Effects of methylphenidate on sleep in children with attention-deficient hyperactivity disorder. An activity monitor study
E. Tirosh, A. Sadeh, R. Munvez and P. Lavie
Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Haifa, Israel.
OBJECTIVE--To assess the effects of methylphenidate hydrochloride on sleep
patterns in children diagnosed as having attention-deficit hyperactivity
disorder (ADHD). DESIGN--A double-blind, controlled drug-placebo cross-over
design. SETTING--Home. SUBJECTS--Ten children (aged 6 years 9 months to 12
years & months) diagnosed as having ADHD were consecutively recruited
and compared with age- and sex-matched normal controls.
TREATMENT--Methylphenidate hydrochloride (0.3 to 0.4 mg/kg) or placebo was
administered at 7:30 AM. MEASUREMENTS AND RESULTS--Each child underwent
activity monitoring at home during 6 days of no treatment (baseline)
followed by placebo and methylphenidate treatment. The results of the three
trial stages, as well as those of the 20 age- and sex-matched normal
controls, were compared. A shorter total sleep duration was evident during
the methylphenidate treatment compared with that of baseline and placebo
treatment. The amount of quiet sleep was lower (however, not significantly)
among the study group compared with controls, whereas no such difference
was noted during methylphenidate treatment. Night-to-night sleep pattern
stability was found. No other differences were found either between
children with ADHD and controls or between on and off stages of
methylphenidate treatment. CONCLUSIONS--These results support the notion
that ADHD is a centrally generated disorder attributable to hypoarousal,
which subsequently stimulates motor overactivity. Methylphenidate does not
appear to affect sleep patterns adversely and possibly normalizes them in
patients with ADHD.
