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

Rev Paul Pediatr. 2023 May 29:41:e2022065. doi: 10.1590/1984-0462/2023/41/2022065. eCollection 2023.

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.

Objetivo:: Analisar a interferência do tratamento farmacológico no padrão de sono das crianças com transtorno do déficit de atenção com hiperatividade (TDAH).

Fontes de dados:: Busca eletrônica de alta sensibilidade nas bases de dados Cochrane Library, Medical Literature Analysis and Retrieval System Online (MEDLINE) via United States National Library of Medicine (PubMed), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) via Biblioteca Virtual em Saúde (BVS), Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Web of Science, de acordo com o preconizado pelo Cochrane Handbook, de artigos que passaram pela revisão por pares segundo o Guia PRESS.

Síntese dos dados:: Os estudos que contemplaram o uso das drogas atomoxetina (ATX), guanfacina, metilfenidato (MPH), dasotralina, L-teanina e lisdexanfetamina mostraram eficiência na redução dos sintomas do TDAH, embora todos os medicamentos, exceto a atomoxetina, tenham afetado a qualidade do sono — reduzindo REM total, fase não REM, tempo de sono de ondas lentas e maior latência de início do sono.

Conclusões:: Os fármacos utilizados no tratamento do TDAH costumam cursar com repercussões negativas sobre a qualidade do sono de crianças, e o fármaco atomoxetina demonstrou menores efeitos sobre essa variável.

Publication types

  • Systematic Review

MeSH terms

  • Atomoxetine Hydrochloride / therapeutic use
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Central Nervous System Stimulants* / therapeutic use
  • Child
  • Humans
  • Methylphenidate* / therapeutic use
  • Sleep

Substances

  • Atomoxetine Hydrochloride
  • Central Nervous System Stimulants
  • Methylphenidate