Faraone Stephen V, Glatt Stephen J, Bukstein Oscar G, Lopez Frank A, Arnold L Eugene, Findling Robert L
SUNY Upstate Medical University, Department of Psychiatry and Behavioral Sciences, Syracuse, NY 13210, USA.
J Atten Disord. 2009 Jan;12(4):308-15. doi: 10.1177/1087054708314844. Epub 2008 Apr 9.
Methylphenidate is a leading first-line treatment for ADHD (AD/HD). This stimulant has long been suspected to adversely affect sleeping patterns of treated individuals, especially children. There are few studies on the effects of recently developed longer-acting methylphenidate treatments, such as once-daily oral or transdermal formulations, on sleep.
The authors examined eight indices of sleep behavior among children treated with either of these two methylphenidate preparations or placebo in a randomized, double-blind, multicenter, parallel-group study.
The main predictor of sleep problems was baseline numbers or severity of preexisting sleep problems, whereas the different treatments and placebo varied little in their propensity to elicit such problems. There was no significant relationship between dosage and severity or frequency of sleep problems.
The authors found little evidence that methylphenidate treatment (at least in sustained-release forms) was a significant cause of sleep problems in treated children who were carefully titrated to an optimal dose.
哌醋甲酯是治疗注意力缺陷多动障碍（AD/HD）的一线主要药物。长期以来，人们一直怀疑这种兴奋剂会对接受治疗的个体，尤其是儿童的睡眠模式产生不利影响。关于最近开发的长效哌醋甲酯治疗方法，如每日一次口服或透皮制剂对睡眠的影响，研究较少。
在一项随机、双盲、多中心、平行组研究中，作者检查了接受这两种哌醋甲酯制剂或安慰剂治疗的儿童的八项睡眠行为指标。
睡眠问题的主要预测因素是既往睡眠问题的基线数量或严重程度，而不同治疗方法和安慰剂引发此类问题的倾向差异不大。剂量与睡眠问题的严重程度或频率之间没有显著关系。
作者发现几乎没有证据表明，在仔细滴定至最佳剂量的接受治疗的儿童中，哌醋甲酯治疗（至少是缓释形式）是睡眠问题的重要原因。
