The Circadian Phenotype of ADHD explained; an Infographic


Brainclinic’s Martijn Arns and Madelon Vollebregt will present a poster showing the latest insights into the circadian phenotype of ADHD at the EUNETHYDIS conference in Nijmegen on Thursday, September 19, 2019

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.

Vollebregt M. A., Arns M., Monastra V., Roley-Roberts M. E., Arnold L. E., & Hollway J. A. (2019a, June 12). Shedding light on the etiology of ADHD: The influence of disturbed sleep on symptomatology.

Vollebregt M. A., Kenemans J.L., Buitelaar J.K., Deboer T., Cain S., Palmer D., … Arns M. (2019b, June 12). Annual variation in attentional response after Methylphenidate treatment. In revision in European Child & Adolescent Psychiatry

Bijlenga, D., Vollebregt, M. A., Kooij, J. J. S., & Arns, M. (2019). The role of the circadian system in the etiology and pathophysiology of ADHD: Time to redefine ADHD? Attention Deficit and Hyperactivity Disorders, 11(1), 5-19. doi:10.1007/s12402-018-0271-z

Arns, M., & Vollebregt, M. A. (2019). Editorial: Time to wake up: Appreciating the role of sleep in attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 58(4), 398-399.

Arns, M., Swanson, J. M., & Arnold, L. E. (2015). DHD prevalence: Altitude or sunlight? Better understanding the interrelations of dopamine and the circadian system. Journal of Attention Disorders. doi:10.1177/1087054715599574

Arns, M., Feddema, I., & Kenemans, J. L. (2014). Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency.. Frontiers in Human Neuroscience, 8, 1019. doi:10.3389/fnhum.2014.01019

Arns M., van der Heijden K.B., Arnold L.E. & Kenemans J.L. (2013): Geographic variation in the prevalence of attention-deficit/hyperactivity disorder: The sunny perspective. Biological Psychiatry: DOI: 10.1016/j.biopsych.2013.02.010

Arns, M. & Kenemans, J.L. (2012). Neurofeedback in ADHD and insomnia: Vigilance Stabilization through sleep spindles and circadian networksNeuroscience and Biobehavioral Reviews 183-194doi: 10.1016/j.neubiorev.2012.10.006