Table 1.

Prospective studies of sleep intervention in adults with ADHD.

Study (Year)	Population	Comorbidity and Other Treatments	Intervention	Design	Baseline Characterization Related to Sleep	Significant Findings
Van Andel et al. (2021) [27]	N = 51 DSM-IV ADHD and Delayed Sleep Phase Syndrome, (m = 29.53 yrs) (32 females)	Mental health comorbidity exclusionary, no ADHD supports reported	Advancing melatonin (0.5 mg/d) timed to dim light melatonin onset (DLMO) with and without bright light therapy (BLT), 3 weeks	Three-arm randomized placebo controlled	DLMO, Sleep Diagnosis List (SDL), Sleep Hygiene Questionnaire (VSH)	Melatonin advanced DLMO by 1 h and 28 min, p = 0.001. Melatonin plus BLT advanced DLMO by 1 h and 58, p < 0.001. Placebo had no effect on DLMO. Melatonin reduced ADHD symptoms by 14% p = 0.038, which returned to baseline 2 weeks post-treatment.
Fargason et al. (2017) [28]	N = 16 DSM-IV ADHD (m = 35.25 yrs) (9 females)	Mental health comorbidity exclusionary. 11 on amphetamine drugs, 1 on buproprion	BLT, 2 weeks after 1 week baseline	Open treatment	DLMO PSQI Sleep Diary	BLT advanced DLMO by 31 min p = 0.002. vs. 1 week baseline BLT advanced mid-sleep time by 57 min p = 0.004. “Sleepiness” ratings in sleep diary were reduced p = 0.033. PSQI overall quality score improved p < 0.001.
Jernelov et al. (2019) [30]	N = 19 people with clinical record of ADHD and self reported sleep problems (m = 37) (13 females)	Participants had an average of 3 mental health conditions in the last year. 11 on forms of amphetamine, 7 on methylphenidate, 8 on current sleep agents	Group sessions of CBT-i for insomnia, 10 weeks	Open treatment with three-month follow up	SLEEP-50 Karolinska Sleep Questionnaire Insomnia Severity Index	Insomnia severity decreased p = 0.002. At three-month follow up, insomnia severity had further improved p < 0.0001 from pre-treatment.
Rybak et al. (2006) [29]	N = 29 DSM ADHD by Conner’s and Wender Utah Scales (14 females)	41% had major depression, 13% had seasonal affective disorder; 7 subjects taking psychostimulants only, 4 taking antidepressants only, 4 taking both	BLT, 3 weeks after 1 week baseline	Open treatment	Brown Adult ADD Scale Conners’ Adult ADD Scale Horne–Ostberg Morningness-Eveningness Questionnaire Neuropsychological Tests	Significant phase advance in circadian preference, p = 0.016, decrease in self-report ADHD symptoms (p = 0.001), and change in 10 out of 18 neuropsychological tests (p range = 0.05 to 0.001).
Ekholm et al. (2020) [31]	N = 13 cohort subset with clinical record of sleep disorders and ADHD	Various concurrent treatments	Weighted chain blankets, 4 weeks	Between group (vs. plastic chain blanket)	Insomnia severity index, fatigue symptom inventory, hospital anxiety and depression scale, wrist actigraphy	Insomnia severity improved more than in light blanket group p = 0.003.
Fargason et al. (2011) [32]	N = 36 adults (18 females) with DSM-IV ADHD	Individuals with elevated Hamilton Anxiety/Depression ratings or other cause of insomnia excluded.	Ramelteon 8 mg, 2 weeks each of placebo, washout, and active, after 1 week baseline	Open treatment crossover	Actigraphy, Epworth Sleepiness Scale (ESS), and ADHD-RS	7.0 ± 32.3 min phase advance; placebo 39.2 ± 44.6 min phase delay (p = 0.046 for both); # participants with significant ESS score more than doubled p < 0.017.