Melatonin for sleep disturbance in children with neurodevelopmental disorders: prospective observational naturalistic study

Ayyash, Hani; Preece, P. M.; Morton, Richard E.; Cortese, Samuele

doi:10.1586/14737175.2015.1041511

Cited by 23 publications

(19 citation statements)

References 30 publications

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“…For melatonin, three RCTs 30,61,62 , and three observational studies [63][64][65] met the inclusion criteria. Two studies 62,66 had the same data for melatonin, hence only one was included.…”

Section: Search Results and General Characteristics Of Included Studiesmentioning

confidence: 99%

“…Hoebert et al 64 in a follow-up study, aimed to determine the long-term effectiveness and safety of melatonin Ayyash et al 65 subjectively assessed the effects of melatonin on sleep latency and night-time awakening in children with neurodevelopmental disorders (ADHD, autism spectrum disorder or intellectual disability) in an observational study. The increase in the mean (± SD) for total sleep time (hours/night) in children with ADHD only was 2.68 ± 1.22, (p<0.001), for sleep latency the mean decrease was 1.24 ± 1.20 hours, (p<0.02) and for awakening (number/night) the mean decrease was 0.23 ± 0.22, (p<0.02).…”

Section: Melatoninmentioning

confidence: 99%

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Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment

et al. 2017

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ObjectiveA large proportion of paediatric patients with attention-deficit/hyperactivity disorder (ADHD) have associated sleep problems which not only affect the child's well-being but also impact family functioning. Management of sleep problems is consequently an important aspect of overall ADHD management in paediatric patients. Although some drugs are being used off-label for the management of paediatric insomnia, there is scant clinical evidence supporting their use. Our aim was to identify and assess the quality of published studies reporting the safety, tolerability and efficacy of drugs used for treating behavioural insomnia in children with ADHD. MethodAfter an initial screen to determine which drugs were most commonly used, we conducted a systematic review of English-language publications from searches of PubMed, EMBASE, PsychInfo and two trial register databases to February 2017, using keywords clonidine, melatonin, zolpidem, eszopiclone, L-theanine, guanfacine, ADHD, sleep disorder and children. For quality assessment of included studies, we used the CONSORT checklist for randomized control trials (RCTs) and the Downs and Black checklist for non-RCTs. ResultsTwelve studies were included. Two case series for clonidine, two RCTs and four observational studies for melatonin and one RCT each for zolpidem, eszopiclone, L-theanine and guanfacine. Of the 12 included studies, only one on eszopiclone scored excellent. The quality of the rest of the studies varied from moderate to low. For clonidine, melatonin and L-theanine, improvement in sleep-onset latency and total sleep duration, were reported; however, zolpidem, eszopiclone and guanfacine failed to show any improvement when compared with placebo. Clonidine, melatonin, L-theanine, eszopiclone and guanfacine were well tolerated with mild to moderate adverse events except for zolpidem which was associated with neuropsychiatric adverse effects. ConclusionThere is generally poor evidence for prescribing drugs for behavioural insomnia in children with ADHD. Further controlled studies are warranted.

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Section: Search Results and General Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Melatoninmentioning

confidence: 99%

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment

et al. 2017

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“…This is due to the fact that the effectiveness of MLT is influenced by inter-individual differences in the rate of hepatic metabolism, intestinal absorption and body weight [48]. Effective dose should be established for each patient individually [104]. In turn, Malow et al observed that the child's age or weight was not associated with MLT dose response [59].…”

Section: Melatonin In the Treatment Of Sleep Disorders In Childrenmentioning

confidence: 99%

“…According to Grigg-Damberger et al, the dose should be increased by 1 mg every 2 weeks [6]. Although therapy is generally effective, even high doses of exogenous MLT did not result in the intended effect [104] in slow MLT metabolizers due to a single nucleotide polymorphism (SNP) of CYP1A2 [105].…”

Section: Melatonin In the Treatment Of Sleep Disorders In Childrenmentioning

confidence: 99%

Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder—A Review of the Literature

