Assessment and Management of Sleep Problems in Youths With Attention-Deficit/Hyperactivity Disorder

Cortese, Samuele; Brown, Thomas E.; Corkum, Penny; Gruber, Reut; O’Brien, Louise M.; Stein, Mark A.; Weiss, Margaret; Owens, Judith

doi:10.1016/j.jaac.2013.06.001

Cited by 207 publications

(152 citation statements)

References 48 publications

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“…This finding is compatible with the studies of Cortese et al and Yook, Jain, and Shapiroin which the researchers indicated that resistance against sleep, delay in falling asleep, decrease in the quantity of sleep, increase in the amount waking at night, and daytime somnolence increased in children with ADHD [8,9]. These children slept 1 hour later and sleep quantity was 1.5 hours less than the control group.…”

Section: Discussionsupporting

confidence: 91%

“…Their parents report sleep problems in 25-55% [4] and the prevalence of sleep problems, such as falling asleep and maintaining sleep, can vary between 55% and 74% [5][6][7]. The primary sleep disorder symptoms are resistance against sleep, an increase in the amount waking at night, and sleepiness during the day [8,9]. The most frequently reported symptoms of children and the parents are resistance against sleeping and sleeponset insomnia [8].…”

Section: Introductionmentioning

confidence: 99%

“…The primary sleep disorder symptoms are resistance against sleep, an increase in the amount waking at night, and sleepiness during the day [8,9]. The most frequently reported symptoms of children and the parents are resistance against sleeping and sleeponset insomnia [8]. The increase in sleep disorders in these children is associated with the increase in ADHD symptoms [10] and weakening in functionality of the child and the family [7].…”

Section: Introductionmentioning

confidence: 99%

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Behavioural sleep problems in previously untreated children with attention deficit hyperactivity disorder

Eyüboğlu

2017

Psychiatry and Clinical Psychopharmacology

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OBJECTIVE: Although sleep symptoms are not included in the diagnostic criteria of attention deficit hyperactivity disorder (ADHD), these problems are common in children with ADHD. The presence of sleep problems was associated with impairment in functionality and increase in ADHD intensity. The aims of the study were to evaluate sleep problems of children with ADHD who had never received any psychiatric treatment and investigate the effects of these problems in functionality. METHODS: The present study included 83 children who were diagnosed as having ADHD and had never received any psychiatric treatment. The control group consisted of 106 healthy children. Psychiatric diagnostic interview was applied to all children. The parents completed the Conner's Parent Questionnaire to evaluate the intensity of ADHD in the children, the Children's Sleep Habits Questionnaire (CSHQ) to evaluate sleep problems, and the Weiss Functional Impairment Rating Scale to evaluate the functionality of the children. RESULTS: The total scores of subscale and scales of CSHQ were significantly higher in the study group. ADHD children slept 1 hour later and sleep quantity was 1.5 hours less than the control group. There was a significant correlation between sleep problems, ADHD severity, and functionality of these children. CONCLUSIONS:The results demonstrated that children with ADHD experienced more sleep problems and slept less than the children in the healthy control group, and functional impairments increased due to these problems. Another important finding is that sleep problems are not related to drug use. Maintaining sleep hygiene or interventions against sleep problems may increase sleep quality and may improve self and family functionality. Therefore, the standardized sleep evaluation must be performed in cooperation with parents in all children with ADHD. ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Behavioural sleep problems in previously untreated children with attention deficit hyperactivity disorder

Eyüboğlu

2017

Psychiatry and Clinical Psychopharmacology

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“…A panel of experts in ADHD and sleep concluded that non-pharmacological interventions, which include sleep hygiene and behavioural interventions, should be the first-line management 10,21 . The National Institute for Health and Care Excellence (NICE) also recommends non-pharmacological interventions such as good sleep hygiene or behavioural therapy…”

Section: Introductionmentioning

confidence: 99%

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment

et al. 2017

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ObjectiveA large proportion of paediatric patients with attention-deficit/hyperactivity disorder (ADHD) have associated sleep problems which not only affect the child's well-being but also impact family functioning. Management of sleep problems is consequently an important aspect of overall ADHD management in paediatric patients. Although some drugs are being used off-label for the management of paediatric insomnia, there is scant clinical evidence supporting their use. Our aim was to identify and assess the quality of published studies reporting the safety, tolerability and efficacy of drugs used for treating behavioural insomnia in children with ADHD. MethodAfter an initial screen to determine which drugs were most commonly used, we conducted a systematic review of English-language publications from searches of PubMed, EMBASE, PsychInfo and two trial register databases to February 2017, using keywords clonidine, melatonin, zolpidem, eszopiclone, L-theanine, guanfacine, ADHD, sleep disorder and children. For quality assessment of included studies, we used the CONSORT checklist for randomized control trials (RCTs) and the Downs and Black checklist for non-RCTs. ResultsTwelve studies were included. Two case series for clonidine, two RCTs and four observational studies for melatonin and one RCT each for zolpidem, eszopiclone, L-theanine and guanfacine. Of the 12 included studies, only one on eszopiclone scored excellent. The quality of the rest of the studies varied from moderate to low. For clonidine, melatonin and L-theanine, improvement in sleep-onset latency and total sleep duration, were reported; however, zolpidem, eszopiclone and guanfacine failed to show any improvement when compared with placebo. Clonidine, melatonin, L-theanine, eszopiclone and guanfacine were well tolerated with mild to moderate adverse events except for zolpidem which was associated with neuropsychiatric adverse effects. ConclusionThere is generally poor evidence for prescribing drugs for behavioural insomnia in children with ADHD. Further controlled studies are warranted.

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“…Lalita D. Ramnaraine, Mariam Rahmani, and myself, we systematically discern and summarize data regarding sleep dysfunctions in young patients with attention-deficit/hyperactivity disorder (ADHD). [7][8][9] We discuss that patients with ADHD are more susceptible to sleep disruption resulting from poor sleep habits and other disorders, and that adequate sleep is important but seems to be especially vital in patients with ADHD.…”

mentioning

confidence: 99%

Bi-Directional Relationship Between Sleep Problems and Psychiatric Disorders

Khurshid¹

2016

Psychiatric Annals

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Assessment and Management of Sleep Problems in Youths With Attention-Deficit/Hyperactivity Disorder

Cited by 207 publications

References 48 publications

Behavioural sleep problems in previously untreated children with attention deficit hyperactivity disorder

Behavioural sleep problems in previously untreated children with attention deficit hyperactivity disorder

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment

Bi-Directional Relationship Between Sleep Problems and Psychiatric Disorders

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