Sleep disturbances in ADHD: investigating the contribution of polygenic liability for ADHD and sleep-related phenotypes

Lewis, Katie J.S.; Martin, Joanna; Gregory, Alice M.; Anney, Richard; Thapar, Anita and Langley, Kate. 2023. Sleep disturbances in ADHD: investigating the contribution of polygenic liability for ADHD and sleep-related phenotypes. European Child and Adolescent Psychiatry, 32(7), pp. 1253-1261. ISSN 1018-8827 [Article]

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Abstract or Description

Sleep disturbances are common in attention deficit hyperactivity disorder (ADHD) and associated with poor outcomes. We tested whether, in children with ADHD, (1) polygenic liability for sleep phenotypes is over- or under-transmitted from parents, (2) this liability is linked to comorbid sleep disturbances, and (3) ADHD genetic risk is associated with comorbid sleep disturbances.

We derived polygenic scores (PGS) for insomnia, chronotype, sleep duration, and ADHD, in 758 children (5-18 years old) diagnosed with ADHD and their parents. We conducted polygenic transmission disequilibrium tests for each sleep PGS in complete parent-offspring ADHD trios (N=328) and an independent replication sample of ADHD trios (N=844). Next, we tested whether insomnia, sleep duration, and ADHD PGS were associated with co-occurring sleep phenotypes (hypersomnia, insomnia, restless sleep, poor sleep quality, and nightmares) in children with ADHD.

Children’s insomnia and chronotype PGS did not differ from mid-parent average PGS but long sleep duration PGS were significantly over-transmitted to children with ADHD. This was supported by a combined analysis using the replication sample. Insomnia, sleep duration, and ADHD PGS were not associated with comorbid sleep disturbances.

There is weak evidence that children with ADHD over-inherit polygenic liability for longer sleep duration and do not differentially inherit polygenic liability for insomnia or chronotype. There was insufficient evidence that childhood sleep disturbances were driven by polygenic liability for ADHD or sleep traits, suggesting that sleep disturbances in ADHD may be aetiologically different to general population sleep phenotypes and do not index greater ADHD genetic risk burden.

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The work was supported by funding from the Wellcome Trust (grant no. 079711), Medical Research Council Centre (grant no. MR/L010305/1), Health and Care Research Wales (grant no. 514032), Action Medical Research and Baily Thomas. We also acknowledge the support of the Supercomputing Wales project, which is part-funded by the European Regional Development Fund (ERDF) via Welsh Government.

JM was supported by a NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation (grant no. 27879). KJSL was supported by the Wellcome Trust and the National Centre for Mental Health (NCMH) which is funded by Health and Care Research Wales. As this research was funded in whole, or in part, by the Wellcome Trust [220488/Z/20/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. KL was supported by a grant from The Waterloo Foundation (grant no. 918/3021).


sleep, ADHD, comorbidity, polygenic scores

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17 December 2021Accepted
7 January 2022Published Online
July 2023Published

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Date Deposited:

20 Dec 2021 14:44

Last Modified:

18 Jul 2023 13:57

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Yes, this version has been peer-reviewed.


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