Melatonin an option for insomnia in children with ADHD and autism

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Goodfellow Gems

"Melatonin an option for insomnia in children with ADHD and autism"

Sleep problems are common in children with neurodevelopmental disorders such as ADHD or autism.1 The child’s history should be carefully assessed as there may be features amenable to management (e.g. adjusting concomitant medication). Sleep hygiene and behavioural interventions should be tried before drug treatment is introduced.

Based on a limited number of small, short-term clinical trials, melatonin has been shown to reduce the delay before sleep onset and increase the total duration of sleep. However, the absolute size of such changes is quite small. Little is known about melatonin's long-term effects in children. It is not always licensed for use in children, but doses for a child 1 month–18 years of 2–3mg (lower doses in very young children) daily before bedtime initially, increased if necessary after 1–2 weeks to 4–6mg daily before bedtime- maximum of 10mg daily. Short courses and regular breaks are recommended. Long-term effects are unknown. Treatment should be initiated by a specialist.

This GEM has been reviewed by Dr Matt Eggleston Child Psychiatrist Canterbury District Health Board.

References:

  1. Drug and therapeutic bulletin. 2015;53:117-120. http://dtb.bmj.com/content/53/10/117.abstract

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.


As published in NZ Doctor 17/02/2016