The role of sleep quality and quantity in moderating the effectiveness of medication in the treatment of children with ADHD

Atten Defic Hyperact Disord. 2017 Mar;9(1):31-38. doi: 10.1007/s12402-016-0204-7. Epub 2016 Aug 11.

Abstract

The current study examined: (1) whether long-acting stimulant medication is effective in improving performance on measures of memory, attention, and academic productivity; and (2) whether sleep impacts the relationship between medication and performance. Participants were 21 newly diagnosed, medication-naïve children (mean age = 9.1 years) with ADHD, who participated in a 4-week blinded placebo-controlled randomized trial of long-acting MPH. Participants underwent assessments of sleep (i.e., polysomnography) and of cognitive performance. Long-acting stimulant medication was found to be an effective treatment for enhancing alerting attention, executive attention, working memory, and academic productivity, but resulted in poorer sleep. Moreover, sleep duration was found to impact the treatment response to medication, in that longer sleep duration at baseline was related to improved executive attention. These results underscore the importance of evaluating and monitoring sleep when prescribing stimulant medication as a treatment for ADHD in children.

Keywords: ADHD; Children; Medication; Polysomnography; Sleep; Sleep quality; Sleep quantity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Attention / drug effects
  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Child
  • Delayed-Action Preparations / therapeutic use
  • Double-Blind Method
  • Educational Status
  • Female
  • Humans
  • Male
  • Memory / drug effects
  • Methylphenidate / adverse effects
  • Methylphenidate / therapeutic use*
  • Polysomnography / drug effects
  • Sleep Initiation and Maintenance Disorders / chemically induced
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / psychology*

Substances

  • Delayed-Action Preparations
  • Methylphenidate