Treatment with methylphenidate helps adults with ADHD sleep

Treatment with methylphenidate (MPH) appears to have beneficial effects on sleep parameters in adults with ADHD, including increased sleep efficiency and a feeling of improved restorative value of sleep, according to a study published in the March 1 issue of the journal SLEEP.

The study, authored by Esther Sobanski, MD, of the Central Institute of Mental Health in Mannheim, Germany, focused on 34 non-medicated patients with ADHD, of whom 24 were without current psychiatric disorders, and 34 control subjects without current psychiatric disorders or psychotropic medication. Compared to the control group, all subjects in the ADHD sample displayed reduced sleep efficiency, with longer sleep onset latency and more nocturnal awakenings. They had altered sleep architecture, with a higher percentage of stage 1 and reduced percentage of REM sleep. Patients also showed a trend toward the reduced total REM density and elevated percentage of wakefulness after sleep onset.

According to Dr. Sobanski, this study showed that objective and subjective sleep problems in adults with ADHD are identical with sleep problems in children with ADHD, including longer sleep latencies, more nocturnal activity, reduced sleep efficiency, more nocturnal awakenings and slightly decreased REM activity during sleep, although the clinical significance of the last findings remains to be clarified.

Dr. Sobanski added that the effects of MPH on sleep in adults with ADHD have never been shown before, and that this study demonstrated that it has beneficial effects on several sleep parameters in addition to the positive effects on daytime functioning.

“Under treatment with MPH, patients reported improved evening mood, less psychosomatic symptoms while falling asleep, reduced sleep latency, and fewer nocturnal awakenings during the night spent in our sleep laboratory,” said Dr. Sobanski. “For the two weeks at home preceding their polysomnographic investigation, patients reported significantly better restorative value of sleep and a trend for less nocturnal awakenings compared to baseline.”

MPH is a prescription stimulant commonly used to treat ADHD. It is also one of the primary drugs used to treat the daytime drowsiness symptoms of narcolepsy and chronic fatigue syndrome.

A medication can provide much needed relief for someone with a severe sleep problem. This can promote good health and an overall sense of well being. But there is also a level of risk involved with the use of any medication. Many people will have some side effects.

Keep in mind that the same drug can affect people in different ways. A medication that helps someone else may not work for you. Your doctor can determine if a medication is the best treatment for your sleep problem. Never take a medication without the approval of your doctor.

It is recommended that adults get between seven and eight hours of nightly sleep.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night's sleep:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Get a full night's sleep every night.
• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
• Do not bring your worries to bed with you.
• Do not go to bed hungry, but don't eat a big meal before bedtime either.
• Avoid any rigorous exercise within six hours of your bedtime.
• Make your bedroom quiet, dark and a little bit cool.
• Get up at the same time every morning.