Investigating the best treatment for the Delayed Sleep Phase Syndrome in adults with Attention-Deficit/Hyperactivity Disorder and it’s effect on health and appetite

About 80% of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) have chronic sleep-onset problems and the majority of them has a Delayed Sleep Phase Syndrome (DSPS). DSPS is characterized by chronic sleep dept, which has negative consequences for physical health and is associated on the long term with weight gain, obesity, diabetes, hypertension, metabolic syndrome, cardiovascular disease, and even cancer. This study investigates the best treatment of DSPS (melatonin, placebo or melatonin and light therapy), and will determine whether patients with ADHD and DSPS have suboptimal biomarkers of chronic diseases like diabetes. Fifty-one adults with ADHD and DSPS will be recruited from the PsyQ Outpatient clinics in the Netherlands.

This study will investigate the best treatment of Delayed Sleep Phase Syndrome (melatonin, placebo or melatonin and light therapy), and will determine whether patients with ADHD and DSPS have blood values that may indicate susceptibility for chronic diseases like diabetes.



The results will give insight into the association between DSPS, ADHD, and chronic conditions such as diabetes, and may serve as a model for the increase in obesity and metabolic syndrome in the general population, in which sleep loss is common due to the extended use of artificial light.

All outcomes will be measured at baseline, directly after treatment and three weeks after treatment.



Methods of measurement:

Improvement of appetite hormones - blood

Improvement of diabetic parameters -blood

Improvement of biomarker profiles -blood

Improvement of cardiovascular parameters – ECG/ Ambulant Blood Pressure Monitor

Improvement of sleep parameters -actigraphy

Improvement of quality of life -questionnaire

Decrease of ADHD symptoms - questionnaire

Decrease of intake of carbohydrate-rich food -questionnaire

Treatment satisfaction -questionnaire

Patients will be randomized for sleep education, plus:

(1) 0.5 mg of melatonin daily,

(2) 0.5 mg of placebo daily, or

(3) 0.5 mg of melatonin daily, plus 30 minutes of light therapy in the morning between 7 and 8 AM.

Each treatment takes three weeks; the Melatonin intake will be three hours before the patient’s individually determined Dim-Light Melatonin Onset (DLMO), and will be advanced during the treatment period.