Medicines used to treat attention-deficit/hyperactivity disorder (ADHD) in children may cause sleep problems, suggests new research published online in the Nov. 23 Pediatrics. According to the study, poor sleep has the potential to render the medications less effective.
“Sleep impairment is related to many cognitive, emotional and behavioral consequences, such as inattention, irritability, and defiance,” lead study author Katie Kidwell, a doctoral student at the University of Nebraska-Lincoln, said in a news release. “Sleep-adverse effects could undermine the benefits of stimulant medications in some cases,” she added.
Stimulant medications – including Ritalin and Adderall – are the most commonly used treatment for ADHD in kids. The study authors estimate 3.5 million children are prescribed ADHD medications.
Previous studies on the effect of these drugs on sleep have produced conflicting findings. Some have suggested that the medications may lead to insomnia, while others found that the drugs may actually help kids sleep better because they relieve ADHD symptoms and reduce resistance to bedtime.
To determine the effect of stimulant medicines on kids, the study authors reviewed nine studies published through March 2015 that included 246 children with ADHD. The kids in the studies were randomly assigned to stimulants and their sleep was objectively measured, rather than depending on parental reporting.
Findings showed that children who were treated with stimulant medications took longer to fall asleep, slept for shorter amounts of time and did not sleep as well as kids with ADHD who were not taking the drugs. According to the news release, the researchers were unable to determine whether varying dosage amounts changed the effect on sleep, but they did find that more frequent dosages made it harder for children to fall asleep.
The findings also showed that the drugs tend to cause more sleep problems for boys than girls. The researchers also noted that sleep problems may dissipate, but never completely cease the longer the children are on the medication.
Kidwell and her colleagues cautioned that the new findings do not mean that kids with ADHD should stop taking these medications. However, they called on pediatricians to “carefully consider dosage amounts, standard versus extended-release, and dosage frequencies to minimize sleep problems while effectively treating ADHD symptoms.”
Kidwell also said parents can help their children by encouraging evening routines before bedtime. She suggested reading stories or other quiet time activities before bed.
“We are not arguing that children should stop taking stimulant medications, because they are beneficial,” Kidwell told Live Science. Rather, the research team is suggesting “that parents can be advocates for their children,” if they are having sleeping problems.