title: Effects of Melatonin and Bright Light Treatment in Childhood Chronic Sleep Onset Insomnia With Late Melatonin Onset: A Randomized Controlled Study.
abstract: Chronic sleep onset insomnia with late melatonin onset is prevalent in childhood, and has negative daytime consequences. Melatonin treatment is known to be effective in treating these sleep problems. Bright light therapy might be an alternative treatment, with potential advantages over melatonin treatment. In this study, we compare the effects of melatonin and bright light treatment with a placebo condition in children with chronic sleep onset insomnia and late melatonin onset.
  
  
  
  Eighty-four children (mean age 10.0 years, 61% boys) first entered a baseline week, after which they received melatonin (N = 26), light (N = 30), or placebo pills (N = 28) for 3 to 4 weeks. Sleep was measured daily with sleep diaries and actigraphy. Before and after treatment children completed a questionnaire on chronic sleep reduction, and Dim Light Melatonin Onset (DLMO) was measured. Results were analyzed with linear mixed model analyses.
  
  
  
  Melatonin treatment and light therapy decreased sleep latency (sleep diary) and advanced sleep onset (sleep diary and actigraphy), although for sleep onset the effects of melatonin were stronger. In addition, melatonin treatment advanced DLMO and had positive effects on sleep latency and sleep efficiency (actigraphy data), and sleep time (sleep diary and actigraphy data). However, wake after sleep onset (actigraphy) increased with melatonin treatment. No effects on chronic sleep reduction were found.
  
  
  
  We found positive effects of both melatonin and light treatment on various sleep outcomes, but more and stronger effects were found for melatonin treatment.
authors.affiliation: Research Institute of Child Development and Education, University of Amsterdam,Amsterdam,The Netherlands.
authors.forename: Annette
authors.initials: A
authors.lastname: van Maanen
authors.affiliation: Research Institute of Child Development and Education, University of Amsterdam,Amsterdam,The Netherlands.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Meijer
authors.affiliation: Centre of Sleep-Wake Disorders and Chronobiology, Hospital Gelderse Vallei,Ede,The Netherlands.
authors.forename: Marcel G
authors.initials: MG
authors.lastname: Smits
authors.affiliation: Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands.|Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
authors.forename: Kristiaan B
authors.initials: KB
authors.lastname: van der Heijden
authors.affiliation: Research Institute of Child Development and Education, University of Amsterdam,Amsterdam,The Netherlands.
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Oort
mesh_terms: D002492:Central Nervous System Depressants / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000627:therapeutic use*; D010789:Phototherapy / Q000379:methods*; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D002492:Central Nervous System Depressants; D008550:Melatonin
keywords: Chronic sleep onset insomnia; children; late melatonin onset; light therapy.; melatonin treatment