How Do Stimulant Medications Affect Sleep in Children With ADHD?

Peter M. Yellowlees, MBBS, MD


March 11, 2016

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. Stimulants are very widely prescribed by child psychiatrists and pediatricians. Despite common complaints from patients about the adverse effects on sleep, there have been mixed findings from formal studies evaluating whether stimulant medications actually alter children's sleep.

A team of investigators from the University of Nebraska recently published a systematic review and meta-analysis of randomized controlled trials evaluating the effect of stimulants on sleep in children with attention-deficit/hyperactivity disorder (ADHD).[1] Overall, they found 9 studies, consisting of 246 participants, through March 2015. They concluded that stimulant medication use led to longer sleep latency, worse sleep efficiency, and shorter sleep duration, and that overall, children had worse sleep when on stimulant medications.

From the clinical perspective, it seems that the evidence now supports our long-held clinical impressions. All of us who prescribe stimulants should carefully assess sleep problems in children with ADHD. We should monitor medication type and dosage schedules to promote optimal sleep and minimize any medication-induced sleep impairments. Stimulants are excellent medications for many children with ADHD, but we now know that one of their unintended consequences is impaired sleep.

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