Sleep Matters In Primarily Inattentive ADHD

My eldest son has a lot of trouble falling asleep.  He stays awake reading sometimes until 12:30 at night.  He complains that he cannot fall asleep.  He is not on a stimulant so this is not the reason for his lack of sleep.  In the morning he is a zombie and even a cup of coffee does not revive him much.  His teacher emailed me this week that he is zoning out.

My son sleeps better when he has had a lot of exercise.  He, however, seems to get less exercise in the winter as they go outside less at school and at home we are inside more.  I walk about 3-4 miles a day and he goes out and walks with me on most nights.  In the last few weeks he has had mountains of homework and he has walked with me less.

I did not fall asleep easily when I was his age.  I remember staying up as late as he does listening to talk radio on this little radio that I had been given for my birthday.  What my son has and I had is Sleep Onset Insomnia or SOI.  Research studies have suggested that circadian rhythm disturbances are what cause SOI in people with ADHD.  There has been a demonstrated delay in salivary melatonin onset and sleep delay in some individuals with ADHD when they are compared with normal controls.

There is another connection between Inattentive ADHD and sleep problems.  Individuals with inattentive ADHD are more likely to be night owls.  This was confirmed in two studies.  One of the studies was performed in France in 2009; the other study was performed on children with ADHD at the University of North Carolina in 2008.   Both the delayed melatonin and the tendency to be 'night owls' keep us awake.  (Or more likely, we are night owls because of the delayed melatonin).

I have been recently looking into Melatonin treatment.  There are several recent studies that have shown that Melatonin in doses of 3mg to 6mg (depending on weight) is extremely effective in treating Sleep Onset Insomnia in ADHD.  One study followed children for 4 years and found that the treatment resulted in no adverse events or side effects and that 93% of children responded to the treatment.  Tonight I will try to give him some melatonin.  I will post tomorrow on how it goes.

2 comments:

  1. Could you please report on how the melatonin worked? Thanks!

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  2. The melatonin has worked quite well but I alternate it with diphenhydramine 50mg (Benadryl). His pediatrician wanted him on Claritin daily as he tends to have seasonal allergies and we live in a city with lots of trees, grasses and molds. He does not take the Claritin but does take the every other day Benadryl.

    He takes the Benadryl nightly during high allergy season and if he is taking Benadry at night then he takes no melatonin.

    My son reports that the melatonin is much better than the Benadry for getting him to sleep but I do not want him to take the melatonin every day as it is unclear how this would effect his natural production of Melatonin. I took him off the Melatonin completely in the summer and he does not take it on weekends.

    The studies on Melatonin have reported it to be safe but no one has been on it indefinately and no tests have been done on children taking it longer than a few months. My son, as do all of us, does so much better when he has slept well and the Melatonin is a tool that I am happy to have but also reluctant to use continuously.

    Thanks for reminding me to post about this!!

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