Hope for Children with Insomnia

Is there anything worse than a child who can’t get to sleep? Okay, maybe a relentlessly crying kid whose 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 the authors indicate it can be a safe and helpful way to improve the falling-asleep process for these young insomniacs. Here is what they found:

• Melatonin is a hormone your body produces to help it 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 3-6mg is between 3 and 6 times the dose that is needed in adults - could this be an over dosage?

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 has them:

• 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 television, 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

Follow me on Twitter:   http://twitter.com/thesleepdoctor

Click here to order Dr. Breus's book, Beauty Sleep, on Amazon or Kindle, or here to buy it for the Barnes & Noble Nook.

Comments

[JD Moyer]

We noticed a dramatic change in our two-year-old daughters sleep schedule during an experiment in which we turned off all artificial light after sundown. I've written about the experience here: http://jdmoyer.com/2010/03/04/sleep-experiment-a-month-with-no-artificial-light/

Artificial (esp. blue) light blocks melatonin production -- for most kids (and adults) melatonin supplementation probably isn't necessary.

Misty -- it might be worth a try -- it was fun to go a month with only candles. Good luck and I hope things get better.

[Dr. Breus]

Misty,
In these types of cases I often will consider a sleep study to see if there may be something else going on. Have you considered this option?

Dr. B

[Misty Croft]

I have a child who is almost 5 years old and goes to sleep well but still wakes 2-8 times per night. We have tried everything from reward to scolding to giving medication without success. We have always had her in her own bed and have strict bedtime with the same routines. What can we do next??