Melatonin Effective for Treating Insomnia in Children with ADHD
Journal of Pineal Research
Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
Insomnia, Sleep Disorders
Insomnia is a chronic inability to obtain or sustain sleep. While everyone
occasionally experiences sleeplessness, chronic insomnia is an ongoing,
often debilitating condition. After a night of inadequate sleep, those with
insomnia report impaired mental and physical abilities, diminished memory,
reduced alertness, and impaired reaction time. Chronic lack of sleep
threatens the well being, productivity, and safety of millions of
Americans. Insomnia is not a disease but a condition associated with a
number of physical and emotional disorders. The incidence of insomnia is
higher among people with chronic illnesses, such as hyperthyroidism, renal
insufficiency, multiple sclerosis, and Alzheimer's disease. Pregnancy,
alcohol intake, stress, and depression are also leading causes of insomnia.
As any parent of a child diagnosed with attention deficit hyperactivity
disorder (ADHD) can tell you, coping with the daily frustrations is a
challenge at best. ADHD is one of the most frequently diagnosed childhood
psychiatric conditions. While there are many theories regarding the cause
of ADHD, we now know that many of the children diagnosed today, have a
biological parent who shares the same diagnosis. Other factors that may
contribute to the symptoms of ADHD are fetal alcohol syndrome, lead
poisoning, meningitis, and a genetic resistance to thyroid hormone. Also,
while not a primary cause, there seems to be a positive association that
exists between negative family environment factors and ADHD. A child with
ADHD is unable to focus his/her attention on repetitive tasks, is easily
distracted, has frequent outbursts of energy, is often fidgety, and has
difficulty following instructions. Depending on the severity, a child may
be considered "difficult to control." While adjusting to the symptoms that
a child with ADHD displays is difficult, treatment is usually not necessary
until the child enters school. When a child enters school, however, the
demands for performance and consistency of behavior may accentuate the
symptoms and the parent or the teacher may request testing to determine if
ADHD is present.
Melatonin is a hormone that is produced by the pineal gland in the brain.
For years, scientists have known that melatonin's main function was in the
control of our sleep patterns. However, more recent research has revealed
that it also functions as an important antioxidant. After puberty melatonin
output begins a gradual steady decline. Adults experience about a 37
percent decline in daily melatonin output between the ages of 20 and 70
with the majority of the decline occurring after age 40. In 1994, melatonin
became a sensation when studies revealed that supplementation provided
significant life extension in several different species of laboratory
animals. Although long-term studies on humans have not been conducted,
melatonin became a popular product in health food stores and pharmacies
throughout the country. Melatonin's primary function seems to be its role
in regulating sleep/wake cycle. When darkness falls melatonin levels rise
which triggers the sleep cycle.
A study published in the Journal of Pineal Research investigated the
long-term melatonin treatment for effectiveness and safety in children with
ADHD and chronic sleep onset insomnia (CSOI). Parents of the 94 children
participating in the study were asked to answer a structured questionnaire.
The follow-up was 3.7 years and no serious adverse events or treatment
related co-morbidities were reported. Long-term melatonin treatment was
found to be safe and effective for insomnia in 88 percent of the cases.
Also, 71 percents of the children experienced improved behavior and 61
percent experienced improved mood. When melatonin treatment was
discontinued, there would be a relapse of sleep onset insomnia. Researchers
concluded that melatonin remains an effective therapy for long-term
treatment of CSOI in children with ADHD and there are no safety concerns
regarding serious adverse events or treatment related co-morbidity.1
1 Hoebert M, van der Heijden KB, van Geijlswijk IM, Smits MG. Long-term
follow-up of melatonin treatment in children with ADHD and chronic sleep
onset insomnia. J Pineal Res. Aug2009;47(1):1-7.
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