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Melatonin

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Summary

  • In some children with ADHD, melatonin improved sleep onset and duration, but not behavior or cognition.
  • Shifting late sleep and treating adult insomnia differ; a clinician should assess suitability and timing.
  • Bring current medicines and product details to discuss sleep goals, product differences, and interactions.

Ways to apply

  1. On your own

    Free, no special equipment to buy

    1. Record sleep and wake times and the sleep difficulty most needing improvement for a clinical visit.
    2. Bring medicines and product details; ask a clinician about suitability, timing, and interactions.
    3. If advised to use it, follow the agreed plan; track sleep and daytime changes separately for review.

Better sleep does not mean fewer daytime ADHD difficulties

Research-backed

A four-week trial enrolled medication-free children with attention deficit hyperactivity disorder (ADHD) and longstanding difficulty falling asleep. Compared with placebo, melatonin moved sleep onset earlier and increased sleep duration. Behavior, cognitive performance, and quality of life did not improve significantly(VAN et al., 2007).

Sleep and daytime functioning therefore need separate assessment. The sleep benefits seen in this trial do not justify replacing usual ADHD treatment with melatonin.

Shifting sleep timing and treating insomnia need different judgments

Research-backed

The American Academy of Sleep Medicine guideline conditionally supports melatonin timed to the body clock for delayed sleep-wake phase disorder. This recommendation does not apply to all insomnia(Auger et al., 2015).

For adult chronic insomnia without a circadian component, the European insomnia guideline does not recommend fast-release melatonin(Riemann et al., 2023). Discussion with a clinician starts with the goal: moving sleep earlier or addressing other persistent sleep difficulties. Trouble falling asleep alone does not determine how to use it.

Product differences and other medicines belong in the assessment

Research-backed

The US National Heart, Lung, and Blood Institute notes that melatonin supplement brands sold in the United States may differ in active ingredient content and purity. It also advises consulting a clinician about product choice, side effects, and drug interactions(National et al., 2022).

When discussing whether to try melatonin, specific product details and a current medicine list are more useful than the name alone. Products sharing that name cannot be assumed interchangeable.

Evidence

References (4)
  1. Randomized trialEffect of Melatonin on Sleep, Behavior, and Cognition in ADHD and Chronic Sleep-Onset InsomniaVAN der HEIJDEN, SMITS, VAN SOMEREN, RIDDERINKHOF, GUNNING (2007). Journal of the American Academy of Child & Adolescent Psychiatry
  2. GuidelineClinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015Auger, Burgess, Emens, Deriy, Thomas, Sharkey (2015). Journal of Clinical Sleep Medicine
  3. GuidelineThe European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023Riemann, Espie, Altena, Arnardottir, Baglioni, Bassetti, Bastien, Berzina, Bjorvatn, Dikeos, Dolenc Groselj, Ellis, Garcia‐Borreguero, Geoffroy, Gjerstad, Gonçalves, Hertenstein, Hoedlmoser, Hion, Holzinger, Janku, Jansson‐Fröjmark, Järnefelt, Jernelöv, Jennum, Khachatryan, Krone, Kyle, Lancee, Leger, Lupusor, Marques, Nissen, Palagini, Paunio, Perogamvros, Pevernagie, Schabus, Shochat, Szentkiralyi, Van Someren, van Straten, Wichniak, Verbraecken, Spiegelhalder (2023). Journal of Sleep Research
  4. GuidelineCircadian Rhythm Disorders: TreatmentNational Heart, Lung, and Blood Institute (2022). NIH NHLBI patient guidance