Association between sleep pattern and pharmacological treatment in children with attention deficit disorder with hyperactivity: a systematic review

Rocha, Nathalia Sena; Correa, Rogério do Espírito Santo Amorim; Dias, Adria Carolina de Melo; Bueno, Cláudia Dizioli Franco

doi:10.1590/1984-0462/2023/41/2022065

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Revista Paulista de Pediatria

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Review Article • Rev. paul. pediatr. 41 • 2023 • https://doi.org/10.1590/1984-0462/2023/41/2022065 copy

Association between sleep pattern and pharmacological treatment in children with attention deficit disorder with hyperactivity: a systematic review

Associação entre padrão de sono e tratamento farmacológico em crianças com transtorno do déficit de atenção com hiperatividade: uma revisão sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

The aim of this study was to analyze the effect of the pharmacological treatment on the sleep patterns of children with attention deficit hyperactivity disorder (ADHD).

Data source:

A high-sensitivity electronic search was performed in the following databases: Cochrane Library, MEDLINE via PubMed, LILACS via the Regional Health Portal (BVS), Embase, Scopus, CINAHL, and Web of Science, as recommended by the Cochrane Handbook, and which has undergone peer review according to the PRESS Guide.

Data synthesis:

The studies contemplated the use of the drugs atomoxetine, guanfacine, methylphenidate, dasotraline, L-theanine, and lisdexamfetamine. They showed efficiency in reducing the symptoms of ADHD, although all, except atomoxetine, affected sleep quality, such as by reducing total rapid eye movement (REM), non-REM phase, slow-wave sleep time, and longer sleep-onset latency.

Conclusions:

The drugs used in the treatment of ADHD seem to have negative repercussions on the sleep quality of children, with the drug atomoxetine showing lesser effects on this variable.

Keywords:
Attention deficit disorder with hyperactivity; Drug therapy; Sleep

Authors and year of publication	Total population	Age (years)	Intervention drug	Intervention duration	Instrument
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Rugino¹¹11. Rugino TA. Effect on primary sleep disorders when children with ADHD are administered guanfacine extended release. J Atten Disord. 2018;22:14-24. https://doi.org/10.1177/1087054714554932 https://doi.org/10.1177/1087054714554932... , 2014	29	6–12	Guanfacine extended release (GXR)	5 weeks	Polysomnography and Children’s Sleep Habits Questionnaire
Ricketts et al.¹²12. Ricketts EJ, Sturm A, McMakin DA, McGuire JF, Tan PZ, Smalberg FB, et al. Changes in sleep problems across attention-deficit/hyperactivity disorder treatment: findings from the multimodal treatment of attention-deficit/hyperactivity disorder study. J Child Adolesc Psychopharmacol. 2018;28:690-8. https://doi.org/10.1089/cap.2018.0038 https://doi.org/10.1089/cap.2018.0038... , 2018	576	7–9	Methylphenidate	14 months	Achenbach Child Behavior Checklist 6-18
Goldman et al.¹⁸18. Goldman RS, Hopkins SC, Koblan KS, Pikalov AA, Hsu J, Mandel M, et al. Dasotraline in children with ADHD: effects on sleep habits as measured by the children’s sleep habits questionnaire. J Am Acad Child Adolesc Psychiatry. 2018;57:S179. https://doi.org/10.1016/j.jaac.2018.09.149 https://doi.org/10.1016/j.jaac.2018.09.1... , 2018	342	6–12	Dasotraline	6 weeks	Children’s Sleep Habits Questionnaire
Owens et al.¹³13. Owens J, Weiss M, Nordbrock C, Mattingly G, Wigal S, Greenhill LL, et al. Effect of aptensio XR (methylphenidate HCl extended-release) capsules on sleep in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2016;26:873-81. https://doi.org/10.1089/cap.2016.0083 https://doi.org/10.1089/cap.2016.0083... , 2016	256	Study 1: 6–12 Study 2: 6–18	Methylphenidate HCl extended-release capsules	16 weeks	Children’s or Adolescent Sleep Habits Questionnaire
Becker et al.¹⁷17. Becker SP, Froehlich TE, Epstein JN. Effects of methylphenidate on sleep functioning in children with attention-deficit/hyperactivity. J Dev Behav Pediatr. 2016;37:395-404. https://doi.org/10.1097/DBP.0000000000000285 https://doi.org/10.1097/DBP.000000000000... , 2016	163	7–11	Methylphenidate	4 weeks	Pittsburgh Side Effects Rating Scale
Stein et al.¹⁶16. Stein M, Garison M, Hart A, Newcorn J. Sleep problems in ADHD youth before and during treatment with methylphenidate and atomoxetine. 5th World Congress on ADHD: from child to adult disorder glasgow United Kingdom. 2015 may 28-31. United Kingdom p. 46-7., 2015	230	Uninformed	Methylphenidate and atomoxetine	3–7 weeks	A sleep assessment scale validated and completed by parents
Lyon et al.¹⁹19. Lyon MR, Kapoor MP, Juneja LR. The effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial. Altern Med Rev. 2011;16:348-54. PMID: 22214254, 2011	93	8–12	L-Theanine chewable tablets	6 weeks	Pediatric Sleep Questionnaire and actigraphy
Solleveld et al.¹⁴14. Solleveld MM, Schrantee A, Baek HK, Bottelier MA, Tamminga HG, Bouziane C, et al. Effects of 16 weeks of methylphenidate treatment on actigraph-assessed sleep measures in medication-naive children with ADHD. Front Psychiatry. 2020;11:82. https://doi.org/10.3389/fpsyt.2020.00082 https://doi.org/10.3389/fpsyt.2020.00082... , 2020	50	10–12	Immediate-release methylphenidate	16 weeks	Actigraphy, Holland Sleep Disorder Questionnaire; Epworth Sleepiness Scale, and Evaluation List Insomnia Therapy
Ashkenasi¹⁵15. Ashkenasi A. Effect of transdermal methylphenidate wear times on sleep in children with attention deficit hyperactivity disorder. Pediatr Neurol. 2011;45:381-6. https://doi.org/10.1016/j.pediatrneurol.2011.09.003 https://doi.org/10.1016/j.pediatrneurol.... , 2011	26	6–12	Transdermal methylphenidate	4 weeks	Daily updated sleep diary
Giblin and Strobel²⁰20. Giblin JM, Strobel AL. Effect of lisdexamfetamine dimesylate on sleep in children with ADHD. J Atten Disord. 2011;15:491-8. https://doi.org/10.1177/1087054710371195 https://doi.org/10.1177/1087054710371195... , 2011	24	6–12	LDX administration	3 weeks	Polysomnography, actigraphy, and CSHQ

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[1] * Corresponding author. E-mail: nathalia.rocha@aluno.uepa.br (N. S. Rocha)