The Circadian Phenotype of ADHD explained; an Infographic
Vollebregt, M.A., Koppenberg, M., Arns, M.
Daylight is the strongest synchronizer of human circadian rhythms. When daylight reaches the retina, it provides the internal clock system [suprachiasmatic nuclei (SCN)] with information about the time of day, thereby leading to daylight entrainment. Even modest misalignment of the internal clock from sleep/wake behavior can result in poorer sleep quality. The circadian pathway hypothesis posits that synchrony between daylight and the circadian system relates to (in)attention. Sleep onset insomnia (SOI) or Delayed sleep phase disorder, a circadian rhythm sleep–wake disorder, is highly prevalent in 73–78% of children and adults with Attention-deficit/hyperactivity disorder (ADHD). Phase-delaying effects can be counteracted by intense natural light in the morning, when our circadian clock is most sensitive to entrainment to the 24h rhythm. Exposure to intense natural light in the morning is more common in geographic areas characterized by high sunlight intensity. Corroboratively, prevalence rates of ADHD are lower in these areas compared to those with less sunlight intensity. The dopamine neurotransmitter system is implicated in regulating the circadian system as well as in ADHD. We demonstrate the role of functional genetic variation in the gene encoding of dopamine-receptor-D4 (DRD4) in the relationship between inattention and seasonal daylight (changes). We also show indications that appropriate lighting could potentiate the effects of stimulants.
Vollebregt M.A., Franke B., Buitelaar J.K., Arnold L.E., Faraone S.V., Grevet E.H., Reif A., Zayats T., Bralten J., Bau C.H.D., Haavik J., Kuntsi J., Cupertino R.B., Loo S.K., Lundervold A.J., Ribasés M., Sánchez-Mora C., Ramos-Quiroga, J.A., Asherson P., Swanson J.M., Arns M.. The Role of Gene Encoding Variation of DRD4 in the Relationship between Inattention and Seasonal Daylight. Under review in Neuropsychopharmacology.
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