title: Systematic review of melatonin treatment in children with neurodevelopmental disabilities and sleep impairment.
abstract: Sleep disturbances in children with neurodevelopmental disabilities are common and frequently difficult to treat with conventional pharmacological and behavioural methods. Melatonin is a pineal hormone known to be important in the regulation of the circadian rhythm, including the sleep-wake cycle. This systematic review of available evidence from randomized clinical trials assesses whether melatonin plays a beneficial role in these children and, in particular, its effect on total sleep time, time to sleep onset (sleep latency), and number of awakenings. We also looked at a parental view of the effect. Randomized clinical trials were identified where oral melatonin was compared with a placebo in children with any type of neurodevelopmental disability and associated sleep disturbance. Only three studies, reporting a total of 35 children, fulfilled the criteria for inclusion. The two studies that reported time to sleep onset showed a significant decrease (p<0.05) in this specific outcome where melatonin was compared with a placebo. There was no significant effect of melatonin compared with a placebo on the other outcome measures of total sleep time, night-time awakenings, and parental opinions. Despite the extremely limited randomized clinical trial data, melatonin appears to remain a commonly prescribed drug for disturbed sleep in children with neurodevelopmental abnormalities.
authors.affiliation: Department of Neurology, Royal Liverpool Children's NHS Trust, Liverpool L12 2AP, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Phillips
authors.forename: Richard E
authors.initials: RE
authors.lastname: Appleton
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use*; D001921:Brain / Q000503:physiopathology*; D002648:Child; D002658:Developmental Disabilities / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008550:Melatonin / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000453:epidemiology; D014851:Wakefulness / Q000502:physiology
chemical_list: D000975:Antioxidants; D008550:Melatonin