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Choice Between Treatment Modality Remains Weak for Pediatric ADHD and Sleep Disorders
Sleep interventions could increase sleep quality and quantity among children with attention-deficit/hyperactivity disorder (ADHD). Still, evidence remains limited for other sleep-related outcomes such as quality of life (QoL), sleep onset latency (SOL), sleep efficiency, and ADHD symptoms. Researchers from the School of Health and Welfare in the Department of Health and Care at Halmstad University, Sweden, published their findings in Sleep Medicine.
“The 2 [studied] behavioral interventions were shown to lead to decreased ADHD symptoms and parent-reported sleep disturbances among the children at 3-month follow-up. Based on these findings, we could not determine whether any of the interventions suited better for children with ADHD,” researchers said in the study. “Thus, for healthcare professionals working with children with ADHD, the choice between treatment modality, pharmacological or behavioral, has a weak evidence base which calls for further research to support practice.”
Behavioral interventions studied in this literature review included sleep hygiene strategies and a management plan tailored to the patient’s needs. Pharmacological interventions included in this review were melatonin and eszopiclone treatment plans as part of 2 double-blind, placebo-controlled trials.
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After a careful screening process following the Cochrane Collaboration methodology recommendations for a literature review, researchers identified 8 papers from 5 studies of controlled trials with a minimum of 20 children in each group, aged 6-18.
In summary, the study yielded the following notable results among children with ADHD:
- Sleep interventions, either behavioral or pharmacological, may increase total sleep time (TST);
- Sleep interventions with melatonin, not eszopiclone, may reduce SOL but the evidence is uncertain;
- Melatonin may increase sleep efficiency, but the evidence is uncertain; and
- Behavioral sleep interventions, not pharmacological melatonin, slightly decrease ADHD symptoms, but the evidence is uncertain.
“This...review found only 4 studies with good scientific quality,” researches noted about the reasons behind the limited evidence obtained in the study. “The rigorous methods used in this review warrant that the results reported are unbiased, as careful quality assessments have eliminated studies that are not of the highest scientific standard throughout the review process.”
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