Exogenous melatonin for sleep problems in individuals with intellectual disability: a meta‐analysis

Abstract

Recent meta-analyses on melatonin has raised doubts as to whether melatonin is effective in treating sleep problems in people without intellectual disabilities. This is in contrast to results of several trials on melatonin in treating sleep problems in individuals with intellectual disabilities. To investigate the efficacy of melatonin in treating sleep problems in individuals with intellectual disabilities, we performed a meta-analysis of placebo-controlled randomized trials of melatonin in individuals with intellectual disabilities and sleep problems. Data were selected from articles published on PubMed, Medline, and Embase between January 1990 and July 2008. We examined the influence of melatonin on sleep latency, total sleep time, and number of wakes per night. Quality of trials was assessed using the Downs and Black checklist. Nine studies (including a total of 183 individuals with intellectual disabilities) showed that melatonin treatment decreased sleep latency by a mean of 34 minutes (p<0.001), increased total sleep time by a mean of 50 minutes (p<0.001), and significantly decreased the number of wakes per night (p<0.05). Melatonin decreases sleep latency and number of wakes per night, and increases total sleep time in individuals with intellectual disabilities.

Hormones, hormonal agents, and neuropeptides involved in the neuroendocrine regulation of sleep in humans

“…114 Melatonin also decreases sleep latency and number of awakenings per night and increases total sleep time in individuals with intellectual disabilities. 115 Various lines of evidence show that depressed patients exhibit disturbances in both the amplitude and shape of the melatonin secretion rhythm and that exogenous melatonin can improve their quality of sleep. Moreover, a growing number of epidemiologic studies have evaluated the relationship between night shift work, as well as the effect of varying duration of sleep on peak melatonin secretion at night.…”

Circadian Rhythm Abnormalities

“…21 Small open-label trials using doses of 2 mg to 20 mg of melatonin have shown some benefit in children with developmental disorders. 28 Controlled-release formulation appeared more effective than immediate release in this subpopulation. The AASM practice parameters recommend using a combination of environmental and behavioral modifications and bright light therapy for ISWRD.…”

Use of melatonin for sleep disturbance in a large intellectual disability psychiatry service

“…In their systematic review and meta-analysis on the use of melatonin in autism spectrum disorders in children, Rossignol and Frye (2011) found an improvement in sleep duration and sleep onset latency, better daytime behavior and minimal side-effects although some studies only had a small sample size and protocols measuring changes in sleep parameters were variable. Braam et al (2009) also found that melatonin decreased sleep latency, number of wakes per night and increased sleep time in their meta analysis of 9 randomized controlled trials in individuals with intellectual disability. Only in Braam (2008) were the subjects adults with ID.…”