Effect of transdermal methylphenidate wear times on sleep in children with attention deficit hyperactivity disorder
1Pediatric Neurology of the Ozarks, Cox Health Systems, Springfield, Missouri 65807, USA. Arie.ashkenasi@coxhealth.com
Insights
Individualizing wear times for methylphenidate patches did not significantly alter sleep latency or total sleep time in children with attention deficit hyperactivity disorder (ADHD). However, longer wear times showed a trend toward improved sleep quality without adverse effects.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Pharmacology
Background:
- Sleep disturbances are prevalent in children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD).
- The methylphenidate transdermal system is a common treatment for ADHD, but its impact on sleep requires further investigation.
- Optimizing treatment delivery, such as transdermal patch wear times, may influence therapeutic outcomes and side effect profiles.
Purpose of the Study:
- To evaluate the impact of individualized wear times for the methylphenidate transdermal system on sleep parameters in pediatric patients with ADHD.
- To determine if adjusting patch wear duration affects sleep latency, total sleep time, and sleep quality.
- To assess the influence of varied wear times on ADHD symptoms and related behavioral measures.
Main Methods:
- An open-label, randomized trial involving 26 children with ADHD and sleep disturbances.
- Participants were assigned to groups with varying sequences of patch wear times (9, 10, 11, and 12 hours daily).
- Sleep latency, total sleep time, and sleep quality were primary and secondary endpoints, analyzed using mixed-effects regression models.
Main Results:
- No statistically significant effect of methylphenidate patch wear time was observed on sleep latency or total sleep time.
- A trend towards improved sleep quality was noted with longer patch wear durations (P = 0.059).
- Extended wear times of the methylphenidate transdermal system did not result in adverse effects on sleep parameters.
Conclusions:
- Individualizing the wear time of the methylphenidate transdermal system may be a viable strategy for managing ADHD and associated sleep disturbances.
- Further research with larger sample sizes is warranted to confirm these findings.
- Tailoring patch wear duration to individual patient needs and responses could optimize treatment efficacy and tolerability.
Abstract:
Sleep disturbances are common among children and adolescents with attention deficit hyperactivity disorder. This study sought to evaluate the effects of individualizing wear times of the methylphenidate transdermal system on sleep parameters. In this open-label, randomized trial, 26 children with attention deficit hyperactivity disorder and sleep disturbances were randomized (after dose optimization) to one of four groups with different sequences of patch wear times (i.e., 9, 10, 11, and 12 hours per day wear times each for week in different sequences). The primary endpoint comprised sleep latency. Secondary endpoints included total sleep time, sleep quality, and attention deficit hyperactivity disorder and related signs (assessed with Attention Deficit Hyperactivity Disorder Rating Scale-IV and Connor's Global Impression-Parent). A mixed-effects regression model evaluated the effects of patch wear time on sleep and symptom measures. Patch wear time exerted no significant effect on sleep latency or total sleep time, although a trend toward improved sleep quality was evident (P = 0.059) with longer patch wear times. Sleep parameters were not adversely affected by longer methylphenidate transdermal system patch wear times. Thus, if replicated in larger samples, the individualization of patch wear times should be considered according to the needs and responses of patients.
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