Research indicates the hormone supplement may safely improve sleep difficulties in both adults and children with attention deficit hyperactivity disorder
Melatonin may provide a safe and effective supplement to aid sleep for both adults and children with attention deficit hyperactivity disorder, particularly those taking stimulant medications like methylphenidate. The hormone naturally produced by the pineal gland helps regulate the body’s internal clock, also called the circadian rhythm. Sleep-related difficulties commonly affect people with ADHD, especially those who take stimulant medications.
Several studies have found melatonin to be a safe and effective supplement to help people with ADHD fall asleep earlier. However, melatonin is a hormone and can cause side effects in some people, making consultation with healthcare professionals recommended before starting supplementation.
Dosage recommendations vary by age
The typical melatonin dosage for adults with ADHD is generally the same as for adults without ADHD. The recommended starting dose is typically 1 to 3 milligrams, taken 1 to 2 hours before bedtime. The optimal dosage may depend on specific ADHD-related sleep difficulties individual patients experience.
Melatonin has shown promise in improving sleep difficulties in children with ADHD who are taking methylphenidate. One common side effect of methylphenidate involves disrupted sleep patterns, including difficulties falling asleep and waking up, as well as daytime sleepiness. While these effects are usually temporary, they can persist in some children.
Studies demonstrate effectiveness in children
Observational studies have shown that melatonin can be effective in reducing sleep latency, the time it takes to fall asleep, and overall sleep disturbances in children with ADHD who are taking methylphenidate. In a small 2019 study of 74 children with ADHD who were taking methylphenidate, researchers found that melatonin was effective in improving sleep problems in 60.8% of participants. The effectiveness was similar in males and females, as well as in children and adolescents.
Possible melatonin supplement side effects reported in children include drowsiness, agitation, bedwetting or increased urination in the evening, headaches, dizziness and depression. The National Center for Complementary and Integrative Health warns that since melatonin is a hormone, using supplements may potentially affect aspects of hormonal development such as puberty, menstruation and prolactin production. However, the evidence remains unclear.
ADHD affects circadian rhythm patterns
The relationship between ADHD and melatonin production is complex and not fully understood. Various studies have reported differences in melatonin secretion patterns, delayed onset of melatonin release or abnormalities in the circadian rhythm in individuals with ADHD. Research suggests that up to 75% of adults who have had ADHD since childhood experience a delay in their circadian rhythm phase.
Compared to people without ADHD, those with ADHD have important biological markers that occur later in the night, about 1.5 hours later. In a 2009 study that included 182 adults with ADHD and 117 adults without ADHD, researchers found that those with ADHD went to bed later and were more likely to take longer than an hour to fall asleep.
Combination therapy shows enhanced results
Researchers have evaluated several sleep aids for ADHD including melatonin supplements, bright light therapy, behavioral therapy, weighted blankets, extended-release stimulant medications and relaxation techniques. The combination of melatonin and bright light therapy may be particularly effective in advancing the internal circadian rhythm.
In a 2021 study involving 51 adults with ADHD and delayed sleep phase syndrome, internal circadian rhythm advanced by about 1 hour 28 minutes in those who received melatonin alone and about 1 hour 58 minutes in those who received melatonin plus bright light therapy. The melatonin group also reported a 14% reduction in ADHD symptoms, but these improvements did not continue 2 weeks after treatment.
Individual responses require monitoring
No clear evidence suggests that melatonin supplementation can make ADHD symptoms worse. Some research suggests that melatonin might worsen reactive aggression in healthy male adults, though this does not necessarily translate to ADHD. As with any medication or supplement, individual responses can vary, and consulting healthcare professionals for personalized advice and monitoring remains essential.
A growing body of evidence suggests that melatonin is a safe and effective supplement for improving sleep difficulties in adults and children with ADHD. Individuals with ADHD who find falling asleep challenging may want to discuss taking melatonin with healthcare professionals.