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Sleep in children with attention-deficit hyperactivity disorder (ADHD): a review of naturalistic and stimulant intervention studies
Abstract
Attention-Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder of childhood. Multiple clinical and research reports suggest extensive sleep 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 sleep data in children with ADHD, to provide a more accurate description of the current knowledge of the relationship between sleep and ADHD, and to provide current information on the effect of stimulant medication on sleep. Twenty-five of the reviewed studies used subjective reports of sleep, six were actigraphic studies, and 16 were overnight polysomnographic sleep studies (two of which also included Multiple Sleep Latency Tests). All participants were between the age of 3 and 19, and 60% were male. The results indicate high rates of parental reports of sleep disturbances in medicated and unmedicated children with ADHD, however, the majority of these findings have not been confirmed by objective sleep data. Although, agreement among objective studies is not absolute, the data suggest increased nighttime activity, reduced rapid eye movement sleep, 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 sleep in children with ADHD, however, little differences in sleep-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 sleep and ADHD and the effects of stimulants on sleep of children with ADHD.
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“In a review of subjective reports on medicated versus unmedicated children with ADHD there were high rates of parental report of sleep problems, but few of these were confirmed by objective sleep data [29].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [29]
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Metadata
- Authors
- Cohen-Zion, M., & Ancoli-Israel, S.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2004-10
- Volume
- 8
- Issue
- 5
- Pages
- 379-402
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2113870936
- Cited by
- 203
- References
- 209
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 10 · 2017: 6 · 2016: 6 · 2015: 10 · 2014: 15 · 2013: 10 · 2012: 20
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5f31mh065793-02)
- National Institute on Aging (R01AG008415, AG 08415)
- National Institute of Mental Health (MH65793)
- National Cancer Institute (CA25864)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- attention deficit hyperactivity disorder, sleep disorders, children, stimulant medication, sleep-disordered breathing, periodic limb movements in sleep, REM sleep, daytime somnolence, nighttime activity, actigraphy, polysomnography, multiple sleep latency test
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Clinical Trials as Topic, Humans, Reaction Time, Sleep Wake Disorders, Comorbidity, Treatment Outcome, Polysomnography
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