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Assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder.

Journal of the American Academy of Child and Adolescent Psychiatry
August 1, 2013
Samuele Cortese et al. (8 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tReviewHuman Study
Study Details

Study Goal

To evaluate the efficacy of melatonin in reducing sleep-onset delay in youths with ADHD.

Results Summary

The study found that randomized controlled trials support the use of melatonin to reduce sleep-onset delay in youths with ADHD, though evidence for other medications is more limited.

Population

Youths with ADHD experiencing sleep disturbances.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Healthy sleep practices
decrease
sleep problems
youths with ADHD
-
are recommended as the foundation of management strategies
#1
Behavioral interventions
decrease
insomnia
youths with ADHD
-
should be considered as first-line treatment
#2
melatonin
decrease
sleep-onset delay
youths with ADHD
-
RCTs support the use
#3
Abstract

OBJECTIVE: To provide evidence- or consensus-based recommendations concerning the assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder (ADHD). METHOD: PubMed, Ovid, EMBASE, and Web of Knowledge were searched through October 31, 2012. When no evidence was available, consensus of the authors was achieved. The evidence-level of the recommendations on the management of sleep disturbances was based on the Scottish Intercollegiate Guidelines Network (SIGN) system. RESULTS: A total of 139 original articles on sleep and childhood ADHD were retrieved, including 22 on treatment of sleep disturbances. This review focuses on behaviorally based insomnia, circadian rhythm disorder, sleep-disordered breathing, restless legs syndrome/periodic limb movement disorder, and sleep disturbances due to comorbid psychiatric disorders or ADHD medications. Healthy sleep practices are recommended as the foundation of management strategies. Behavioral interventions should be considered as first-line treatment of insomnia, although further evidence from randomized controlled trials (RCTs) is needed to prove their efficacy in ADHD. Among pharmacological treatments, RCTs support the use of melatonin to reduce sleep-onset delay, whereas there is more limited evidence for other medications. CONCLUSION: Growing empirical evidence is informing assessment/management strategies of sleep problems in youths with ADHD. However, further RCTs are warranted to support current recommendations.

Medical Subject Headings (MeSH)
AdolescentAttention Deficit Disorder with HyperactivityComorbidityHumansSleep Wake Disorders
Study Links
Quality Scores
SafetyNot Assessed
Efficacy80/10
Quality75/10
Citation Metrics
Total Citations143
Citations/Year11.9
Relative Citation Ratio6.51
NIH Percentile95.5%
Research Impact Scores
APT Score0.95
Weight Score1.68
Normalized Score0.67
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