Melatonin adjunctive to stable pharmacotherapy improves parent-reported sleep disturbances and Stroop Color-Word Test performance in pediatric ADHD over 6 weeks, though causal attribution is limited by the open-label single-arm design.
In 32 children and adolescents with ADHD and comorbid sleep disturbances on stable methylphenidate or atomoxetine, adjunctive melatonin (3-5 mg/day) for 6 weeks reduced Children's Sleep Habits Questionnaire (CSHQ) total scores from 50.25 ± 3.60 to 34.31 ± 2.69 (F=506.238, p < .001, partial η²=0.942). Stroop Color-Word Test scores showed large observed changes (d=1.12-1.19, all p < .001), but practice effects cannot be excluded without a control group.
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Melatonin adjunctive to stable pharmacotherapy improves parent-reported sleep disturbances and Stroop Color-Word Test performance in pediatric ADHD over 6 weeks, though causal attribution is limited by the open-label single-arm design. The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 48/100 (low).
The Claim
Melatonin adjunctive to stable pharmacotherapy improves parent-reported sleep disturbances and Stroop Color-Word Test performance in pediatric ADHD over 6 weeks, though causal attribution is limited by the open-label single-arm design.
This conclusion is most relevant to: Children and adolescents with ADHD and comorbid sleep disturbances (CSHQ score ≥41) on stable methylphenidate or atomoxetine..
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Sleep and Stroop Performance with Adjunctive Melatonin in Pharmacotherapy-stable Pediatric ADHD: A Prospective Open-label Study. (Indian journal of psychological medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Melatonin administered 1 hour before bedtime may help regulate circadian rhythms and improve sleep quality.
- ▸Improved sleep may enhance cognitive functions such as attention and executive function.
- ▸Stroop Color-Word Test performance improved, reflecting better inhibitory control and processing speed.
- ▸However, sleep-cognition correlations were small and non-significant (r=0.19-0.29, p > .10), suggesting the improvements may be independent or due to practice effects.
Who Might Benefit
Evidence fit by population:
- ▸Children and adolescents with ADHD and comorbid sleep disturbances (CSHQ score ≥41) on stable methylphenidate or atomoxetine.
Recommended Dose
3 mg/day (<40 kg) or 5 mg/day (≥40 kg)
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Open-label, single-arm design without a control group, so causal attribution is not possible.
- ▸Practice effects on Stroop test cannot be excluded; no parallel cognitive assessment forms were used.
- ▸Sleep was measured via parent report, not objective measures (e.g., actigraphy or polysomnography).
- ▸Small sample size (n=32 completers) limits generalizability.
Frequently Asked Questions
What dose of melatonin was used in this study?▼
Melatonin was given at 3 mg/day for children weighing less than 40 kg and 5 mg/day for those weighing 40 kg or more, administered 1 hour before bedtime.
Did melatonin improve sleep in children with ADHD?▼
Yes, parent-reported sleep disturbance scores (CSHQ) significantly declined from 50.25 to 34.31 over 6 weeks, with large effect size (partial η²=0.942).
Did melatonin improve cognitive performance in this study?▼
Stroop Color-Word Test scores showed large improvements (d=1.12-1.19), but the authors caution that practice effects may account for these changes due to lack of a control group.
Is this study a randomized controlled trial?▼
No, it was a prospective, open-label, single-arm study, so causal conclusions cannot be drawn.
References
- 1.Tripathi R, Singh S, Arya A, Agarwal V. “Sleep and Stroop Performance with Adjunctive Melatonin in Pharmacotherapy-stable Pediatric ADHD: A Prospective Open-label Study..” Indian journal of psychological medicine, 2026. PMID: 42620628 DOI: 10.1177/02537176261472435