Iatrogenic effects of stimulant medication on sleep in children with ADHD

Over the past decade there has been a substantial increase in the rates of stimulant medication prescriptions used for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). Currently, it is estimated that approximately four million school-aged children in North America take stimulant medications (such as Ritalin) for treatment of ADHD. There has also been a significant shift in clinical practice with regard to the recommended number of doses of stimulant medication. In order to treat ADHD symptoms throughout the day and evening, stimulant medication is now given three times a day (or long acting medications are used). Past research has demonstrated that stimulant medication taken just during daytime hours can negatively affect sleep. Given that there is ample evidence demonstrating the detrimental impact of sleep disturbances on children¿s cognitive, emotional and behavioural functioning, it is critical to determine the affect on sleep when medication is used throughout the day and evening. Our study will evaluate changes in sleep in children with ADHD during a three-week acute medication trial followed by a four week maintenance trial. We want to determine both the short term and longer term impact on sleep as a result of stimulant medication given three times a day. The findings from the proposed research will provide important information to clinicians treating ADHD, which should aid in reducing the negative impact on sleep while maintaining the positive benefits of stimulant medication.