A Meta-Analysis of the Effect of Experimental Sleep Restriction on Youth’s Attention and Hyperactivity

Lundahl, Alyssa; Kidwell, Katherine M.; Dyk, Tori R. Van; Nelson, Timothy D.

doi:10.1080/87565641.2014.939183

Cited by 25 publications

(30 citation statements)

References 51 publications

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“…This approach has been used in previous published meta-analyses of sleep outcomes in both adults and children. 24,25 This assumption results in a downward bias (toward zero) of effect size estimates (thus, conservative estimates) and unintended heterogeneity due to an ). The mean total dosage per day (in milligrams) was coded as the average milligram of stimulants that children took in a day.…”

Section: Effect Size Calculationmentioning

confidence: 99%

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

et al. 2015

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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 children/adolescents who had attention-deficit/hyperactivity disorder (ADHD), random assignment to stimulants, and objective sleep measurement. Studies that did not include information about key variables were excluded. DATA EXTRACTION: Study-level, child-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 (20.32) 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 (20.59) was significant, such that stimulants led to shorter sleep duration. LIMITATIONS:Limitations include few studies, limited methodologic variability, and lack of unpublished studies.CONCLUSIONS: Stimulant medication led to longer sleep latency, worse sleep efficiency, and shorter sleep duration. Overall, youth had worse sleep on stimulant medications. It is recommended that pediatricians carefully monitor sleep problems and adjust treatment to promote optimal sleep.Department of Psychology, University of Nebraska-Lincoln, Lincoln, NebraskaMs Kidwell contributed to the conceptualization of the study, organized literature searches, coded the original studies, and drafted the introduction and discussion sections; Ms Van Dyk contributed to the conceptualization of the study, coded the original studies for reliability analyses, and reviewed and revised the manuscript; Ms Lundahl contributed to the conceptualization of the study, conducted the meta-analyses, and drafted the methods and results sections; Dr Nelson contributed to the conceptualization of the study and provided critical editing of the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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Section: Effect Size Calculationmentioning

confidence: 99%

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

et al. 2015

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“…Attention is a fundamental mechanism underlying cognitive abilities that is affected by sleep debt. Experimentally shortened sleep impairs attention in children ( 7 , 8 ), and impaired attention related to reduced sleep in members of the military causes performance deficits in reaction times and accuracy, as measured by the Attention Network Test (ANT), and in continuous visual tracking ( 9 ). Thus, the impacts of sleep loss on attention, and the consequences for cognitive performance, are far-reaching and may be applicable to a wide range of both clinical and otherwise healthy populations.…”

Section: Introductionmentioning

confidence: 99%

Acute Sleep Restriction Has Differential Effects on Components of Attention

et al. 2018

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Inadequate nightly sleep duration can impair daytime functioning, including interfering with attentional and other cognitive processes. Current models posit that attention is a complex function regulated by several separate, but interacting, neural systems responsible for vigilance, orienting, and executive control. However, it is not clear to what extent each of these underlying component processes is affected by sleep loss. The purpose of this study was to evaluate the effects of acute sleep restriction on these attentional components using the Dalhousie Computerized Attention Battery (DalCAB). DalCAB tasks were administered to healthy women (aged 19–25 years) on two consecutive mornings: once after a night with 9 h time in bed (TIB), and once again after either another night with 9 h TIB (control condition, n = 19) or after a night with 3 h TIB (sleep restriction condition, n = 20). Self-ratings of sleepiness and mood were also obtained following each sleep condition. Participants showed increases in self-reported sleepiness and fatigue after the second night only in the sleep restriction group. Sleep restriction primarily affected processing speed on tasks measuring vigilance; however, performance deficits were also observed on some measures of executive function (e.g., go/no-go task, flanker task, working memory). Tasks assessing orienting of attention were largely unaffected. These results indicate that acute sleep restriction has differential effects on distinct components of attention, which should be considered in modeling the impacts of sleep loss on the underlying attentional networks.

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“…The literature on sleep and inhibitory control, however, is more mixed, with some pediatric studies reporting significant effects (e.g., Gruber, Cassoff, Frenette, Wiebe, & Carrier, 2012) but others reporting null findings or even improvement in inhibition with poorer sleep (e.g., Fallone, Acebo, Arnedt, Seifer, & Carskadon, 2001;Sadeh, Gruber, & Raviv, 2003). In a meta-analysis of experimental sleep restriction studies with children, Lundahl, Kidwell, Van Dyk, and Nelson (2015) found that hyperactivity/impulsivity was not significantly affected by sleep loss and, instead, suggested that poor sleep may lead to a "hypoactivity" that delays responses by slowing cognitive tempo (Fallone, Acebo, Seifer, & Carskadon, 2005).…”

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Preschool Sleep Problems and Differential Associations With Specific Aspects of Executive Control in Early Elementary School

Nelson

Kidwell

James

et al. 2015

Developmental Neuropsychology

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This study examined the differential associations between parent-reported child sleep problems in preschool and specific aspects of executive control in early elementary school in a large sample of typically developing children (N = 215). Consistent with expectations, sleep problems were negatively associated with performance on tasks assessing working memory and interference suppression inhibition, even after controlling for general cognitive abilities, but not with flexible shifting or response inhibition. The findings add to the literature on cognitive impairments associated with pediatric sleep loss and highlight the need for early intervention for children with sleep problems to promote healthy cognitive development.

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A Meta-Analysis of the Effect of Experimental Sleep Restriction on Youth’s Attention and Hyperactivity

Cited by 25 publications

References 51 publications

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

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

Acute Sleep Restriction Has Differential Effects on Components of Attention

Preschool Sleep Problems and Differential Associations With Specific Aspects of Executive Control in Early Elementary School

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