Stimulant medications like Ritalin and Adderall given to children with attention deficit hyperactivity disorder (ADHD) may hinder them from the sleep they need to obtain, according to new research.
In a statement, psychologist Katie Kidwell stated that "We would recommend that pediatricians frequently monitor children with ADHD who are prescribed stimulants for potential adverse effects on sleep."
The team from the University of Nebraska-Lincoln analyzed 10,000 articles and reviewd over 160 full tests before they picked nine studies for the meta-analysis. Rather than relying on parental reports, they chose the study that were obtained through clincally and mechanically via wearable sleep monitors. The team segregated both methylphenidate (Ritalin) and amphetamine (Adderall) during analysis but found no significant difference.
Results revealed that the two prompt sleep problems among kids taking ADHD medications. Even though the exact dosage to put these kids to sleep was not pinpointed, they reported that frequent dosage did give children sleeping difficulties.
"One reason we did the study is that researchers have hypothesized different effects, and there are some conflicting findings in the literature," associate professor of psychology Timothy Nelson explained. "This is when a meta-analysis is most useful. By aggregating and summarizing previous research in a rigorous and statistical way, we can identify the main findings that we see across all these studies. It's essentially a study of studies."
"Sleep adverse effects could undermine the benefits of stimulant medications in some cases. Pediatricians should carefully consider dosage amounts, standard versus extended release, and dosage frequencies to minimize sleep problems while effectively treating ADHD symptoms," Kidwell suggested.
However, talking about treatment choices to children living with ADHD, they unfortunately do not have a lot of cards laid on the deck. Some would recommend behavioral therapies but still end up sorting to stimulant meds.
"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."
