Skip to main content

ADHD Treatments, Sleep, and Sleep Problems: Complex Associations

Neurotherapeutics volume 9, pages 509–517 (2012)Cite this article

Abstract

ADHD, sleep, and ADHD treatments are highly interrelated. In this review, we describe the effects of stimulants and non stimulant medications on sleep in children, adolescents, and adults with ADHD. Clinical predictors of sleep problems during pharmacotherapy include age, sleep problems prior to initiating treatment, and dose and dosing schedule. As yet, we have little understanding of the biological or genetic factors related to individual variation in drug response and sleep.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Dulcan MK, Benson RS. AACAP Official Action. Summary of the practice parameters for the assessment and treatment of children, adolescents, and adults with ADHD. J Am Acad Child Adolesc Physchiatry 1997;36:1311-1317.

    Article  CAS  Google Scholar 

  2. Adler LA. Pharmacotherapy for adult ADHD. J Clin Psychiatry 2009;70:e12.

    Article  PubMed  Google Scholar 

  3. Wilens TE. Pharmacotherapy of ADHD in adults. CNS Spectr 2008;13(5 suppl 8):11-13.

    PubMed  Google Scholar 

  4. Sallee FR, McGough J, Wigal T, Donahue J, Lyne A, Biederman J. Guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder: a placebo-controlled trial. J Am Acad Child Adolesc Physchiatry 2009;48:155-165.

    Article  Google Scholar 

  5. Kollins SH, Jain R, Brams M, et al. Clonidine extended-release tablets as add-on therapy to psychostimulants in children and adolescents with ADHD. Pediatrics 2011;127:e1406-e1413.

    Article  PubMed  Google Scholar 

  6. Wolraich M, Brown L, Brown RT, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2011;128:1007-1022.

    Article  PubMed  Google Scholar 

  7. Swanson JM, Wigal SB, Wigal T, et al. A comparison of once-daily extended-release methylphenidate formulations in children with attention-deficit/hyperactivity disorder in the laboratory school (the Comacs Study). Pediatrics 2004;113(3 pt 1):e206-e216.

    Article  PubMed  Google Scholar 

  8. Pelham WE Jr., Fabiano GA. Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. J Clin Child Adolesc Psychol 2008;37:184-214.

    Article  PubMed  Google Scholar 

  9. Spruyt K, Raubuck D, Grogan K, Gozal D, Stein M. Variable sleep schedules and outcomes n chiuldren with psychopathological problems: preliminary observations. Nat Sci Sleep 2012;4:9-17.

    Article  Google Scholar 

  10. Chervin RD, Ruzicka DL, Giordani BJ, et al. Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy. Pediatrics 2006;117:e769-778.

    Article  PubMed  Google Scholar 

  11. Gruber R, Wiebe S, Montecalvo L, Brunetti B, Amsel R, Carrier J. Impact of sleep restriction on neurobehavioral functioning of children with attention deficit hyperactivity disorder. Sleep 2011;34:315-323.

    PubMed  Google Scholar 

  12. Van der Heijden KB, Smits MG, Van Someren EJ, Ridderinkhof KR, Gunning WB. Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia. J Am Acad Child Adolesc Physchiatry 2007;46:233-241.

    Article  Google Scholar 

  13. Weiss MD, Wasdell MB, Bomben MM, Rea KJ, Freeman RD. Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. J Am Acad Child Adolesc Physchiatry 2006;45:512-519.

    Google Scholar 

  14. Owens JA. A clinical overview of sleep and attention-deficit/hyperactivity disorder in children and adolescents. J Can Acad Child Adolesc Psychiatry 2009;18:92-102.

    PubMed  Google Scholar 

  15. van der Heijden KB, Smits MG, Gunning WB. Sleep-related disorders in ADHD: a review. Clin Pediatr 2005;44:201-210.

    Article  Google Scholar 

  16. Huang YS, Tsai MH, Guilleminault C. Pharmacological treatment of ADHD and the short and long term effects on sleep. Curr Pharm Des 2011;17:1450-1458.

    Article  PubMed  CAS  Google Scholar 

  17. Stein MA. Unravelling sleep problems in treated and untreated children with ADHD. J Child Adolesc Psychopharmacol 1999;9:157-168.

    Article  PubMed  CAS  Google Scholar 

  18. Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Physchiatry 2009;48:894-908.

