:30am then slowly increase in brightness over the next 30 minutes until 8am when it's at full brightness and the alarm goes off (which are nature sounds).

When it first starts, it's more of a warm glow than a light. The max brightness can also be set.

hannasanarion 2 hours ago | parent

Smart bulbs.

You can make your artificial sunrise take as long as you want, and connect them to a sleep tracker so they're timed to wake you up during a comfortable phase.

I've been doing this for 12 years, and I don't think I have ever been upset to hear my alarm since, as long as I'm home and the lights have prepared me. Lately I've even been waking up before my alarm about half the time, even though I work on a schedule one time zone east of where I am.

It's shocking to me that it's not more popular for everybody. I guess the benefit is hard to explain.

al_borland 2 hours ago | parent

I have been using one of those sunrise alarm clocks for around 8 years now. If I go to bed at a reasonable time, the light will wake me up naturally before the alarm actually goes off. However, if I stay up too late the effect of the light fades. I'll sleep right through the light and need the alarm. On one occasion when I must have been really sleep deprived, I slept through the light, an hour of the alarm going off, and another 2-3 hours after that.

44mkultra69 3 hours ago | parent

lists Melatonin, first, then behavioral pseudo-interventions.

stay tuned for more monthly product placements on frontiers in, best digested post prime time.

Welcome to your readjustment. Willkommen beim Nachrichten.

hey, is anyone wondering if kleine & grosse Lauschangriffe are shared with private people or the guys working for these institutions are trustworthy enough and whether they actually deserved their Bachelor degrees or someone somehow decided they are worth it anyway? wait ... it's just a fucking Bachelors degree

herf 2 hours ago | parent

Dr. Sandra Kooij is a good person to look up if you are interested in adult ADHD and sleep. She has a book about it. From what I remember, there are a few things that are known:

1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia

2. you can induce ADHD-like symptoms in normal people by restricting sleep

3. Some of the interventions that improve sleep timing and quality affect ADHD (but it isn't a total cure)

al_borland 2 hours ago | parent

> 1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia

I would think this wouldn't be such a problem if society would acknowledge night owls exist and allow work to adjust accordingly. Forcing a night owl to live the life of a morning lark is likely not the best way to get their best work. The person suffers who has to try and live in a world not designed for when they sleep, and the employer suffers by getting less out of those people.

I have ADHD and left to my own devices I would go to sleep somewhere between 2-4am. At work, I don't function so well before about 2pm some days... and by that point that day is almost over.

brailsafe 2 hours ago | parent

Completely agree, and tend towards the same schedule. I don't even mind working in-person with people, but this idea that everyone should just be uniformly aligned to operate on the same hours is alienating and humiliating at times.

luckydata 2 hours ago | parent

being a night owl is not good for your health for a lot of reasons (I am one).

theshackleford 1 hour ago | parent

This would depend on the individual, or so my sleep team, including my sleep doctor suggest.

It is better for me to align with a pattern where I get some level of restful sleep, as opposed to one where I do not ultimately.

In an ideal world, you are obviously correct, but in the world between a severely disturbed sleep where I get a handful of hours of actually restorative sleep, vs once where I actually sleep for 7 hours? One wins over the other.

And yes, given I have an entire medical team (for other reasons, I have a SCI) I have done about everything you can to resolve sleep. Between ADHD however, symptoms related to the SCI etc, we really do just have to go with whatever we can reasonably get.

autoexec 40 minutes ago | parent

As long as you're getting enough sleep and some sunlight what's the problem? I'm guessing that a lot of people who are night owls aren't getting that, and that a lot of people who have other health issues (especially sleep disorders) end up living the night owl lifestyle, but I don't see why it should matter what specific times you go to bed.

theshackleford 2 hours ago | parent

> I have ADHD and left to my own devices I would go to sleep somewhere between 2-4am. At work, I don't function so well before about 2pm some days... and by that point that day is almost over.

Indeed. I've struggled with it since childhood, not only me. The same "symptoms" for lack of a better word are seen with my mother, my aunt and my grandmother. All are night owls, all sleep poorly etc.

For whatever reason, regardless of how much sleep i've had, my brain begins to kick into high gear with a clarity of thought and capacity to dedicate myself to things starting at about 9PM. This remains true REGARDLESS of sleep, how well rested I am, general health, etc. I could have had NO sleep for 24 hours, still be away at 9PM the next night, and it's like a switch.

The ONLY time this ever differs, for reasons still unknown, and where I fit into "normal society" is for whatever reason, when I visit Russia (which I have not done for some time for obvious reasons.)

