The Use of Exogenous Melatonin in Delayed Sleep Phase Disorder: A Meta-analysis

Geijlswijk, Ingeborg M. van; Korzilius, Hubert; Smits, Marcel G.

doi:10.1093/sleep/33.12.1605

Cited by 227 publications

(127 citation statements)

References 49 publications

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“…Fortunately, sleep problems are a modifiable risk factor; the means to address this vulnerability are available at both the individual and systemic levels. Effective approaches to managing adolescent sleep at the individual level include cognitive-behavioral therapies for insomnia, melatonin, and bright light (Gradisar et al, 2011;van Geijlswijk et al, 2010). Furthermore, districts that have delayed school start times have demonstrated corresponding benefits such as improved grades, reduced depression, and decreased automobile accidents (Danner & Phillips, 2008;Owens et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Restless Sleep and Variable Sleep Timing During Late Childhood Accelerate the Onset of Alcohol and Other Drug Involvement

Hasler

Kirisci

Clark

2016

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Limited prospective data indicate that premorbid sleep disturbances elevate the risk for subsequent alcohol and other drug problems, yet the implications for subsequent substance involvement trajectories remain unclear. In the present analyses, we examined risk associations between sleep characteristics during late childhood and the onset of substance use and substance use disorders into adulthood. Method: A sample of 707 children was recruited at ages 9-13 years and followed over seven additional visits through age 30 years. In 304 participants, fathers had a history of substance use disorder involving illicit drugs. Self-reported baseline sleep characteristics (restless sleep and variable sleep timing) were assessed at approximately ages 9-13 years. Assessment of alcohol, cannabis, and cocaine involvement occurred at follow-up visits. Cox proportional hazard models tested sleep characteristics as predictors of two substance-related outcomes (age at first use or diagnosis of disorder), as well as the onset of major depressive disorder. Results: Restless sleep at baseline significantly predicted an earlier onset age for trying alcohol and cannabis and showed a trend toward predicting early onset of cannabis use disorder. Restless sleep also predicted an earlier onset of depression. Irregular sleep timing at baseline significantly predicted an earlier onset age for alcohol use disorder and showed trends toward predicting early onsets of disorders of cannabis and cocaine use. Conclusions: Disturbed sleep during late childhood appears to accelerate the onset of not only initial substance use but also the development of clinically defined substance use disorder. Sleep-focused preventative efforts during late childhood may reduce the incidence of mood and substance use disorders. (J. Stud. Alcohol Drugs, 77, 649-655, 2016)

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Section: Discussionmentioning

confidence: 99%

Restless Sleep and Variable Sleep Timing During Late Childhood Accelerate the Onset of Alcohol and Other Drug Involvement

Hasler

Kirisci

Clark

2016

J. Stud. Alcohol Drugs

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“…Melatonin, a hormone produced, in part, by the pineal gland, has a well-known role in regulation of sleep-wake cycles through its sleep promoting effects. Melatonin is commonly used to treat sleep disturbances related to sleep-onset latency in children and has been shown to be effective at a dose of 5 mg [5] . Parent-reported sleep disturbances occur in nearly half of children with FD with the most common problems being related to sleep onset and maintenance [6] .…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study

Zybach

Friesen

Schurman

2016

WJGPT

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AIM:To study the effectiveness of melatonin vs placebo in children with functional dyspepsia (FD). METHODS:The study was conducted as a double blind, randomized, placebo controlled crossover trial. Subjects were aged 8-17 years and diagnosed with FD based on Rome Ⅲ criteria. All subjects had failed to respond to 4 wk of acid suppression. Subjects receive a continuous two weeks of placebo and a continuous two weeks of melatonin in an order blinded to the participant and the study team. A Global Clinical Score was obtained to assess changes in abdominal pain. Pain was self-reported to be worse (grade 1), no change (grade 2), moderate improvement (grade 3), good (grade 4; minimal pain and not interfering with daily activities), or excellent (grade 5; no pain), respectively. A positive clinical response was defined as a grade 3 or greater response. Subjects wore an actigraph to assess sleep during a one week baseline period and during each treatment period. Subjects' sleep latency and total sleep time were recorded throughout the duration of the study. RESULTS:Fourteen subjects were enrolled and 12 completed the study. One withdrew prior to starting both melatonin and placebo and the other before starting melatonin. A positive clinical response (grade 3-5) was achieved in 42% of subjects on melatonin vs 50% of subjects on placebo (NS). Effect size was calculated

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“…Exogenous melatonin has no reported tolerance, dependence, or 'hangover effect' [11], and no adverse effect on alertness or mood the following day [12], as well as minimal side-effects (e.g., headache, dizziness, nausea, drowsiness) [13,14] if administered at a low dose. [15] Melatonin has a short half-life of only 30-50 minutes and can induce phase shifts in the circadian timing system (both central and peripheral clocks) and when administered acutely, reduces core body temperature and lowers alertness, encouraging sleep propensity.…”

Section: Melatonin Use In Sleep Disordersmentioning

confidence: 99%

Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders

Auld

Maschauer

Morrison

et al. 2017

Sleep Medicine Reviews

327

142

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Melatonin is a physiological hormone involved in sleep timing and is currently used exogenously in the treatment of primary and secondary sleep disorders with empirical evidence of efficacy, but very little evidence from randomised, controlled studies. The aim of this meta-analysis was to assess the evidence base for the therapeutic effects of exogenous melatonin in treating primary sleep disorders. An electronic literature review search of MEDLINE (1950-present) EMBASE (1980- present), PsycINFO (1987- present), and SCOPUS (1990- present), along with a hand-searching of key journals was performed in July 2013 and then again in May 2015. This identified all studies that compared the effect of exogenous melatonin and placebo in patients with primary insomnia, delayed sleep phase syndrome, Non 24- hour sleep wake syndrome in people who are blind, and REM-Behaviour Disorder. Meta-analyses were performed to determine the effect of magnitude in studies of melatonin in improving sleep. A total of 5030 studies were identified; of these citations, 13 were included for review based on the inclusion criteria of being: double or single-blind, randomised and controlled. Results from the meta-analyses showed the most convincing evidence for exogenous melatonin use was in reducing sleep onset latency in primary insomnia (p=0.002), delayed sleep phase syndrome (p<0.0001), and regulating the sleepwake patterns in blind patients compared with placebo. These findings highlight the potential importance of melatonin in treating certain first degree sleep disorders. The development of large-scale, randomised, controlled trials is recommended to provide further evidence for therapeutic use of melatonin in a variety of sleep difficulties

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The Use of Exogenous Melatonin in Delayed Sleep Phase Disorder: A Meta-analysis

Cited by 227 publications

References 49 publications

Restless Sleep and Variable Sleep Timing During Late Childhood Accelerate the Onset of Alcohol and Other Drug Involvement

Restless Sleep and Variable Sleep Timing During Late Childhood Accelerate the Onset of Alcohol and Other Drug Involvement

Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study

Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders

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