Short summary

Attention Deficit Hyperactivity Disorder (ADHD) is a common neuropsychiatric disorder, affecting an estimated 5.3% of children and adolescents worldwide. A prevalence of  25-55% in persons with ADHD also complaines if sleep disturbances.Treatment of these sleep problems is often melatonin even though we have not established if there is delayed release of endogenous melatonin.

This study will examine whether children with ADHD and sleep problems has normal or delayed release of melatonin and examine whether the effekt of exogene melatonin is different in children with normal and delayed endogenous melatonin.

Rationale

Treatment with melatonin is often initiated on an insufficient basis as it has not been established prior to starting the treatment whether or not the child had delayed release of endogenous melatonin. At the clinic, it has furthermore been observed that the length of time a child experiences an effect of melatonin treatment varies substantially.

In a clinical context, treatment with melatonin is used increasingly (www.Medstat.dk). However, there is no tradition in Denmark for measuring the endogenous melatonin level before initiating such treatment. Hence there is no way of knowing to what extent the sleep problems were indeed caused by delayed melatonin release.

There seem to be no studies on the difference in the effect of melatonin treatment of children and adolescents depending on whether or not they have delayed DLMO. Likewise, there are no studies including adolescents.  

As can be seen, it is important to gain more knowledge about the normal release of melatonin, and the release of melatonin in a group of children and adolescents with a variety of psychiatric diagnoses. It is also essential to investigate whether there are any differences in the release of melatonin in children and adolescents with chronic sleep onset problem and children and adolescents who do not have sleep problems. 

PURPOSE: 

The purpose of this study is 

1: to establish reference values for melatonin secretion in mentally healthy children aged 6-12 years

2a: to measure and assess melatonin secretion in children aged 6-12 years with ADHD

2b: to measure and assess melatonin secretion in children aged 6-12 years with Autism Spectrum Disorder, Anxiety and Depression.

3a: to evaluate the effect of melatonin on sleep in children aged 6-12 years with ADHD who have delayed melatonin release and normal melatonin release respectively.

3b: to evaluate the effect of melatonin over time in children aged 6-12 years with ADHD who have delayed melatonin release and normal melatonin release respectively.

The effect is to be evaluated after 1 month, 3 months and 6 month

Description of the cohort

The participants will be recruited as follow:

Control group 

Children aged 6-12 years admitted to department of paediatrics at Sydvestjysk Sygehus, Esbjerg, irrespective of diagnosis.

Psychiatric group:

Children with ADHD 

Children aged 6-12 years referred to the child and adolescent psychiatric department for examination/treatment for ADHD

Children with other psychiatric diagnosis 

Children and adolescents aged 6-12 years referred to the child and adolescent psychiatric department for examination/treatment for Autism, Anxiety or Depression 

Data and biological material

Clinical data as Diagnosis, Questionnaires, Saliva

Collaborating researchers and departments

Danish Center of Sleep Medicine, Glostrup Hospital

• Professor Poul Jørgen Jennum, DMSc

Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

• Senior research Fellow, Benita Middleton, M.D.

Research Unit, Child- and Adolescent Psychiatry, Odense University Hospital

• Professor Niels Bilenberg, MD, PhD 

The National Centre for Register-based Research, Aarhus University

• Professor Søren Dalsgaard MD, PhD
• Post Doc Julie Werenberg Dreier, MsPH, PhD
• Pharmacologist Christiane Gasse,

Research Unit, Child- and Adolescent Psychiatry , Aalborg University Hospital

• Psychologist Danielle Dam Dahlhus, PhD-student