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Melatonin, Sleep Enhancement, and ADHD
by Anthony Kane, MD
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
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