Sleep as an outcome measure in ADHD randomized controlled trials: A scoping review

McWilliams, S.; Zhou, T.; Stöckler, Sylvia; Elbe, Dean; Ipsiroglu, O.

doi:10.1016/j.smrv.2022.101613

Cited by 12 publications

(10 citation statements)

References 117 publications

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“…Zu beachten ist: ADHS ist nicht immer ADHS (Aufmerksamkeits- und Hyperaktivitätsstörung) [ 30 , 31 ]. Die Bedeutung des Schlafes wird in der ADHS-Diagnostik oft nicht ausreichend berücksichtigt [ 32 , 33 ]. Seitens der Arbeitsgruppe Pädiatrie der DGSM wird im Verbund mit den Österreichischen Gesellschaften für Schlafmedizin, Kinder- und Jugendheilkunde und Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie dringend darauf aufmerksam gemacht, dass man differentialdiagnostisch an Schlafstörungen im Allgemeinen und an Restless-Legs-Syndrom (RLS) im Besonderen denken sollte [ 34 – 36 ].…”

Section: Ergebnisse Und Schwerpunkte Der Letzten 5 Jahreunclassified

“…B. Entwicklungsneurologie/-psychologie, Kinder- und Jugendpsychiatrie) befindet, wird transdisziplinäres Denken zur Notwendigkeit, um Krankheitsbilder ganzheitlich und fachübergreifend erkennen zu können. Eine besondere Bedeutung kommt dabei den niedergelassenen KollegInnen zu, da die Klärung der Ursachen der Tagesmüdigkeit [ 39 ], die Interpretation des Blutbildes und das Erkennen des Eisenmangels mit Eisensubstitution als Therapie der ersten Wahl bei RLS [ 34 , 36 ] – aber auch bei ADHS [ 32 , 40 ] – schon im niedergelassenen Bereich erfolgen kann. Diese Gesichtspunkte werden in der AWMF-Neufassung der D‑A-CH-Leitlinie zum Restless-Legs-Syndrom angesprochen, fehlen aber noch in der ADHS-Leitlinie der AWMF.…”

Section: Ergebnisse Und Schwerpunkte Der Letzten 5 Jahreunclassified

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Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Paditz¹,

Wiater

Ipsiroglu

et al. 2022

Somnologie

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Section: Ergebnisse Und Schwerpunkte Der Letzten 5 Jahreunclassified

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Paditz¹,

Wiater

Ipsiroglu

et al. 2022

Somnologie

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“…The overall paucity of ID treatment studies for ADHD and ASD stands in stark contrast to the abundance of clinical trials published for pharmacological treatments for ADHD. A scoping review investigating interventional ADHD RCTs that used sleep as an outcome measure identified 53 pharmacological RCTs published between 1995–2020 [ 94 ]. Importantly, this represents only a small proportion of pharmacological RCTs for ADHD, given that most studies do not use sleep as an outcome measure.…”

Section: Discussionmentioning

confidence: 99%

Iron deficiency and common neurodevelopmental disorders—A scoping review

McWilliams

Singh²,

Leung³

et al. 2022

PLoS ONE

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Background A wealth of human and experimental studies document a causal and aggravating role of iron deficiency in neurodevelopmental disorders. While pre-, peri-, and early postnatal iron deficiency sets the stage for the risk of developing neurodevelopmental disorders, iron deficiency acquired at later ages aggravates pre-existing neurodevelopmental disorders. Yet, the association of iron deficiency and neurodevelopmental disorders in childhood and adolescence has not yet been explored comprehensively. In this scoping review, we investigate 1) the association of iron deficiency in children and adolescents with the most frequent neurodevelopmental disorders, ADHD, ASD, and FASD, and 2) whether iron supplementation improves outcomes in these disorders. Method Scoping review of studies published between 1994 and 2021 using “iron deficiency / iron deficiency anemia” AND “ADHD” OR “autism” OR “FASD” in four biomedical databases. The main inclusion criterion was that articles needed to have quantitative determination of iron status at any postnatal age with primary iron markers such as serum ferritin being reported in association with ADHD, ASD, or FASD. Results For ADHD, 22/30 studies and 4/4 systematic reviews showed an association of ADHD occurrence or severity with iron deficiency; 6/6 treatment studies including 2 randomized controlled trials demonstrated positive effects of iron supplementation. For ASD, 3/6 studies showed an association with iron deficiency, while 3/6 and 1/1 systematic literature review did not; 4 studies showed a variety of prevalence rates of iron deficiency in ASD populations; 1 randomized controlled trial found no positive effect of iron supplementation on behavioural symptoms of ASD. For FASD, 2/2 studies showed an association of iron deficiency with growth retardation in infants and children with prenatal alcohol exposure. Conclusion Evidence in favor of screening for iron deficiency and using iron supplementation for pediatric neurodevelopmental disorders comes primarily from ADHD studies and needs to be further investigated for ASD and FASD. Further analysis of study methodologies employed and populations investigated is needed to compare studies against each other and further substantiate the evidence created.

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“…Fifty-nine percent of patients were taking medications targeting insomnia (i.e., melatonin and zopiclone), 41% were taking these agents in combination with further non-stimulant medications (i.e., clonidine, guanfacine, atomoxetine), 9% with stimulants, 27% with antidepressants, and 18% with antipsychotics. While stimulants and non-stimulants can cause insomnia ( 18 , 26 ), antidepressants and antipsychotics can negatively affect sleep quality and architecture ( 27 , 28 ). Note that in Canada, most psychiatric medications have a regulatory status of non-approval for treatment of children and adolescents (with the exception of ADHD treatments).…”

Section: Discussionmentioning

confidence: 99%

Understanding patient characteristics and medication prescriptions in children with mental health and neurodevelopmental disorders referred to a sleep clinic—A quality improvement/quality assurance analysis

et al. 2022

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IntroductionMotivated by challenges faced in outpatient sleep services for mental health and neurodevelopmental disorders (MHNDD) during the COVID-19 clinical shutdown, a pan-Canadian/international working group of clinicians and social scientists developed a concept for capturing challenging sleep and wake behaviours already at the referral stage in the community setting.MethodsIn a quality improvement/quality assurance (QIQA) project, a visual logic model was the framework for identifying the multiple causes and possible interventions for sleep disturbances. Intake forms informed clinicians about situational experiences, goals/concerns, in addition to the questions from the Sleep Disturbances Scale for Children (SDSC), the ADHD Rating Scale-IV and medication history. Descriptive statistics were used to describe the sample.Results66% of the pilot study patients (n = 41) scored in the SDSC red domains (highest scoring) with highest sub-scores for insomnia (falling asleep 73%; staying asleep: 51%) and daytime somnolence (27%). A total of 90% of patients were taking at least one medication; 59% sleep initiation/sleep medications, 41% in combination with further non-stimulant medications, 9% with stimulants, 27% with antidepressants and 18% with antipsychotics. Polypharmacy was observed in 62% of all patients and in 73% of the ones medicated for sleep disturbances. Qualitative information supported individualisation of assessments.ConclusionOur intake process enabled a comprehensive understanding of patients’ sleep and wake profiles prior to assessment, at the referral stage. The high prevalence of insomnia in patients, combined with polypharmacy, requires special attention in the triaging process at the community level.

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Sleep as an outcome measure in ADHD randomized controlled trials: A scoping review

Cited by 12 publications

References 117 publications

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Iron deficiency and common neurodevelopmental disorders—A scoping review

Understanding patient characteristics and medication prescriptions in children with mental health and neurodevelopmental disorders referred to a sleep clinic—A quality improvement/quality assurance analysis

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