Dalhousie University, Halifax, Nova Scotia, Canada.
J Sleep Res. 2010 Dec;19(4):546-51. doi: 10.1111/j.1365-2869.2010.00845.x.
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder occurring in approximately 3-5% of school-aged children. The core symptoms of ADHD are effectively treated with stimulant medications such as methylphenidate; however, there are also negative side effects, including insomnia. It has been suggested that administration of stimulant medication may alter the timing or regularity of circadian motor activity levels. This study aimed to investigate the impact of stimulant medication on the strength and timing of circadian rhythms in 16 stimulant medication-naïve children with ADHD. Participants were monitored for changes in motor activity during a 3-week blinded placebo-controlled medication trial to examine the impact of immediate-release methylphenidate hydrochloride. Motor activity was measured by actigraphy, and 24-h activity profiles were analysed using cosinor analyses to identify measurable changes in circadian rhythms. The children in this sample demonstrated significant increases in motor activity during the sleep-onset latency period. They also showed a significant reduction in relative circadian amplitude and a phase-delay in the timing of the daily rhythm. Clinicians and parents of children being treated with stimulant medication for ADHD should be aware that stimulant medication may cause disruption of sleep/circadian rhythms. Behavioural strategies to improve sleep may be useful for children experiencing these negative effects from medication.
注意缺陷多动障碍（ADHD）是一种在学龄儿童中约有 3-5%发生的高度流行障碍。ADHD 的核心症状可以通过兴奋剂药物如哌甲酯有效治疗；然而，也存在一些负面副作用，包括失眠。有研究表明，兴奋剂药物的给药可能会改变昼夜运动活动水平的时间或规律性。本研究旨在调查兴奋剂药物对 16 名无兴奋剂药物使用史的 ADHD 儿童昼夜节律强度和时间的影响。参与者在为期 3 周的盲法安慰剂对照药物试验中监测运动活动的变化，以检查盐酸哌甲酯速释剂的影响。运动活动通过活动记录仪测量，24 小时活动谱使用余弦分析进行分析，以确定昼夜节律的可测量变化。该样本中的儿童在睡眠潜伏期期间表现出显著的运动活动增加。他们还表现出相对昼夜振幅的显著降低和每日节律时间的相位延迟。正在接受兴奋剂药物治疗 ADHD 的儿童的临床医生和家长应该意识到，兴奋剂药物可能会导致睡眠/昼夜节律紊乱。对于经历这些药物副作用的儿童，改善睡眠的行为策略可能是有用的。
