1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-13-72 10.15844/pedneurbriefs-13-9-11 Attention Deficit Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Sleep Disorders in Attention Deficit Disorder http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 09 1999 01 05 2016 13 9 72 72 Copyright: © 1999 The Author(s) 1999 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Combining methylphenidate and clonidine: a clinically sound medication option

Parental perceptions of sleep patterns in children presenting at an ADHD clinic in Washington, DC, were assessed prospectively over a 6-month period.

 Sleep Behavior Questionnaire Achenbach Child Behavior Checklist Daytime Tiredness

Parental perceptions of sleep patterns in children presenting at an ADHD clinic in Washington, DC, were assessed prospectively over a 6-month period. Of 108 children diagnosed with ADHD, 46 were taking stimulant medications. Parents of all ADHD patients, 35 controls with psychiatric disorders attending the same clinic, and 84 general pediatric outpatients were given a Sleep Behavior questionnaire, the Achenbach Child Behavior Checklist, and a medical history questionnaire.

Moderate to severe sleep disorders occurred in 22% of ADHD children, 10% of psychiatric controls, and 6% of pediatric controls (p<0.05). Among ADHD children, insomnia was increased three-fold in patients receiving stimulant therapy. In addition to insomnia, ADHD patients had daytime tiredness, decreased sleep requirement, and frequent awakenings, not associated with parasomnias, enuresis, or respiratory disturbances. [1]

COMMENT. Sleep disorders are more common in ADHD children than in other pediatric patients, and are more prevalent and severe in patients treated with stimulant medications. Questions regarding sleep habits are important in the initial and follow-up examinations of children with ADHD. The substitution of an antihypertensive agent, clonidine or Tenex, may be advisable when insomnia is severe. A combination of stimulant and clonidine is not generally advised, because of reported cardiac complications and rare fatalities. See Ped Neur Briefs May 1999;13:40, for a debate regarding methylphenidate and clonidine combination therapy. [2]

Pearl PL Stein MA Broitman M Efron L Hamburger E Sleep disturbances in children with attention deficit hyperactivity disorder Ann Neurol 1999 Sept 46 524 abstract Wilens TE Spencer TJ Swanson JM Connor DF Cantwell D Combining methylphenidate and clonidine: a clinically sound medication option J Am Acad Child Adolesc Psychiatry 1999 May 38 5 614 9 10.1016/S0890-8567(09)63146-4 10230195