I've found melatonin to be quite helpful for kids and teens with ADHD for both sleep onset and sleep maintenance issues. However, some concerns have popped up about kids and teens using melatonin for long periods of time (more than 6 months) or at high-doses. However, little has been substantiated through research studies.
A recent systematic review of 13 RCTs assessed the safety and efficacy of melatonin for pediatric patients with ND disorders (e.g, ADHD and Autism). Studies included a total of 632 children who took either regular melatonin or controlled release melatonin. The review found that:
I start my kid and adult patients who are dealing with sleep onset problems on a low dose of immediate release melatonin (about 1-2 mg, preferably sublingual), taken about one hour before bedtime. I then very slowly increase the dose every 2-3 days until an effective dose is reached. If an individual is not getting any benefit from doses of melatonin around 5-6 mg, then I usually think about other options. A common indicator that I look for to gauge success is sleep onset in about 25 minutes or less.
For those with sleep maintenance problems, I use a controlled release product. Usual dose for these products is 3-5 mg, also taken about one hour before bedtime.
At minimum, use of melatonin should be combined with two additional strategies to support sleep:
I often look to Relax Powder, Calm Nights, and Serene Sleep for folks who don't see a benefit from Melatonin. L-theanine or 5-HTP at 50-100 mg can also be considered. Be sure to speak with your doctor before starting any of these supplements.
Further reading on sleep and ADHD:
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