Stimulant Medications and Sleep for Youth With XXXX : A Meta-analysis.

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CONTEXT: Mixed findings exist on whether stimulant medications alter youth sleep. OBJECTIVE: To determine the effect of stimulant medications on sleep. DATA STUDIES: Studies published through March 2015 were collected via CINAHL, PsycINFO, and PubMed. References of retrieved articles were reviewed. STUDY SELECTION: Eligibility criteria included studies with @entity1 /adolescents who had @entity71 ( @entity71 ), random assignment to stimulants, and objective sleep measurement. Studies that did not include information about key variables were excluded. DATA EXTRACTION: Study-level, @entity1 -level, and sleep data were extracted by 2 independent coders. Effect sizes were calculated by using random effects models. Potential moderators were examined by using mixed effect models. RESULTS: A total of 9 articles (N = 246) were included. For sleep latency, the adjusted effect size (0.54) was significant, indicating that stimulants produce longer sleep latencies. Frequency of dose per day was a significant moderator. For sleep efficiency, the adjusted effect size (-0.32) was significant. Significant moderators included length of time on medication, number of nights of sleep assessed, polysomnography/actigraphy, and gender. Specifically, the effect of medication was less evident when youth were taking medication longer. For total sleep time, the effect size (-0.59) was significant, such that stimulants led to @entity25 . LIMITATIONS: Limitations include few studies, limited methodologic variability, and lack of unpublished studies. CONCLUSIONS: Stimulant medication led to longer sleep latency, worse sleep efficiency, and @entity25 . Overall, youth had worse sleep on stimulant medications. It is recommended that pediatricians carefully monitor sleep problems and adjust treatment to promote optimal sleep.
