Hyperactive night and day? Actigraphy studies in adult ADHD: a baseline comparison and the effect of methylphenidate.
OBJECTIVE
To investigate parameters of sleep, activity, and circadian rhythm, as well as the effects of methylphenidate on these variables, in adults with ADHD.


METHODS
1) Baseline group comparison; 2) Double blind, placebo-controlled, cross-over medication trial.


METHODS
Data collection took place during daily lives of participants.


METHODS
39 normal controls and 33 adults with ADHD for baseline comparisons; 31 adults with ADHD in medication trial.


METHODS
Treatment with placebo and methylphenidate during medication trial.


RESULTS
Actigraphy and sleep log data were collected for 7 consecutive nights and days to obtain baseline values for ADHD and normal controls. Repeated measurements during placebo and methylphenidate treatment were conducted for the ADHD group. Actigraphic sleep estimates showed that ADHD subjects took longer to fall asleep, had lower sleep efficiency, and had shorter within-night periods of uninterrupted sleep. These findings were consistent with subjective complaints. Actigraphic measures of ADHD subjects showed continuously elevated daytime activity levels, resulting in a 24-hour pattern that was more stable and less variable than in controls. Methylphenidate led to a later bedtime, later sleep onset, and reduction in sleep duration. However, number and total duration of nocturnal awakenings decreased, while mean duration of within-night periods of uninterrupted sleep increased, indicating more consolidated sleep.


CONCLUSIONS
Our data suggest that sleep problems are inherent in adults with ADHD and that methylphenidate reduced total sleep time but improved sleep quality by consolidating sleep.
Boonstra
A Marije
AM
University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands. Boonstra@fsw.eur.nl
Kooij
J J Sandra
JJ
Oosterlaan
Jaap
J
Sergeant
Joseph A
JA
Buitelaar
Jan K
JK
Van Someren
Eus J W
EJ
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002940:Circadian Rhythm; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D017286:Polysomnography; D012892:Sleep Deprivation / Q000139:chemically induced / Q000175:diagnosis; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy*; D014851:Wakefulness / Q000187:drug effects
D000697:Central Nervous System Stimulants; D008774:Methylphenidate