When I am in Russia, with no effort at all, I sleep normal hours without issue, and wake up during the day time actually well rested. This ceases once I return to my timezone. This same pattern is not seen when say, I visit the US instead.

If only I could harness this magic...

mikert89 1 hour ago | parent

its a catch all for people whos brains didnt develop correctly, people who are a genius, and boys

jplusequalt 2 hours ago | parent

How do the authors disentangle cause and effect here? It doesn't follow that sleep issues are an underlying cause, and not just one of the MANY symptoms of ADHD.

Insimwytim 2 hours ago | parent

uBlock filter to fix selection:

  www.frontiersin.org##.InfoDrawer

sid_talks 2 hours ago | parent

For a time I had to wake up at 6AM for work and it was a period where I struggled the most with my ADHD symptoms.

I hope there is more awareness in the future about the importance of sleep for neurodivergent people. This could help with the social jet lag most of us feel with having to follow a schedule that simply does not work for us.

etoxin 2 hours ago | parent

I was formally diagnosed as a kid but didn’t do the drug route due to my father not liking these new drugs. I’m in my 40’s now and only started enforcing a sleep routine 10ish years ago. Eg. Bedtime at 11 and get up when alarm goes off at 7:30. And the effect on me was astounding. Everything just levelled out. I still like/need a coffee in the morning.

nephihaha 2 hours ago | parent

There seems to be some kind of hidden connection between autism and ADHD. At first sight the definitions are contradictory but in reality, many people have both. Sleep disturbance seem to be common among autistic people too.

emil-lp 2 hours ago | parent

Beware that Frontiers In is a very low quality outlet and most scientists stay far far away from it (unless they really need a publication the next three weeks since they have that tenure track review coming up).

Eg see https://retractionwatch.com/2025/07/29/frontiers-retract-122...

autoexec 42 minutes ago | parent

> Frontiers has an artificial intelligence review system for submitted manuscripts, which now includes verification of the reviewers’ and handling editors’ conflict of interest statements, the company said.

problem solved I guess

nickledave 18 minutes ago | parent

yeah, this is what I came here to say

I don't know about Frontiers in Psych specifically, but, see also: https://www.reddit.com/r/AskAcademia/comments/1oi5dhy/whats_...

athrael-soju 2 hours ago | parent

Embrace the nightly builds :P

plozniydev 2 hours ago | parent

i like the web new things to see about ADHD.

anigbrowl 2 hours ago | parent

Has anyone considered that one reason for being/staying awake late at night that's very salient for ADHD people is that night tends to be much quieter, so it's a period when it's much easier to think/read/work without constant interruptions. Noise pollution isn't taken seriously enough.

shoobiedoo 1 hour ago | parent

Oddly, I gravitate towards noise like a busy coffee shops or taking walks along highways. The background noise keeps unwanted thoughts from barging in

autoexec 45 minutes ago | parent

That's a good point, although at the same time, even the most quiet environment can only help so much to stave off distraction and once hyperfocus starts there's very little that can pull you away.

SamDc73 1 hour ago | parent

Three things that helped me with my circadian phase (to certin extend)

1) Melatonine 300mcg 5-6 hours befor desired sleep time 2) 10k lux light for 30m when waking up 3) Nobeltin (nootropic) it enhances clock amplitude, so I do get less sleepy during teh day and more sleepy at night ..

things taht kind of helped but find hard to keep: Keto (I feel less sleepy on Keto, and easier to fall a sleep but it's been a while since ive been on keto)

jghn 1 hour ago | parent

+1 to melatonin. It took me a very long time to dial in the right dose though. It’s not like it’s some miracle cure but it has helped a bunch with being able to fall asleep at a reasonable time, sleep through the night, and thus wake up at a reasonable time. Which of course helps a bit with everything else

elcritch 39 minutes ago | parent

Melatonin lately (about 500 mcg) has helped me get better sleep and hopefully to help with the sleep drift.

However, it's almost like I'm so conditioned to being groggy in the mornings that I still find it hard to get up even if I feel fairly refreshed.

reliablereason 1 hour ago | parent

The title of the article is irresponsibly chosen.

- My time in the field of psychology has made me think that the use of imprecise language for describing psychology has a large and problematic societal impact

ADHD is correlated with but is NOT a "circadian rhythm disorder". This is definitionally true.

