Long-term follow-up of melatonin treatment in children with ADHD and chronic sleep onset insomnia

Authors

  • Michel Hoebert,

    1. Department of Neurology, Elisabeth Hospital, Tilburg
    2. Department of Neurology, Sleep-Wake Disorders and Chronobiology, Hospital de Gelderse Vallei, Ede, the Netherlands
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  • Kristiaan B. Van Der Heijden,

    1. Clinical Child and Adolescent Studies, Leiden University, Leiden
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  • Ingeborg M. Van Geijlswijk,

    1. Faculty of Veterinary Medicine, Pharmacy Department, Utrecht University, Utrecht
    2. Department of Pharmacoepidemiology and Pharmacotherapy, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht
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  • Marcel G. Smits

    1. Department of Neurology, Sleep-Wake Disorders and Chronobiology, Hospital de Gelderse Vallei, Ede, the Netherlands
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  • The results of this study were presented in poster session at the 19th Congress of the European Sleep Research Society in Glasgow, September 2008.

Address reprint requests to Dr Marcel G. Smits, Hospital Gelderse Vallei, P.O. Box 9025, 6710 HN Ede, the Netherlands.
E-mail: smitsm@zgv.nl

Abstract

Abstract:  We conducted this study to assess long-term melatonin treatment course, effectiveness and safety in children with attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia (CSOI). This was conducted by means of a structured questionnaire for the parents. The subjects of this study consisted of participants who previously participated in a randomised clinical trial on melatonin efficacy. The response rate was 93% (94/101). The mean time to follow up was 3.7 yr. No serious adverse events or treatment related co-morbidities were reported. Sixty-five percent of the children still used melatonin daily and 12% occasionally. Temporal discontinuation of treatment resulted in a delay of sleep onset in 92% of the children. Nine percent of the children could discontinue melatonin completely because of improvement of sleep onset insomnia. Long-term melatonin treatment was judged to be effective against sleep onset problems in 88% of the cases. Improvement of behaviour and mood was reported in 71% and 61% respectively. We conclude that melatonin remains an effective therapy on the long term for the treatment of CSOI in children with ADHD and has no safety concerns regarding serious adverse events or treatment related co-morbidity. Discontinuation of melatonin treatment usually leads to a relapse of sleep onset insomnia and in resuming melatonin treatment, even after several years of treatment.

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