HormonesMelatonin

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.

Last updated: Aug 26, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score48/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Sleep and Stroop Performance with Adjunctive Melatonin in Pharmacotherapy-stable Pediatric ADHD: A Prospective Open-label Study.

observational

Tripathi R, Singh S, Arya A, Agarwal V · Indian journal of psychological medicine (2026)

Participants: N/A
Duration: 6 weeks
Intervention: Melatonin 3 mg/day (<40 kg) or 5 mg/day (≥40 kg) administered 1 hour before bedtime for 6 weeks, adjunctive to stable pharmacotherapy (methylphenidate or atomoxetine).
Outcome: Parent-reported sleep disturbance (Children's Sleep Habits Questionnaire total score) and Stroop Color-Word Test performance (Psychology Experiment Building Language version).
Effect Size: partial η²=0.942 for CSHQ; d=1.12-1.19 for Stroop scores
Population: Children and adolescents with ADHD and comorbid sleep disturbances (CSHQ score ≥41) on stable methylphenidate or atomoxetine.

Result:

PubMed: 42620628DOI: 10.1177/02537176261472435

Mechanism Graph

Melatonin administered 1 hour before bedtime may help regulate circadian rhythms and improve sleep quality.
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Improved sleep may enhance cognitive functions such as attention and executive function.
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Stroop Color-Word Test performance improved, reflecting better inhibitory control and processing speed.
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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.

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.