Sleep Problems in Children with Attention Deficit/Hyperactivity Disorder: Current Status of Knowledge and Appropriate Management

  • Ming-Horng Tsai
  • Jen-Fu Hsu
  • Yu-Shu HuangEmail author
Sleep Disorders (P Gehrman, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Sleep Disorders


Attention deficit hyperactivity disorder (ADHD) affects approximately 5 % of children and adolescents, and sleep problems are common in these patients. There is growing evidence informing the significant importance of sleep problems in youth with ADHD. The sleep problems in children with ADHD include specific sleep disorders and sleep disturbances due to comorbid psychiatric disorders or ADHD medications. The specific sleep disorders of ADHD children include behaviorally based insomnia, sleep-disordered breathing, and restless legs syndrome/periodic limb movement disorder. Current practices on the management of sleep problems for ADHD children are based mostly on expert consensus, whereas more evidence-based literature can be found only recently. Assessment of the sleep conditions in ADHD children before initiation of pharmacotherapy is the currently recommended guideline, and good sleep hygiene can be considered as the first-line treatment option. In addition to modifying the dose regimens, formulation, or alternative stimulants when sleep problems are encountered in ADHD children, atomoxetine, once daily guanfacine extended release, and melatonin are potential choices for ADHD children with more severe sleep problems. In this review, we aimed to provide the most updated information, preferably based on meta-analyses, systemic review, and randomized controlled trials published in the latest 3 years, in order to be clinically useful for practitioners and clinicians.


Sleep disorders Attention deficit hyperactivity disorder Children Melatonin Insomnia 



This material is the result of work supported with resources and the use of facilities at the Yunlin Chang Gung Memorial Hospital, Yunlin, Taiwan, Republic of China.

Compliance with Ethical Standards

Conflict of Interest

Ming-Horng Tsai, Jen-Fu Hsu, and Yu-Shu Huang declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Ming-Horng Tsai
    • 1
    • 2
  • Jen-Fu Hsu
    • 2
    • 3
    • 4
  • Yu-Shu Huang
    • 2
    • 3
    • 5
    Email author
  1. 1.Division of Pediatric Neonatology and Hematology/Oncology, Department of PediatricsChang Gung Memorial HospitalYunlinTaiwan
  2. 2.College of MedicineChang Gung UniversityTaoyuanTaiwan
  3. 3.Sleep Center and Child Psychiatry DepartmentChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  4. 4.Division of Neonatology, Department of PediatricsChang Gung Memorial HospitalTaoyuanTaiwan
  5. 5.Department of Child Psychiatry and Sleep CenterChang Gung Memorial HospitalTaoyuanTaiwan

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