VOLUME 11, NO.4 April and May, 2006

NJ ADD/ADHD ADULT NEWSLETTER

ADD ADULT SELF HELP SUPPORT GROUP

FOR ADD/ADHD ADULTS

AND THEIR SIGNIFICANT OTHERS

MEETING: THE NEXT MEETING OF THE ADD ADULT SELF HELP SUPPORT GROUP WILL BE ON May 25, 2006 AT 7:30 PM AT MONMOUTH MEDICAL CENTER, COMMUNITY MEETING ROOM , LONG BRANCH, NJ. GO TO THE MAIN RECEPTION DESK AND GET DIRECTIONS. THE TOPIC WILL BE: MANAGING ADD ANXIETY.\

RESEARCH: In a research article by M.D.Weiss etal., Sleep Hygiene and Melatonin Treatment for Children and Adolescents with ADHD and Initial Insomnia, J.Acad.Child Adolesc.Psychiatry, 2006, 45(5): 512-519, it was found that either sleep hygiene and/or 5 mg of short acting pharmaceutical grade melatonin had a positive effect on improving the time it takes to fall asleep while taking a stimulant medication for ADHD. The children were 6-14 years of age. The effect of combining both melatonin and sleep hygiene procedures was dramatic. At 90 days a re-evaluation of the effect revealed that the time to fall asleep had been reduced by an average of 60 minutes/per night. Sleep hygiene alone reduced sleep onset to less than 60 minutes in 5 of the 27 cases. The average sleep time before treatment was >90 minutes. Sleep hygiene included a fixed bedtime and awakening time with a target sleep duration of at least 9.5 hours, but no more than age expected norms. The bedtime was adjusted for each child. Caffeine during the day and naps were discontinued during the study. Only children who were compliant with the sleep hygiene were then tried on the melatonin treatment. The measures of sleep were the actigraph which objectively measures movement during sleep, and a sleep log.

COMMENTS: This study had many nice controls and is worth reading if you have an interest in ADD sleep or its treatment. There are many issues to discuss regarding ADD sleep. One prominent issue is the proper diagnosis of ADD. Someone with a primary sleep disorder may have symptoms of ADD but not really have it. Treatment with a psychostimulant would likely make the sleep worse. I have some ADD patients who fall sleep better when they take their stimulant medication near bedtime. There are other patients who have a subclinical form of restless legs syndrome which makes it uncomfortable to lie down quietly at bedtime because then they notice the restlessness in their legs; so, they try to delay bedtime until they are exhausted.

This study resulted in a cure of initial insomnia in 71% of the sample. A cure is defined as falling asleep in less than 30 minutes. The authors caution that the study does not inform us of whether the results would be the same if sleep hygiene was not part of the treatment with melatonin.

NOTICE: THE ADD NEWSLETTER WILL RESUME IN SEPTEMBER. WE WILL HAVE A JUNE AND JULY SUPPORT GROUP MEETING WITH THE SAME TOPIC : ADD ANXIETY. THERE WILL BE NO MEETING IN AUGUST.

PEACE!!!

Bob

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