title: Stimulant Medications and Sleep for Youth With ADHD: A Meta-analysis.
abstract: BACKGROUND
  Mixed findings exist on whether stimulant medications alter youth sleep.
  
  
  OBJECTIVE
  To determine the effect of stimulant medications on sleep.
  Studies published through March 2015 were collected via CINAHL, PsycINFO, and PubMed. References of retrieved articles were reviewed.
  
  
  METHODS
  Eligibility criteria included studies with children/adolescents who had attention-deficit/hyperactivity disorder (ADHD), random assignment to stimulants, and objective sleep measurement. Studies that did not include information about key variables were excluded.
  
  
  METHODS
  Study-level, child-level, and sleep data were extracted by 2 independent coders. Effect sizes were calculated by using random effects models. Potential moderators were examined by using mixed effect models.
  
  
  RESULTS
  A total of 9 articles (N = 246) were included. For sleep latency, the adjusted effect size (0.54) was significant, indicating that stimulants produce longer sleep latencies. Frequency of dose per day was a significant moderator. For sleep efficiency, the adjusted effect size (-0.32) was significant. Significant moderators included length of time on medication, number of nights of sleep assessed, polysomnography/actigraphy, and gender. Specifically, the effect of medication was less evident when youth were taking medication longer. For total sleep time, the effect size (-0.59) was significant, such that stimulants led to shorter sleep duration.
  
  
  CONCLUSIONS
  Limitations include few studies, limited methodologic variability, and lack of unpublished studies.
  
  
  CONCLUSIONS
  Stimulant medication led to longer sleep latency, worse sleep efficiency, and shorter sleep duration. Overall, youth had worse sleep on stimulant medications. It is recommended that pediatricians carefully monitor sleep problems and adjust treatment to promote optimal sleep.
authors.affiliation: Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska kkidwell@huskers.unl.edu.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Kidwell
authors.affiliation: Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska.
authors.forename: Tori R
authors.initials: TR
authors.lastname: Van Dyk
authors.affiliation: Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Lundahl
authors.affiliation: Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012890:Sleep / Q000187:drug effects*
chemical_list: D000697:Central Nervous System Stimulants