CLONIDINE FOR SLEEP DISTURBANCES ASSOCIATED WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER - A SYSTEMATIC CHART REVIEW OF 62 CASES

Objective: Children and adolescents with attention-deficit hyperactivi ty disorder (ADHD), with or without psychostimulant treatment, frequen tly suffer from sleep disturbances. This report evaluates the use of c lonidine in the treatment of sleep disturbances associated with ADHD. Method: A systematic search of a computerized database in an outpatien t pediatric psychopharmacology unit of patients treated with clonidine for ADHD-associated sleep disturbances (N = 62; 42 children and 20 ad olescents) was performed. Patients were rated retrospectively about th e type and severity of sleep disturbances at baseline and after treatm ent with clonidine. Results: A majority of patients (85%) treated with clonidine for ADHD-associated sleep disturbances were considered to b e much to very much improved by the National Institute of Mental Healt h global assessment of improvement (sleep). Nighttime clonidine doses ranged from 50 to 800 mu g (mean +/- SEM; 157 +/- 14 mu g), and subjec ts received clonidine for 35.5 +/- 3.5 months. There was no associatio n between response and age group, gender, comorbidity, or concurrent p harmacotherapy. Children and adolescents with ADHD with baseline, medi cine-induced, or medicine-exacerbated sleep disturbances responded equ ally well to clonidine treatment. Mild adverse effects were reported i n 19 subjects (31%). Conclusions: These findings suggest that clonidin e may be an effective agent for sleep disturbances associated with ADH D, or its treatment, and warrant further controlled investigations.