Sleep disturbances in children with ADHD on methylphenidate monotherapy: The role of dysregulation profile

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY Sleep medicine Pub Date : 2025-04-01 Epub Date: 2025-02-06 DOI:10.1016/j.sleep.2025.02.001

Barbara D'Aiello , Ludovica Gessi , Deny Menghini , Stefano Vicari , Pietro De Rossi

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Abstract

Dysregulation profile has been associated with Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents, influencing its progression, outcomes, and potentially the response to treatment with methylphenidate, a commonly prescribed stimulant medication. Sleep disturbances are also closely linked to ADHD, as they significantly impact clinical outcomes and overall functioning, with variable responses to methylphenidate treatment.

This study aimed to investigate whether methylphenidate improves sleep disturbances in children with ADHD and whether the presence of dysregulation profile negatively predicts this improvement. To explore this, we examined the role of baseline dysregulation profile (assessed with the Child Behavior Checklist), age, ADHD symptom severity (assessed with SNAP-IV scores), and functional impairment (assessed with ABAS-II scores) as potential predictors of changes in sleep disturbances (assessed with SDSC scores) following six months of methylphenidate monotherapy.

A total of 115 participants (98 males) aged 6–17 years (mean age 10.32 ± 2.78 years) were included in the study. A hierarchical linear regression model was used to determine whether these baseline factors could predict changes in sleep disturbances, while accounting for initial sleep severity.

The results showed that the presence of dysregulation profile at baseline was associated with higher sleep disturbances after treatment. While ADHD severity at baseline was associated with sleep disturbances at follow-up, it did not demonstrate any significant predictive value for sleep outcomes over time.

In conclusion, dysregulation profile may act as a negative predictor of sleep outcomes following methylphenidate treatment. These findings highlight the importance of systematically assessing dysregulation profile before starting treatment. Future research with larger sample sizes and longer follow-up periods is needed to confirm these results and identify additional factors that contribute to sleep disturbances in children and adolescents with ADHD.

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哌甲酯单药治疗ADHD儿童的睡眠障碍：失调特征的作用

失调特征与儿童和青少年的注意力缺陷/多动障碍（ADHD）有关，影响其进展、结果，并可能影响对哌醋甲酯（一种常用的兴奋剂药物）治疗的反应。睡眠障碍也与多动症密切相关，因为它们显著影响临床结果和整体功能，对哌甲酯治疗的反应不一。本研究旨在探讨哌醋甲酯是否能改善ADHD儿童的睡眠障碍，以及失调特征的存在是否会对这种改善产生负面影响。为了探讨这一点，我们检查了基线失调特征（用儿童行为检查表评估）、年龄、ADHD症状严重程度（用SNAP-IV评分评估）和功能障碍（用ABAS-II评分评估）作为六个月哌醋甲酯单药治疗后睡眠障碍（用SDSC评分评估）变化的潜在预测因素的作用。研究共纳入115名参与者（98名男性），年龄6 ~ 17岁，平均年龄10.32±2.78岁。在考虑初始睡眠严重程度的同时，采用层次线性回归模型来确定这些基线因素是否可以预测睡眠障碍的变化。结果显示，基线时的失调与治疗后更高的睡眠障碍有关。虽然ADHD在基线时的严重程度与随访时的睡眠障碍有关，但随着时间的推移，它并没有显示出任何显著的预测睡眠结果的价值。总之，失调可能是哌甲酯治疗后睡眠结果的负面预测因子。这些发现强调了在开始治疗前系统评估失调特征的重要性。未来的研究需要更大的样本量和更长的随访时间来证实这些结果，并确定导致ADHD儿童和青少年睡眠障碍的其他因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.