title: Sleep Problems in Children with Attention Deficit/Hyperactivity Disorder: Current Status of Knowledge and Appropriate Management.
abstract: Attention deficit hyperactivity disorder (ADHD) affects approximately 5 % of children and adolescents, and sleep problems are common in these patients. There is growing evidence informing the significant importance of sleep problems in youth with ADHD. The sleep problems in children with ADHD include specific sleep disorders and sleep disturbances due to comorbid psychiatric disorders or ADHD medications. The specific sleep disorders of ADHD children include behaviorally based insomnia, sleep-disordered breathing, and restless legs syndrome/periodic limb movement disorder. Current practices on the management of sleep problems for ADHD children are based mostly on expert consensus, whereas more evidence-based literature can be found only recently. Assessment of the sleep conditions in ADHD children before initiation of pharmacotherapy is the currently recommended guideline, and good sleep hygiene can be considered as the first-line treatment option. In addition to modifying the dose regimens, formulation, or alternative stimulants when sleep problems are encountered in ADHD children, atomoxetine, once daily guanfacine extended release, and melatonin are potential choices for ADHD children with more severe sleep problems. In this review, we aimed to provide the most updated information, preferably based on meta-analyses, systemic review, and randomized controlled trials published in the latest 3 years, in order to be clinically useful for practitioners and clinicians.
authors.affiliation: Division of Pediatric Neonatology and Hematology/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ming-Horng
authors.initials: MH
authors.lastname: Tsai
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Sleep Center and Child Psychiatry Department, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.|Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Jen-Fu
authors.initials: JF
authors.lastname: Hsu
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan. hu1109s@yahoo.com.tw.|Sleep Center and Child Psychiatry Department, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. hu1109s@yahoo.com.tw.|Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital, 5, Fu-Shing St., Kwei-Shan, Taoyuan, 333, Taiwan. hu1109s@yahoo.com.tw.
authors.forename: Yu-Shu
authors.initials: YS
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D002648:Child; D006801:Humans; D012893:Sleep Wake Disorders / Q000150:complications* / Q000628:therapy*
keywords: Attention deficit hyperactivity disorder; Children; Insomnia; Melatonin; Sleep disorders