Atomoxetine, Parent Training, and Their Effects on Sleep in Youth with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder

J Child Adolesc Psychopharmacol. 2018 Mar;28(2):130-135. doi: 10.1089/cap.2017.0085. Epub 2017 Nov 7.

Abstract

Objective: Sleep disturbance is often a problem for children with either autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD). Psychostimulant medications used to treat ADHD symptoms can exacerbate this problem. For children with ASD and ADHD, atomoxetine (ATX) is a viable alternative to psychostimulants. We investigated the effects of ATX and a manualized parent training (PT) program targeting noncompliance, on the sleep quality of children with ASD and ADHD.

Methods: Participants in a randomized clinical trial were treated with ATX + PT, ATX alone, PT alone, or placebo (PBO) alone, for 10 weeks. Fifty-four of 128 (42%) caregivers completed the Children's Sleep Habits Questionnaire (CSHQ) at baseline and endpoint. Analysis of covariance was used to investigate possible differences between treatment groups.

Results: There were no significant differences between treatment groups, including PBO on the CSHQ 33-Item total score, total hours of sleep per day, and total minutes awake after sleep onset at the study endpoint.

Conclusion: ATX appears sleep neutral. Clinicians who treat ADHD symptoms in children and adolescents with ASD may prefer ATX over psychostimulants when sleep disturbance is an issue.

Keywords: ADHD; atomoxetine; autism spectrum disorder; clinical trial; parent training; sleep disturbance.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenergic Uptake Inhibitors / administration & dosage
  • Atomoxetine Hydrochloride / administration & dosage*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Autism Spectrum Disorder / drug therapy*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Parents / education
  • Sleep / drug effects*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Adrenergic Uptake Inhibitors
  • Atomoxetine Hydrochloride