73–78% of adults with ADHD have delayed sleep-wake cycles with melatonin onset ~90 minutes later than controls. This isn't just comorbidity — emerging evidence frames ADHD as partly a circadian rhythm disorder. The Delphi consensus protocol: 0.5mg immediate-release melatonin taken 3 hours before habitual sleep onset, advancing by 1 hour weekly for 3–4 weeks. Counterintuitively, stimulant medications may improve (not worsen) sleep quality by reducing pre-sleep rumination.
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