Hollway Jill A, Mendoza-Burcham Marrisa, Andridge Rebecca, Aman Michael G, Handen Benjamin, Arnold L Eugene, Lecavalier Luc, Williams Craig, Silverman Laura, Smith Tristram
1 The Nisonger Center, UCEDD, Ohio State University , Columbus, Ohio.
2 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
J Child Adolesc Psychopharmacol. 2018 Mar;28(2):130-135. doi: 10.1089/cap.2017.0085. Epub 2017 Nov 7.
Sleep disturbance is often a problem for children with either autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD). Psychostimulant medications used to treat ADHD symptoms can exacerbate this problem. For children with ASD and ADHD, atomoxetine (ATX) is a viable alternative to psychostimulants. We investigated the effects of ATX and a manualized parent training (PT) program targeting noncompliance, on the sleep quality of children with ASD and ADHD.
Participants in a randomized clinical trial were treated with ATX + PT, ATX alone, PT alone, or placebo (PBO) alone, for 10 weeks. Fifty-four of 128 (42%) caregivers completed the Children's Sleep Habits Questionnaire (CSHQ) at baseline and endpoint. Analysis of covariance was used to investigate possible differences between treatment groups.
There were no significant differences between treatment groups, including PBO on the CSHQ 33-Item total score, total hours of sleep per day, and total minutes awake after sleep onset at the study endpoint.
ATX appears sleep neutral. Clinicians who treat ADHD symptoms in children and adolescents with ASD may prefer ATX over psychostimulants when sleep disturbance is an issue.
睡眠障碍对于患有自闭症谱系障碍(ASD)或注意力缺陷多动障碍(ADHD)的儿童来说往往是个问题。用于治疗ADHD症状的精神振奋药物可能会使这个问题恶化。对于患有ASD和ADHD的儿童,托莫西汀(ATX)是精神振奋药物的一种可行替代药物。我们研究了ATX以及针对不顺从行为的家长手册化培训(PT)项目对患有ASD和ADHD儿童睡眠质量的影响。
一项随机临床试验的参与者被给予ATX + PT、单独使用ATX、单独使用PT或单独使用安慰剂(PBO)治疗10周。128名护理人员中的54名(42%)在基线和终点完成了儿童睡眠习惯问卷(CSHQ)。协方差分析用于研究治疗组之间可能存在的差异。
在研究终点时,各治疗组之间,包括PBO组,在CSHQ 33项总分、每天总睡眠时间以及入睡后清醒总分钟数方面均无显著差异。
ATX似乎对睡眠无影响。当睡眠障碍是一个问题时,治疗患有ASD的儿童和青少年ADHD症状的临床医生可能会更倾向于选择ATX而非精神振奋药物。