New research points to sleep trouble for kids who take stimulant medications such as Ritalin and Adderall for attention-deficit/hyperactivity disorder (ADHD).
The study, conducted at the University of Nebraska-Lincoln, addresses decades of conflicting opinions and evidence about the medications’ effect on sleep.
In what’s known as a “meta-analysis,” researchers from the UNL Department of Psychology combined and analyzed the results from past studies of how ADHD medications affect sleep. They found that children given the medicines take significantly longer to fall asleep, have poorer quality sleep, and sleep for shorter periods.
“We would recommend that pediatricians frequently monitor children with ADHD who are prescribed stimulants for potential adverse effects on sleep,” said Katie Kidwell, a psychology doctoral student who served as the study’s lead author.
About 1 in 14 children and adolescents in the U.S. are diagnosed with ADHD, a chronic condition that includes attention difficulty, hyperactivity and impulsiveness. In the most common form of ADHD treatment, about 3.5 million are prescribed stimulant medications.
Many research articles have been written in the past 30 years on whether ADHD medications harm the ability to sleep. Some researchers have found that the drugs do interfere with sleep, particularly if taken later in the day. Others maintain the medications improve patients with ADHD’s ability to sleep, by relieving symptoms and reducing resistance to bedtime. Indeed, some suggest that sleep problems are caused by the medication wearing off near bedtime, creating withdrawal symptoms.
UNL found that drugs tend to cause more sleep problems for boys. The problems dissipate, but never completely go away, the longer children continue to take the medication.
“We’re not saying don’t use stimulant medications to treat ADHD,” Nelson said. “They are well tolerated in general and there is evidence for their effectiveness. But physicians need to weigh the pros and cons in any medication decision, and considering the potential for disrupted sleep should be part of that cost-benefit analysis with stimulants.”