Q: Melatonin | Okay for my ADHD child with sleep problems?

Answer: Up to half of children with ADHD have some sort of sleep disruption, and melatonin can seem like a good idea. But, slow down on this one. Melatonin is a hormone that affects the sleep-wake (circadian) cycle. In a natural sleep-wake cycle, melatonin production increases in the afternoon (several hours before it’s time to sleep) in response to the changing daylight. It then drops off toward morning. When people have a sleep-wake phase disorder, their sleep-wake cycle is not correctly synchronized, and melatonin production fails to increase like it should. One treatment is to give supplements. However, caution is in order. 

4 Precautions to Consider When Contemplating Melatonin:

Do not give it to infants–it can interfere with the natural training of their sleep wake cycle to daylight. 

Be careful with teenagers–we still don’t have complete knowledge of how it interacts with all the necessary hormonal developments of adolescence.

Understand the potential side effects, such as night sweats, a morning “hangover,” headaches, daytime “laziness” (from the hangover), and bedwetting.

Check the dosing – over-the-counter formulations are usually too high.

Bottom line: only use melatonin in consultation with your child’s pediatrician. If your child is having sleep problems, try a behavioral solution first. Behavioral counseling can be effective in just a few sessions. See my book Getting Ahead of ADHD on page 113 and surrounding pages for more discussion.