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Melatonin Supplementation Improves Sleep in Children with Neurodevelopmental Disorders

1/15/2019 12:57:34 PM
Children with neurodevelopmental disorders experience more problems with sleep than their neurotypical peers. Studies suggest that nocturnal secretion of melatonin is also lower in children with autism spectrum disorder (ASD) and other neurodevelopmental disorders. Some studies suggest that melatonin supplementation might improve sleep in these children.
To summarize and update the current evidence on the use of melatonin in children with neurodevelopmental disorders, researchers conducted a systematic review and meta-analysis. Thirteen randomized controlled trials (including 682 children under the age of 18) were included in the review.
Participants in the included studies were children with sleep disorders and one of the following: ASD, attention-deficit/hyperactivity disorder (ADHD), fragile X syndrome, Rett syndrome, mental retardation, or neurodevelopmental disorder. Melatonin was compared to placebo or another intervention. The type of melatonin used was fast-release in 10 studies, slow and fast-release in 2 studies, and slow-release in one study. Dosages ranged from 0.1 to 12 mg per night. Study durations ranged from one to 13 weeks.
Results of the meta-analysis showed that melatonin significantly increased total sleep time by about 48 minutes per night (mean difference [MD] = 48.26 min; 95% CI, 36.79-59.73). Melatonin significantly decreased sleep latency (the time taken to fall asleep) by about 29 minutes per night (MD = -28.97; 95% CI, -39.78 to -18.17). Melatonin did not change the frequency of nocturnal waking.
There were no significant differences in adverse events reported between melatonin and controls. Of the 13 studies, 4 reported that the parents felt their children’s behavior improved with melatonin compared with placebo. Some parents and caregivers reported that melatonin improved health issues and family stress.
The overall quality of the evidence, based on GRADE criteria, was judged to be moderate. The conclusions are limited by heterogeneity and small sample sizes of the included studies. Nevertheless, the evidence from this meta-analysis suggests that melatonin improves total sleep time and sleep onset latency in children with neurodevelopmental disorders.  
Abdelgadir IS, Gordon MA, Akobeng AK. Melatonin for the management of sleep problems in children with neurodevelopmental disorders: a systematic review and meta-analysis. Arch Dis Child. 2018; 103: 1155-1162.

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