Attention Deficit Hyperactivity Disorder (ADHD) has many symptoms. Research has found that stimulants – a means of counteracting some of ADHD's symptoms – are causing sleeping problems in the same children that it is meant to help.
However, although the research has found negative sides to using the said medication, the researchers suggest that instead of discontinuing it altogether, doctors should rather look into stimulants' possible sleep-disrupting effects on individual patients.
"We would recommend that pediatricians frequently monitor children with ADHD who are prescribed stimulants for potential adverse effects on sleep," Katie Kidwell, a psychology doctoral student at the University of Nebraska-Lincoln who served as the study's lead author, said in a press release.
"Sleep impairment is related to many cognitive, emotional and behavioral consequences, such as inattention, irritability and defiance," Kidwell said.
The study is published in the journal Pediatrics.
The researchers arrived at the findings after a “meta-analysis” that combined and analyzed the results of past studies that focused on the effects of ADHD medications on sleep. The research team first screened nearly 10,000 articles, then narrowed it to 167 full texts. After reviewing the full texts, they selected nine studies that contained sufficient data for the study.
The nine studies that were chosen were all peer-reviewed, randomized experiments that did not rely on data gathering measures such as parental reports. All of them used objective measures such as clinical sleep studies or home-used wristband monitors.
It was found that both methylphenidate medications like Ritalin and amphetamines such as Adderall cause sleeping problems. Although the sleep-disrupting effects stemming from varied dosage amounts was not determined, it was found that the more frequent the dosages were given, the harder it became for patients to sleep.
Additionally, the researchers found that the drug medications tend to cause more sleeping problems for boys. And although the problems dissipate, they aren't completely gone as long as medications are taken.
"Sleep adverse effects could undermine the benefits of stimulant medications in some cases,” Kidwell said. “Pediatricians should carefully consider dosage amounts, standard versus extended release, and dosage frequencies to minimize sleep problems while effectively treating ADHD symptoms."
Kidwell also suggested considering the use of behavioral treatments to reduce ADHD's negative effects. Such behavioral treatments include parental training and changes to classroom procedures, as well as homework assignments.
"We're not saying don't use stimulant medications to treat ADHD," Timothy Nelson, an associate professor of psychology involved in the study, 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."