    Google Scholar 

  19. Corkum P, Tannock R, Moldofsky H. Sleep disturbances in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Physchiatry 1998;37:637-646.

    Article  CAS  Google Scholar 

  20. Gruber R, Xi T, Frenette S, Robert M, Vannasinh P, Carrier J. Sleep disturbances in prepubertal children with attention deficit hyperactivity disorder: a home polysomnography study. Sleep 2009;32:343-350.

    PubMed  Google Scholar 

  21. Choi J, Yoon IY, Kim HW, Chung S, Yoo HJ. Differences between objective and subjective sleep measures in children with attention deficit hyperactivity disorder. J Clin Sleep Med 2010;6:589-595.

    PubMed  Google Scholar 

  22. Sadeh A, Pergamin L, & Bar-Haim Y. Sleep in children with attention-deficit hyperactivity disorder: A meta-analysis of polysomnographic studies. Sleep Med Rev 2006;10:381-398.

    Article  PubMed  Google Scholar 

  23. Mayes SD, Calhoun SL, Bixler EO, et al. ADHD subtypes and comorbid anxiety, depression, and oppositional-defiant disorder: differences in sleep problems. J Pediatr Psychol 2009;34:328-337.

    Article  PubMed  Google Scholar 

  24. Accardo JA, Marcus CL, Leonard MB, Shults J, Meltzer LJ, Elia J. Associations between psychiatric comorbidities and sleep disturbances in children with attention-deficit/hyperactivity disorder. J Dev Behav Pediatr 2012;33:97-105.

    Google Scholar 

  25. Willoughby MT, Angold A, Egger HL. Parent-reported attention-deficit/hyperactivity disorder symptomatology and sleep problems in a preschool-age pediatric clinic sample. J Am Acad Child Adolesc Physchiatry 2008;47:1086-1094.

    Article  Google Scholar 

  26. Stein MA, Mendelsohn J, Obermeyer WH, Amromin J, Benca R. Sleep and behavior problems in school-aged children. Pediatrics 2001;107:E60.

    Article  PubMed  CAS  Google Scholar 

  27. Cortese S, Konofal E, Yateman N, Mouren MC, Lecendreux M. Sleep and alertness in children with attention-deficit/hyperactivity disorder: a systematic review of the literature. Sleep 2006;29:504-511.

    PubMed  Google Scholar 

  28. Tsai MH, Huang YS. Attention-deficit/hyperactivity disorder and sleep disorders in children. Med Clin North Am 2010;94:615-632.

    Article  PubMed  Google Scholar 

  29. O’Brien LM, Ivanenko A, Crabtree VM, et al. The effect of stimulants on sleep characteristics in children with attention deficit/hyperactivity disorder. Sleep Med 2003;4:309-316.

    Article  PubMed  Google Scholar 

  30. Kooij JJ, Middelkoop HA, van Gils K, Buitelaar JK. The effect of stimulants on nocturnal motor activity and sleep quality in adults with ADHD: an open-label case-control study. J Clin Psychiatry 2001;62:952-956.

    Article  PubMed  CAS  Google Scholar 

  31. Sobanski E, Schredl M, Kettler N, Alm B. Sleep in adults with attention deficit hyperactivity disorder (ADHD) before and during treatment with methylphenidate: a controlled polysomnographic study. Sleep 2008;31:375-381.

    PubMed  Google Scholar 

  32. Surman CB, Adamson JJ, Petty C, et al. Associations between attention-deficit/hyperactivity disorder and sleep impairment in adulthood: evidence from a large controlled study. J Clin Psychiatry 2009;70:1523-1529.

    Article  PubMed  Google Scholar 

  33. Wigal SB, Kollins SH, Childress AC, Squires L. A 13-hour laboratory school study of lisdexamfetamine dimesylate in school-aged children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2009;3:17.

    Article  PubMed  Google Scholar 

  34. Findling RL, Turnbow J, Burnside J, Melmed R, Civil R, Li Y. A randomized, double-blind, multicenter, parallel-group, placebo-controlled, dose-optimization study of the methylphenidate transdermal system for the treatment of ADHD in adolescents. CNS Spectr 2010;15:419-430.

    PubMed  Google Scholar 

  35. Rechtschaffen A, Maron L. The effect of amphetamine on the sleep cycle. Electroencephalogr Clin Neurophysiol 1964;16:438-445.