There are many causes of ADHD. One of them is likely sleep issues.

swader999 1 hour ago | parent

ADHD meds also impact circadian rhythm. So I don't really know how a study could look at this dynamic with any usefulness.

edelbitter 11 minutes ago | parent

So does eating properly and consistently. A likely expensive but also likely useful study could therefore measure multiple known sleep hygiene approaches in isolation, then in combination, and then look at the degree of correlation in comparison to controls. Some of the observed differences might be cleanly attributed to previously not properly controlled for effects such as irregular meal schedules.

hirvi74 1 hour ago | parent

I believe it. I even sought out medical advice on how to best deal with it all. I was given the usual recommendation of low-dose melatonin and light therapy.

However, my issue at the time was that I could never find a light with high enough lux values that I felt like I could trust. Plus, another issue with light therapy is that one can basically never stop for any moderate amount of time, and well, my ADHD makes that near impossible.

I honestly think I would have better success with sleep issues if I could just control my own schedule or have a flexible schedule, but that is not really a luxury most jobs can provide.

taurath 1 hour ago | parent

> Melatonin and bright light therapy has advanced DLMO in both children and adults with ADHD

Tried it with gusto over about 3, among a ton of other things. Didn't work for me at all.

> we propose a pragmatic, behavioral-first clinical pathway

Read: cheap

autoexec 36 minutes ago | parent

> we propose a pragmatic, behavioral-first clinical pathway

> Read: cheap

I mean, if it works great, if it doesn't there's a lot of other options.

randomImmigrant 1 hour ago | parent

Chronobiologist here. And also have ADHD.

The associations with ADHD really are there, but that may just also be because a huge number of brain processes have a circadian regulation, and those get disrupted by whatever is causing ADHD.

The causality is also bidirectional, because whatever ADHD does could cause light exposure behavioral changes, which could leave a circadian phenotype.

In general, a huge number of diseases have circadian phenotypes. To be a circadian disorder, you’d have to have clock mutations, and ADHD really doesn’t have those. So calling it a circadian disorder feels off.

But from personal experience, the linkage is strong enough to warrant deeper research, and beyond that, there’s some steps we can take ourselves. Regular walks in nature, going out to get sun… all generally useful things to do that do seem to help ADHD as well.

elcritch 24 minutes ago | parent

> The causality is also bidirectional, because whatever ADHD does could cause light exposure behavioral changes, which could leave a circadian phenotype.

This seems the most likely given my own experience with ADHD and sleep issues. Good sleep alleviates some of the worse aspects of ADHD. Conversely bad sleep exacerbates ADHD symptoms which can also worsen sleep, etc.

My 23andme profile says I have genes associated with delayed sleep. ADHD (and autism) really seem like they're driven by a cluster of multiple genes with many overlapping between people with the condition(s), but not all.

One rationale for that is how surprisingly prevalent ADHD is across many societies, which only makes sense to me if there's multiple genes which combine and which together confer various advantages to societies as a whole (if not to the individuals). One of the gene sets seem to be sleep issues. It makes sense in a pop-psychology level evolutionary biology where the "creative" types also tend to stay up later which might give them more focus time, or perhaps for story tellers / poets recounting tribal history, etc.

I hope this area gets more research. These things are highly inheritable among families.

inshard 59 minutes ago | parent

Could explain one pathway on how Guanfacine, an ADHD-approved, blood pressure-lowering, sleep-inducing drug, works.

captainbland 43 minutes ago | parent

I can't help but notice that there's a lot in the direction of ADHD is linked to sleep pattern differences, and there's evidence that you can alter those sleep pattern differences through a number of environmental/behavioural interventions but the idea that this actually helps ADHD symptoms as such seems to be left up to the imagination of the reader.

Gensui 39 minutes ago | parent

I have both ADHD and Orthostatic Dysregulation (OD), a 20-40% comorbidity where ADHD-induced sleep issues disrupt the autonomic nervous system, making standard OD treatments less effective.

posix_compliant 10 minutes ago | parent

Do you have any reading you'd recommend for this? I have ADHD. dysautonomia, and sleep issues so it seems adjacent to my line of research.

gxs 39 minutes ago | parent

Dude I saw sleep specialists at Stanford here in Palo Alto and we still don’t know a lot about it, regardless of what you might read

The whole sleep hygiene things been sort of discredited and doctors just follow a script with like 5 things they will prescribe you for sleep problems and after those 5 things it’s like oh well we tried

I once showed them a study I found online in a reputable journal (at least the study was conducted by someone from a well regarded university in a journal that wasn’t obviously bad)

The doctor didn’t even look at the study, he just saw where it came from and said “yeah we don’t use that journal”

I would have much more appreciated an answer if I don’t have time to read your bullshit vs what he gave me

RobRivera 37 minutes ago | parent

Can someone give me the tl:dr, I lost track after the title /s

(Adhd joke hehe/no hehe)