Attention deficit/hyperactivity disorder (ADHD) is frequently associated with comorbid aggression and sleep disturbances. The sleep/wake cycle is under the control of the circadian system which is moderated by clock genes. Clock genes can regulate the transcription of monoamine oxidase A, which is involved in the degradation of monoamines. Disturbances in monoamine interaction with clock genes in those with monoamine gene polymorphisms may regulate susceptibility of ADHD and comorbid aggression/sleep disturbances. While monoamines influence circadian rhythm and clock gene expression, circadian rhythm components modulate aggressive behavior, and altered clock genes expression have been associated with ADHD. We propose a mechanism by which circadian rhythm and clock gene expression may influence ADHD and comorbid aggression through the modulation of neurotransmitters. The role of clock genes in ADHD patients with comorbid aggression awaits further research; therefore we also indicate directions for future studies to help increase understanding of the underlying mechanisms in ADHD with comorbid aggression and sleep disturbances.

注意缺陷多动障碍（ADHD）经常与合并症侵略和睡眠障碍相关。睡眠/唤醒周期受生物钟系统的控制，该生物钟系统由时钟基因调节。时钟基因可以调节单胺氧化酶A的转录，而单胺氧化酶A参与单胺的降解。具有单胺基因多态性的那些与时钟基因相互作用的单胺干扰可能调节多动症的易感性，并伴有侵略性/睡眠障碍。虽然单胺影响昼夜节律和时钟基因表达，但昼夜节律成分调节侵略行为，并且改变的时钟基因表达与ADHD有关。我们提出了一种机制，通过该机制昼夜节律和时钟基因表达可通过调节神经递质来影响多动症和共病侵略。时钟基因在多动症合并症患者中的作用有待进一步研究。因此，我们也指出了未来研究的方向，以帮助人们加深对并发性侵略和睡眠障碍的注意力缺陷多动症的潜在机制的了解。