    Article  PubMed  CAS  Google Scholar 

  36. Stein M, Pao M. Is sleep delayed, disrupted, or disturbed? In: Greenhill L, Osman B, editors. Ritalin: theory and patient management: New York: Liebert, 1999:287-299.

  37. Ahmann PA, Waltonen SJ, Olson KA, Theye FW, Van Erem AJ, LaPlant RJ. Placebo-controlled evaluation of Ritalin side effects. Pediatrics 1993;91:1101-1106.

    PubMed  CAS  Google Scholar 

  38. Barkley RA, McMurray MB, Edelbrock CS, Robbins K. Side effects of methylphenidate in children with attention deficit hyperactivity disorder: a systemic, placebo-controlled evaluation. Pediatrics 1990;86:184-192.

    PubMed  CAS  Google Scholar 

  39. Stein MA, Sarampote CS, Waldman ID, et al. A dose-response study of OROS methylphenidate in children with attention-deficit/hyperactivity disorder. Pediatrics 2003;112:e404.

    Article  PubMed  Google Scholar 

  40. Giblin JM, Strobel AL. Effect of lisdexamfetamine dimesylate on sleep in children with ADHD. J Atten Disord 2011;15:491-498.

    Article  PubMed  Google Scholar 

  41. Wigal SB, Wong AA, Jun A, Stehli A, Steinberg-Epstein R, Lerner MA. Adverse events in medication treatment naive children with attention-deficit/hyperactivity disorder: results from a small, controlled trial of lisdexamfetamine dimesylate. J Child Adolesc Psychopharmacol 2012;22:149-156.

    Google Scholar 

  42. Chatoor I, Wells KC, Conners CK, Seidel WT, Shaw D. The effects of nocturnally administered stimulant medication on EEG sleep and behavior in hyperactive children. J Am Acad Child Psychiatry 1983;22:337-342.

    Article  PubMed  CAS  Google Scholar 

  43. Stein MA, Blondis TA, Schnitzler ER, et al. Methylphenidate dosing: twice daily versus three times daily. Pediatrics 1996;98(4 pt 1):748-756.

    PubMed  CAS  Google Scholar 

  44. Kent JD, Blader JC, Koplewicz HS, Abikoff H, Foley CA. Effects of late-afternoon methylphenidate administration on behavior and sleep in attention-deficit hyperactivity disorder. Pediatrics 1995;96(2 pt 1):320-325.

    PubMed  CAS  Google Scholar 

  45. Sangal RB, Owens J, Allen AJ, Sutton V, Schuh K, Kelsey D. Effects of atomoxetine and methylphenidate on sleep in children with ADHD. Sleep 2006;29:1573-1585.

    PubMed  Google Scholar 

  46. Greenhill L, Puig-Antich J, Goetz R, Hanlon C, Davies M. Sleep architecture and rapid eye movement sleep measures in prepubertal children with attention deficit disorder with hyperactivity. Sleep 1983;6:91-101.

    PubMed  CAS  Google Scholar 

  47. Kim HW, Yoon IY, Cho SC, et al. The effect of OROS methylphenidate on the sleep of children with attention-deficit/hyperactivity disorder. Int Clin Psychopharmacol 2010;25:107-115.

    Article  PubMed  Google Scholar 

  48. Wilens TE, Boellner SW, Lopez FA, et al. Varying the wear time of the methylphenidate transdermal system in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Physchiatry 2008;47:700-708.

    Article  Google Scholar 

  49. Faraone SV, Glatt SJ, Bukstein OG, Lopez FA, Arnold LE, Findling RL. Effects of once-daily oral and transdermal methylphenidate on sleep behavior of children with ADHD. J Atten Disord 2009;12:308-315.

    Article  PubMed  Google Scholar 

  50. Efron D, Jarman F, Barker M. Side effects of methylphenidate and dexamphetamine in children with attention deficit hyperactivity disorder: a double-blind, crossover trial. Pediatrics 1997;100:662-666.

    Article  PubMed  CAS  Google Scholar 

  51. McCracken JT, Biederman J, Greenhill LL, et al. Analog classroom assessment of a once-daily mixed amphetamine formulation, SLI381 (Adderall XR), in children with ADHD. J Am Acad Child Adolesc Physchiatry 2003;42:673-683.

    Article  Google Scholar 

  52. Stein MA, Waldman ID, Charney E, et al. Dose effects and comparative effectiveness of extended release dexmethylphenidate and mixed amphetamine salts. J Child Adolesc Psychopharmacol 2011;21:581-588.

