Melatonin, Sleep Enhancement, and ADHD

by Anthony Kane, MD


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Overview
Melatonin is a natural hormone, which is produced and secreted by the pineal gland. Melatonin plays an important role in the regulation of many hormones in the body. Among its key roles, melatonin controls the body's circadian rhythm, an internal 24-hour time-keeping system that controls when we fall asleep and when we wake up.

Melatonin is also a very powerful antioxidant. In one study, melatonin was 60 times more effective than Vitamin C or water-soluble Vitamin E in protecting DNA from damage. Preliminary evidence suggests that it may help strengthen the immune system.

There are numerous claims and theories concerning all the things that melatonin may do and as a result it has become one of the popular life extension and life enhancing supplements that are currently available on the market today.

Uses
The most accepted function of Melatonin is it role in sleep regulation. Melatonin supplements help induce sleep in people with disrupted circadian rhythms. Melatonin is significantly more effective in decreasing the amount of time required to fall asleep, increasing the number of sleeping hours, and boosting daytime alertness.

Melatonin is purported to be one of those miracle substances that has a hand in everything. This may be due to the fact that during the height of the antioxidant craze, Melatonin was found to be a more powerful and more universal antioxidant than both vitamin C and vitamin E. Whatever the reason, Melatonin ostensibly plays a role in numerous health conditions.

Here is a partial list:

Insomnia
Osteoporosis
Menopause
Depression
Eating Disorders
Breast Cancer
Prostate Cancer
Cancer-related Weight Loss
Sarcoidosis
Rheumatoid Arthritis
Epilepsy
Sunburn
Viral Encephalitis
Heart Disease

Since a lot of evidence for many of these claims is rather light and since I am not trying to sell you melatonin supplements, I am going to focus only on its role in sleep enhancement.

Insomnia
As many parents realize, drugs like Ritalin are not without side effects. One of the major complaints that parents have is that their children who take Ritalin can't fall asleep at night. Many parents report that their children, who may be only five or six years old, are wide awake until 11 pm or later.

Melatonin may be able to help these children. Since it is the primary chemical in the body that helps to induce sleep, children who suffer from insomnia often find that Melatonin restores their normal sleep cycle and helps them to be more awake and alert during the day.

How to Take It
There are currently no guidelines as to how to take Melatonin. Sensitivity to Melatonin is an individual thing and doses that are ineffective in one person may be too much for someone else.

The best approach for any condition is to begin with very low doses and slowly add more until you get the effect that you are seeking.

In children, it is best to start with a dose of about 0.3 mg/day or less. Although current research suggests that even doses as high as 10 mg are perfectly safe, it is best to proceed with caution.

In adults, 3 mg is usually a safe starting dose and you can increase it or decrease it as you see fit.

Availability
Melatonin is readily available in most health food stores in the United States and it is very cheap. In Europe it is a controlled substance. Most Europeans who wish to use Melatonin find it cheaper and easier to have it shipped from the US.

Adverse Effects
Melatonin is one of the least toxic substances known. In one extensive clinical trial, a high dose of 75 milligrams of melatonin per day was given to 1400 women in the Netherlands for up to four years with no ill effects.

The only consistent side effect of high doses has been drowsiness and a slower reaction time.

Other common complaints include:

Vivid dreams or nightmares
Stomach cramps
Dizziness
Headache
Irritability
Decreased libido
Breast enlargement in men
Decreased sperm count.

These side effects were in healthy people. We also don't know how melatonin may affect people suffering from disease.

Possible Drug Interactions
Melatonin may interact or interfere with other drugs.

These include:

Antidepressant Medications
Antipsychotic Medications: many of these medications are now being used in treating children with ADHD and Bipolar disorder
Benzodiazepines
Blood Pressure Medications
Blood-thinning Medications, Anticoagulants
Interleukin-2
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Steroids and Immunosuppressant Medications
Tamoxifen

If your child is taking any of these things, you should consult with his doctor before giving Melatonin.

Also, caffeine, tobacco, and alcohol can all diminish levels of melatonin in the body while cocaine and amphetamines may increase melatonin production.

Conclusion
Often children with ADHD have a great deal of difficulty falling asleep. This can be due to the medications that they are taking or just be one component in the spectrum of their problems. When used properly, melatonin may be a safe and effective way to handle sleep problems in ADHD children.


Anthony Kane, MD
ADD ADHD Advances
http://addadhdadvances.com