Sleep Well

Is there anything worse than a child who can’t get to sleep?

Okay, maybe a relentlessly crying kid who’s having a temper tantrum in public. But for parents of children with attention deficit hyperactivity disorder (ADHD) who can’t fall asleep easily, there could be a new solution: melatonin.

A new study published recently analyzed reams of data on the efficacy and safety of melatonin for treating insomnia in children with ADHD and indicated it can be a safe and helpful way to improve the falling-asleep process for these young insomniacs. Here is what the researchers found:

• Melatonin is a hormone your body produces to help regulate your sleep-wake cycles. It usually starts pumping out of your pineal gland after it has become dark outside and your body prepares for bedtime. When melatonin levels in the blood rise, you begin to feel less alert and sleep becomes more inviting.
• Children with ADHD usually have trouble falling asleep, which can have tremendous consequences to both their health and family life. Less sleep means a less-than-optimal refreshment of the brain and body during the night.
• Giving 3 to 6 mg of melatonin within a few hours of bedtime has been shown to help kids with ADHD overcome some of their insomnia and improve their sleep. “Kids” in most cases reviewed in the study meant 6 to 14 years of age.

But hold on: There were several things about this study that would make me not just jump on the bandwagon to try melatonin in kids:

• Melatonin is a hormone. Most kids produce plenty of Melatonin; it just might not be at the time of day when parents want them to go to sleep.
• We have no idea what Melatonin will do to kids over the long term.
• A dosage of 3-6 mg is between 3 and 6 times the dose that is needed in adults – could this be an overdosage?

While this research is very important in our understanding of ADHD and sleep, I would not consider placing a child on melatonin without working with both a sleep specialist and the child’s pediatrician.

There’s a lot to be said for instilling good sleep hygiene habits in your kids early on. They should be adhering to a pretty strict routine every night that includes:

• Performing the same bedtime routine every night (winding down, getting ready for bed, brushing teeth, being read to or reading on their own, etc.).
• Going to bed at the same time 7 days a week.
• Avoiding stimulants within (at least!) an hour of bedtime. This includes electronics and digital media like the TV, computer and cell phone.

If your kids don’t currently keep a regular bedtime routine, start there. The best prescription for a good night’s sleep could be in your children’s habits – regardless of any other condition like ADHD. Besides, who wants their children to have trouble sleeping before they even reach the throes of those oft sleep-deprived teen years? They need all the sleep they can get.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

Comment on this post and talk with others about ADHD and sleep problems on the ADD/ADHD Exchange.