Sleep in children with attention-deficit hyperactivity disorder (ADHD): a review of naturalistic and stimulant intervention studies

Attention-Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder of childhood. Multiple clinical and research reports suggest extensive steep disturbances in children with ADHD, however, current data is contradictory. This paper reviewed 47 research studies (13 stimulant intervention and 34 naturalistic) on ADHD that were published since 1980. The main objectives of this review were to provide pediatric clinicians and researchers a clear and concise summary of published steep data in children with ADHD, to provide a more accurate description of the current knowledge of the relationship between steep and ADHD, and to provide current information on the effect of stimulant medication on steep. Twenty-five of the reviewed studies used subjective reports of steep, six were actigraphic studies, and 16 were overnight polysomnographic steep studies (two of which also included Multiple Steep Latency Tests). All participants were between the age of 3 and 19, and 60% were mate. The results indicate high rates of parental reports of steep disturbances in medicated and unmedicated children with ADHD, however, the majority of these findings have not been confirmed by objective steep data. Although, agreement among objective studies is not absolute, the data suggest increased nighttime activity, reduced rapid eye movement steep, and significant daytime somnolence in unmedicated children with ADHD when compared to controls. Data also suggest a possible increased prevalence of periodic limb movements in steep in children with ADHD, however, little differences in steep-disordered breathing. The limited number of studies, small and heterogeneous samples, and other methodological limitations make definite results difficult to determine. Future research will need to further clarify the relationship between steep and ADHD and the effects of stimulants on steep of children with ADHD. (C) 2004 Elsevier Ltd. All rights reserved.