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

Research shows that circadian rhythm dysfunction is highly prevalent in individuals with ADHD, with sleep disturbances affecting up to 80% of adults and 82% of children, along with delayed sleep-wake timing and significantly delayed melatonin onset. Interventions such as melatonin, bright light therapy, and sleep programs have successfully advanced circadian phase and improved ADHD symptoms. The authors propose a behavioral-first clinical approach including screening for circadian disturbances, chronotype assessment, morning light exposure, and selective melatonin treatment for confirmed delays.