Insomnia Research Today is a free monthly online journal that collates and summarizes the latest research about Insomnia, including details on sleep disorders, treatment, medication.

Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia.

Van der Heijden KB, Smits MG, Van Someren EJ, Ridderinkhof KR, Gunning WB

Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.

OBJECTIVE: To investigate the effect of melatonin treatment on sleep, behavior, cognition, and quality of life in children with attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia. METHOD: A total of 105 medication-free children, ages 6 to 12 years, with rigorously diagnosed ADHD and chronic sleep onset insomnia participated in a randomized, double-blind, placebo-controlled trial using 3 or 6 mg melatonin (depending on body weight), or placebo for 4 weeks. Primary outcome parameters were actigraphy-derived sleep onset, total time asleep, and salivary dim light melatonin onset. RESULTS: Sleep onset advanced by 26.9 +/- 47.8 minutes with melatonin and delayed by 10.5 +/- 37.4 minutes with placebo (p < .0001). There was an advance in dim light melatonin onset of 44.4 +/- 67.9 minutes in melatonin and a delay of 12.8 +/- 60.0 minutes in placebo (p < .0001). Total time asleep increased with melatonin (19.8 +/- 61.9 minutes) as compared to placebo (-13.6 +/- 50.6 minutes; p = .01). There was no significant effect on behavior, cognition, and quality of life, and significant adverse events did not occur. CONCLUSION: Melatonin advanced circadian rhythms of sleep-wake and endogenous melatonin and enhanced total time asleep in children with ADHD and chronic sleep onset insomnia; however, no effect was found on problem behavior, cognitive performance, or quality of life.

Published 23 January 2007 in J Am Acad Child Adolesc Psychiatry, 46(2): 233-41.
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