Stimulant medications such as Adderall and Ritalin are commonly prescribed to children with attention-deficit/hyperactivity disorder (ADHD). Prescription stimulants have a calming and “focusing” effect on children with ADHD. They are prescribed for daily use, and come in the form of tablets or capsules of varying dosages. Treatment of ADHD with stimulants, often combined with psychotherapy, helps to improve ADHD symptoms together with the child’s self-esteem, thinking ability, and social and family interactions. However, a new study has found that the stimulants can impact the quality of sleep. The findings were published online on November 23 in the journal Pediatrics.
The study authors note that controversy exists regarding whether stimulant medications alter children’s sleep. Therefore, they conducted a study to determine the effect of stimulant medications on sleep. They reviewed the medical literature for studies published through March 2015 that addressed the impact of sleep medications on sleep among children with ADHD.
Eligibility criteria comprised studies of children or teens who had ADHD) who were randomly assigned to receive stimulants and underwent objective sleep measurements. Studies that did not include pertinent factors were excluded. The data was reviewed by two independent researchers.
The investigators identified nine studies (246 children with ADHD). They found that sleep latency (the time it took to fall asleep) was significantly longer among children who were taking stimulants and that the frequency of dose per day was a significant moderating factor. Sleep efficiency was significantly impacted by the stimulants. Significant moderating factors included length of time on medication, number of nights of sleep examined, polysomnography/actigraphy (sleep studies), and gender. Specifically, the effect of medication was less among subjects who had been taking stimulants for a longer period of time. Total sleep time was significantly less among the children taking stimulants.
The authors noted that their study had some limitations: few studies, limited differences in study methods, and lack of unpublished studies. However, they concluded that taking stimulant medication resulted in longer sleep latency, poorer sleep efficiency, and shorter sleep duration. Overall, children and adolescents had poorer sleep on stimulant medications. The researchers recommended that pediatricians carefully monitor sleep problems and adjust treatment to promote the best quality sleep.