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Sleep in children with attention-deficit/hyperactivity disorder (ADHD) before and after 6-month treatment with methylphenidate: a pilot study

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Abstract

Children with ADHD may present with sleep disturbances that add to the impairment of the disorder. The long-term sleep effects of the first-line pharmacological treatment for ADHD, i.e., psychostimulants, are unclear. In this pilot study, we compared polysomnographic variables in children with ADHD (n = 11, aged 6–15 years), before pharmacological treatment, and in children without ADHD (n = 22, aged 5–14 years); we also assessed polysomnographic changes in children with ADHD (n = 7) after a 6-month treatment with methylphenidate immediate-release (once or twice daily). Compared to children without ADHD, those with ADHD at baseline presented with significantly increased duration of awakenings (p = 0.02), reduction in sleep efficiency (p = 0.03), and increase in stage I (N1) (p < 0.01) and reduction in stage II (N2) (p = 0.02) and stage III–IV (N3) percentages. Methylphenidate treatment did not significantly change any parameter of sleep architecture.

Conclusion: Preliminary evidence from this pilot study shows that, compared to children without ADHD, those with ADHD presented a more fragmented and less effective sleep at baseline and that the 6-month methylphenidate treatment did not further negatively impact on sleep architecture.

What is known:

Children with ADHD may present with subjectively reported and/or objectively confirmed disturbances of sleep.

The long-term effects on sleep of the first-line pharmacological treatment for ADHD, i.e., psychostimulants, are not clear.

What is new:

Our study showed that the 6-month continuous treatment with methylphenidate did not further negatively impact on sleep architecture in children with ADHD.

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Abbreviations

ADHD:

Attention-Deficit/Hyperactivity Disorder

CAP:

Cyclic Alternating Pattern

DCD:

Developmental Coordination Disorder

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders, fourth edition

GM:

Global Movements in sleep

LD:

Learning Disorder

MPH:

Methylphenidate

N1:

sleep stage I

N2:

sleep stage II

N3:

sleep stages III-IV

ODD:

Oppositional Defiant Disorder

REM:

Rapid Eye Movement sleep

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Acknowledgments

The authors acknowledge the clinical research grant from “Compagnia di San Paolo—Torino—Programma Neuroscienze.”

Authors’ contribution

Piernanda Vigliano: conception and design of the study, data collection, critically revising the manuscript

Giovanni Battista Galloni: data collection, critically revising the manuscript

Irene Bagnasco: data collection, critically revising the manuscript

Giuliana Delia: data collection, critically revising the manuscript

Alessandra Moletto: data collection, critically revising the manuscript

Mauro Mana: data collection, critically revising the manuscript.

Samuele Cortese: critically revising the study design, drafting the manuscript, critically revising the manuscript

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Correspondence to Samuele Cortese.

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Conflict of interests

Dr. Cortese received financial support to attend medical meetings from Eli Lilly and Company (2007–9) and Shire Pharmaceuticals (2009–10) and was a coinvestigator in studies sponsored by GlaxoSmithKline (2006), Eli Lilly and Company (2007–8), and Genopharm (2008). He served as a consultant for Shire Pharmaceuticals (2009–10). He received royalties from Argon Healthcare Italy (2010–2012). Dr. Cortese has no current relationships with pharmaceutical companies. No other conflicts of interest were reported by any of the other coauthors.

Research involving human participants/informed consent

All procedures performed were in accordance with the ethical standards of the study institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This was a retrospective study. For this type of study formal consent is not required.

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Communicated by Jaan Toelen

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Vigliano, P., Galloni, G.B., Bagnasco, I. et al. Sleep in children with attention-deficit/hyperactivity disorder (ADHD) before and after 6-month treatment with methylphenidate: a pilot study. Eur J Pediatr 175, 695–704 (2016). https://doi.org/10.1007/s00431-016-2695-9

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  • DOI: https://doi.org/10.1007/s00431-016-2695-9

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