0948 Melatonin for sleep disorders in children with attention deficit/hyperactivity disorder (ADHD)

There is literature stating that the hypnotic and rhythm-regulating potential of melatonin and agonists such as ramelteon and agomelatine render them eligible for inclusion in the list of medications for treatment of primary and secondary insomnia and circadian rhythm sleep disorders. As such, melatonin has been used to treat insomnia in children with ADHD and with autism, as well as in children with other neurodevelopmental disorders in which there are sleep problems. A fairly impressive study carried out in the Netherlands followed up 93 children for whom melatonin had been prescribed (on average 3.7 years before) for chronic sleep onset insomnia. Two-thirds still used melatonin daily and 12% occasionally, with the regular users stating that discontinuation resulted in a delay of sleep onset. A review of various studies that included 2 meta-analyses, 5 randomised trials, safety studies, retrospective analyses and review articles concluded that whereas there are limitations in terms of quality of the available data, there is indeed a suggestion that melatonin is a well-tolerated and efficacious option for patients with chronic sleep onset insomnia and ADHD. However regulated products and larger, well-designed studies are needed to establish optimal dosing and long-term safety.

Read more:
Ann Pharmacother. 2009 Dec 22. [Epub ahead of print]
J Pineal Res 2009; 47: 1-7
CNS Drugs 2007; 21: 995-1018