The effect of stimulants on sleep characteristics in children with attention deficit/hyperactivity disorder

Received 12 November 2002; received in revised form 7 January 2003; accepted 7 February 2003.

Abstract

Objective: To investigate the effects of stimulant medications on subjective and objective sleep characteristics of children with attention deficit/hyperactivity disorder (ADHD) compared with control children.

Methods: An observational study in the sleep clinic and the community. Children with characteristics of ADHD, both stimulant-medicated (n=53), and non-medicated (n=34), together with control children (n=53) completed a sleep habits questionnaire prior to undergoing full overnight polysomnographic assessment.

Results: Medicated and non-medicated ADHD subjects were reported to have more sleep disturbances compared with controls. Both groups of ADHD children also demonstrated decreased REM sleep percentage compared with controls (P=0.006 for ADHDmed; P=0.02 for ADHDnon). However, the use of stimulant medication (n=53) was not associated with differences in subjective sleep quality or objective sleep measures, compared to ADHD children not taking any medication (n=34; P=n.s.).

Conclusions: Despite the high prevalence of reported sleep disturbance in children with ADHD, stimulant medication appears to have minimal effects on subjective and objective sleep characteristics in children with reported ADHD.

Keywords: Child, Sleep, Attention deficit/hyperactivity disorder, Stimulant medication, Polysomnography, Rapid eye movement sleep

Abbreviations: ADHD, attention-deficit hyperactivity disorder, ADHDmed, children with ADHD and medicated with stimulants, ADHDnon, children with ADHD and not medicated, AHI, apnea/hypopnea index, AI, apnea index, DSM-IV, diagnostic and statistical manual version IV, ECG, electrocardiogram, EEG, electroencephalogram, EMG, electromyogram, EOG, electro-oculogram, OSA, obstructive sleep apnea, PLMS, periodic leg movements during sleep, PSG, polysomnography, REM, rapid eye movements, SpO2, arterial oxygen saturation measured by pulse oximetry, SWS, slow wave sleep, TIB, time in bed, TST, total sleep time

Kosair Children's Hospital Research Institute, and Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, Louisville, KY 40202, USA

Corresponding author. Tel.: +1-502-852-2323; fax: +1-502-852-2215

PII: S1389-9457(03)00071-6

doi:10.1016/S1389-9457(03)00071-6

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