Effect on Primary Sleep Disorders When Children With ADHD Are Administered Guanfacine Extended Release
11 Children's Specialized Hospital, Toms River, NJ, USA.
Insights
Guanfacine extended-release (GXR) improved ADHD symptoms but reduced total sleep time in children. Sedation was a common side effect, suggesting caution with morning GXR administration.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Pharmacology
Background:
- Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with sleep problems in children.
- Guanfacine extended-release (GXR) is used to manage ADHD symptoms.
Purpose of the Study:
- To investigate the effects of GXR on sleep patterns in children with ADHD using polysomnography (PSG).
Main Methods:
- A double-blind, randomized, placebo-controlled study involving 29 children (aged 6-12 years) with ADHD.
- Participants underwent polysomnography (PSG) after a period of dose adjustment and stabilization with either GXR or placebo.
Main Results:
- GXR improved ADHD symptoms but significantly reduced total sleep time compared to placebo (p = .005).
- Increased time awake after sleep onset was the primary cause of reduced sleep.
- While REM, non-REM, and N3 sleep stages were reduced, this was proportional to overall sleep reduction.
- Sedation occurred in 73% of children on GXR versus 6% on placebo.
Conclusions:
- Morning administration of GXR in children with ADHD leads to decreased sleep duration.
- Sedation is a significant adverse effect associated with GXR treatment in this population.
Objective:
To evaluate children with ADHD and sleep problems with polysomnography (PSG) after guanfacine extended-release (GXR) administration.
Method:
Double-blind, randomized, placebo-controlled study was terminated early due to treatment-emergent concerns after enrolling 29 children aged 6 to 12 years. After >4 weeks dose adjustment and >1 week dose stabilization, 11 children received GXR and 16 controls underwent analyses with PSG.
Results:
Although GXR improved ADHD symptoms, the primary outcome variable, total sleep time, was shorter in contrast to placebo (-57.32, SD = 89.17 vs. +31.32, SD = 59.54 min, p = .005). Increased time awake after sleep onset per hour of sleep was the primary factor for the reduction. Although rapid eye movement (REM), non-REM, and N3/slow wave sleep times were reduced, these were proportional to the overall sleep reduction. Sedation was common with GXR (73% vs. 6%).
Conclusion:
Morning-administered GXR resulted in decreased sleep and may contribute to sedation.
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