Rzepka-Migut¹,

Paprocka

2020

Brain Sciences

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Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with disturbed melatonin secretion profile and sleep problems. The growing incidence of ASD and ADHD inspires scientists to research the underlying causes of these conditions. The authors focused on two fundamental aspects, the first one being the presentation of the role of melatonin in ASD and ADHD and the second of the influence of melatonin treatment on sleep disorders. The authors present the use of melatonin both in the context of causal and symptomatic treatment and discuss melatonin supplementation: Dosage patterns, effectiveness, and safety. Sleep disorders may have a different clinical picture, so the assessment of exogenous melatonin efficacy should also refer to a specific group of symptoms. The review draws attention to the wide range of doses of melatonin used in supplementation and the need to introduce unified standards especially in the group of pediatric patients.Brain Sci. 2020, 10, 219 2 of 21 requiring flexibility and behavioral problems [9]. In the presented disorders, the clinical picture is heterogeneous [10] and the etiology is still unclear [11].Autism spectrum disorder (ASD) can be defined based on the diagnostic criteria which include communication and social interaction disorders and limited repetitive patterns of behavior and interests. In addition to the fundamental symptoms, many patients also present with anxiety attacks, (self)-aggression, mood disorders, and sleep difficulties [12,13]. The first symptoms of autism are observed already in early childhood and usually persist throughout life. An increase in the incidence of ASD has been reported over recent years. According to the CDC's Autism and Developmental Disabilities Monitoring (ADDM) report in 2000 the incidence of ASD was estimated at 1 in 150 children, in 2014 this incidence was 1 diagnosis in 59 children at the age of 8 [14]. The causes of this tendency may be different, e.g., a higher standard of medical and diagnostic care [15], higher social awareness, and the older age of parents at childbearing [16,17]. The etiology of ASD is most likely multifactorial [11], being the result of genetic and environmental factors [6]. Hallmayer et al. indicated the predominance of environmental factors, estimating the shared environmental component to be 58% and heritability to 38%. This distribution was similar among women and men [18]. So far multiple potential risk factors for ASD have been reported in the literature, including the use of illicit drugs during pregnancy, medications, organophosphate pesticides [19], fatty acid deficiency [20], gestational diabetes, and low birth weight [11]. Despite numerous scientific studies, no genetic abnormality that would account for more than 1% of ASD has been identified yet [11]. One of the hypothesis defines ASD as a collection of many forms of a rare monogenic disorder with a different etiology [21]. Ten percent of ASD can be explained as a component of a specific genetic sy...

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“…In adults, taking melatonin in low doses of 0.1-0.3 mg 2 h prior to bedtime is thought to be effective in raising the plasma melatonin to normal levels. The doses which may be effective in children are unclear [3,4,[15][16][17][18][19].…”

Section: Melatonin and Melatonin Agonistsmentioning

confidence: 99%

Pharmacotherapy of Insomnia in Children

Pelayo

Huseni

2016

Curr Sleep Medicine Rep

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Insomnia is defined as the inability to fall asleep and/or the inability to maintain sleep to the point that it has a negative impact on time awake. Insomnia in adults may lead to daytime fatigue and sleepiness but in children, the lack of quality sleep may lead to daytime behavioral problems such as hyperactivity and academic difficulty. The pharmacological treatment of insomnia in children is a challenging problem for clinicians since there is paucity of Food and Drug Administration (FDA) approved. Parents often seek medical attention for their children when their own or other members of the family's sleep schedule has been disrupted. The clinician has to take into account the entire family when evaluating a child and making therapeutic recommendations. When evaluating a child with insomnia, it is not only important to take a thorough history of the child's sleep schedule but it also involves getting a detailed evaluation of the other family member's sleep history. The pharmacological management of insomnia is dependent on the child's age. The primary healthcare physician may have limited training in pediatric sleep disorders. Although the mainstay treatment for insomnia in children is behavioral therapy, in this chapter, we will provide a review of the medications that may be used as an adjunct treatment for pediatric insomnia.

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Melatonin for sleep disturbance in children with neurodevelopmental disorders: prospective observational naturalistic study

Abstract: Melatonin is generally effective and safe in children with neurodevelopmental conditions. Increasing above 6 mg/night adds further benefit only in a small percentage of children.

Cited by 23 publications

References 30 publications

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment

Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder—A Review of the Literature

Pharmacotherapy of Insomnia in Children

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