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Sleep interventions for children with attention deficit hyperactivity disorder (ADHD): A systematic literature review.

Sleep medicine
February 1, 2023
I Larsson et al. (7 authors)
Systematic ReviewJournal ArticleReviewResearch Support, Non-U.S. Gov'tHuman Study
Extracted Claims (4)
InterventionDirectionEndpointPopulationDosageImpactClaim #
behavioral sleep interventions
decrease
sleep disturbances
children aged 5-13 years with ADHD
-0.49 standardized mean differences (95% confidence interval -0.65;-0.33)
moderate effect size
#1
pharmacological intervention using melatonin
increase
total sleep time
children with ADHD
-
moderate effect size
#2
one behavioral intervention
increase
total sleep time
children with ADHD
-
moderate effect size
#3
sleep interventions
increase
sleep quantity and quality
children with ADHD
-
impact
#4
Abstract

OBJECTIVE/BACKGROUND: Healthy sleep is particularly important for children with attention deficit hyperactivity disorder (ADHD), as sleep disturbances might aggravate disease symptoms. This review aims to synthesize and report evidence on the effectiveness of sleep interventions in increasing sleep, quality of life (QoL), and ADHD symptoms among children with ADHD. PATIENTS/METHODS: The systematic literature review follows the Cochrane Collaboration methodology recommendations for literature reviews. Four databases were used based on the population, intervention, control and outcome (PICO) framework. Controlled trials with minimum 20 children in each group, aged 6-18, and published from 2005 and onwards were included. Results from the studies were reported in forest plots and three of the seven review outcomes were synthesized in meta-analyses. RESULTS: The search identified 7710 records; of which 4808 abstracts were screened. After fulltext-screening of 99 papers, eight papers from five studies were included. The studies included behavioral sleep interventions and pharmacological interventions using melatonin and eszopiclone. For six of the seven outcomes, the effect sizes were small to moderate and the certainty of the evidence was low. For one outcome, sleep disturbances, the effect size was a moderate -0.49 standardized mean differences (95% confidence interval -0.65;-0.33), with a moderate certainty of evidence for the behavioral interventions for children aged 5-13 years with ADHD. CONCLUSIONS: This review identified few and heterogeneous studies. A moderate certainty of evidence for a moderate effect size was only obtained for sleep disturbances from the behavioral interventions. A low certainty of the evidence for a moderate effect size was found for the total sleep time from the pharmacological intervention using melatonin and one behavioral intervention, which indicates that these sleep interventions impact sleep quantity and quality among children with ADHD.

Medical Subject Headings (MeSH)
ChildHumansAttention Deficit Disorder with HyperactivityQuality of LifeMelatoninBehavior TherapySleep Wake DisordersSleep
Study Links
Citation Metrics
Total Citations22
Citations/Year11.0
Relative Citation Ratio7.61
NIH Percentile96.5%
Research Impact Scores
APT Score0.95
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