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QUESTION 1
  1. Sarah Snowden
  1. Yorkshire Deanery, UK; snowden@doctors.org.uk

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DOES MELATONIN IMPROVE SLEEP PATTERN IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER?

Adam is an 8-year-old boy with attention deficit hyperactivity disorder (ADHD) who you see with his mother in your paediatric outpatient clinic. She explains that life is being made increasingly stressful for the whole family as Adam is having difficulty getting off to sleep. It often takes him several hours to calm down and go to sleep, and the next day he gets angry and seems to be tired all the time.

Adam’s insomnia is causing him and his mother to become frustrated and exhausted. She is at the end of her tether, but has recently seen on a television programme that melatonin may be effective in improving sleep pattern in children with ADHD. She asks you whether it would work in Adam.

Are the television producers correct? If melatonin is prescribed for Adam, will it be harmful or helpful in improving his sleep?

Clinical bottom line

  • Melatonin administration can be used to advance sleep onset to normal values in children with attention deficit hyperactivity disorder (ADHD) who are not on stimulant medication. (Grade A)

  • Combining …

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