    Article  PubMed  CAS  Google Scholar 

  53. Biederman J, Krishnan S, Zhang Y, McGough JJ, Findling RL. Efficacy and tolerability of lisdexamfetamine dimesylate (NRP-104) in children with attention-deficit/hyperactivity disorder: a phase III, multicenter, randomized, double-blind, forced-dose, parallel-group study. Clin Ther 2007;29:450-463.

    Article  PubMed  CAS  Google Scholar 

  54. Biederman J, Boellner SW, Childress A, Lopez FA, Krishnan S, Zhang Y. Lisdexamfetamine dimesylate and mixed amphetamine salts extended-release in children with ADHD: a double-blind, placebo-controlled, crossover analog classroom study. Biol Psychiatry 2007;62:970-976.

    Article  PubMed  CAS  Google Scholar 

  55. Brams M, Giblin J, Gasior M, Gao J, Wigal T. Effects of open-label lisdexamfetamine dimesylate on self-reported quality of life in adults with ADHD. Postgrad Med 2011;123:99-108.

    Article  PubMed  Google Scholar 

  56. Surman CB, Roth T. Impact of stimulant pharmacotherapy on sleep quality: post hoc analyses of 2 large, double-blind, randomized, placebo-controlled trials. J Clin Psychiatry 2011;72:903-908.

    Article  PubMed  Google Scholar 

  57. Adler LA, Liebowitz M, Kronenberger W, et al. Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder. Depress Anxiety 2009;26:212-221.

    Article  PubMed  CAS  Google Scholar 

  58. Yildiz O, Sismanlar SG, Memik NC, Karakaya I, Agaoglu B. Atomoxetine and methylphenidate treatment in children with ADHD: the efficacy, tolerability and effects on executive functions. Child Psychiatry Hum Dev 2011;42:257-269.

    Article  PubMed  Google Scholar 

  59. Block S, Kelsey D, Coury D, et al. Once-daily atomoxetine for treating pediatric attention-deficit/hyperactivity disorder: comparison of morning and evening dosing. Clin Pediatr 2010;48:723-733.

    Google Scholar 

  60. Wilens TE, Biederman J, Spencer T. Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Physchiatry 1994;33:424-426.

    Article  CAS  Google Scholar 

  61. Prince JB, Wilens TE, Biederman J, Spencer TJ, Wozniak JR. Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder: a systematic chart review of 62 cases. J Am Acad Child Adolesc Physchiatry 1996;35:599-605.

    Article  CAS  Google Scholar 

  62. Daviss WB, Patel NC, Robb AS, et al. Clonidine for attention-deficit/hyperactivity disorder: II. ECG changes and adverse events analysis. J Am Acad Child Adolesc Physchiatry 2008;47:189-198.

    Article  Google Scholar 

  63. Faraone SV, Glatt SJ. Effects of extended-release guanfacine on ADHD symptoms and sedation-related adverse events in children with ADHD. J Atten Disord 2010;13:532-538.

    Article  PubMed  Google Scholar 

  64. Weinberg WA, Brumback RA. Primary disorder of vigilance: a novel explanation of inattentiveness, daydreaming, boredom, restlessness, and sleepiness. J Pediatr 1990;116:720-725.

    Article  PubMed  CAS  Google Scholar 

  65. Owens JA. The ADHD and sleep conundrum: a review. J Dev Behav Pediatr 2005;26:312-322.

    Article  PubMed  Google Scholar 

  66. Spruyt K, Gozal D. Sleep disturbances in children with attention-deficit/hyperactivity disorder. Expert Rev Neurother 2011;11:565-577.

    Article  PubMed  Google Scholar 

Download references

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Author information

Authors and Affiliations

  1. University of Illinois at Chicago, Chicago, IL, USA

    Mark A. Stein & Laura Hlavaty

  2. University of British Columbia, Vancouver, Canada

    Margaret Weiss

Authors
  1. Mark A. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margaret Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Hlavaty
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark A. Stein.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 374 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Stein, M.A., Weiss, M. & Hlavaty, L. ADHD Treatments, Sleep, and Sleep Problems: Complex Associations. Neurotherapeutics 9, 509–517 (2012). https://doi.org/10.1007/s13311-012-0130-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13311-012-0130-0

Keywords

  • ADHD
  • Sleep
  • Psychopharmacology