Perspective on Melatonin Use for Sleep Problems in Autism and Attention-Deficit Hyperactivity Disorder: A Systematic Review of Randomized Clinical Trials.

Tarun Parvataneni,Kaushal Shah,Rikinkumar S Patel,Sushma Srinivas

doi:10.7759/cureus.8335

Abstract

Melatonin is a hormone produced by the pineal gland and is available over the counter for treating sleep problems in the pediatric population. We conducted a systematic review of randomized clinical trials (RCTs) on MEDLINE and included six studies that met our inclusion criteria. RCTs were conducted in patients from two to 18 years of age with a diagnostic and statistical manual of mental disorders (DSM)-IV diagnosis of autism spectrum disease (ASD) and/or attention-deficit hyperactivity disorder (ADHD) in both short-term and long-term RCTs ranging from eight-week to 52-week studies. The mean difference in the children’s sleep disorder showed statistically significant improvement in sleep duration and sleep latency onset compared to the placebo. Overall, a high response rate was observed in the melatonin group compared to the placebo in treating sleep problems in children. Melatonin is a well-tolerated and safe medication in the dose range of 2-10 mg/day in the child and adolescent population.

Highlights

BackgroundSleep problems are increasingly becoming prevalent in children, as recent data found that about 50% of children from four to 12 years old have different sleep issues [1]
We conducted a systematic review of randomized clinical trials (RCTs) on MEDLINE and included six studies that met our inclusion criteria
RCTs were conducted in patients from two to 18 years of age with a diagnostic and statistical manual of mental disorders (DSM)-IV diagnosis of autism spectrum disease (ASD) and/or attention-deficit hyperactivity disorder (ADHD) in both short-term and long-term RCTs ranging from eight-week to 52-week studies

Summary

Introduction

Sleep problems are increasingly becoming prevalent in children, as recent data found that about 50% of children from four to 12 years old have different sleep issues [1]. Sleep disturbances co-occur with psychiatric disorders including attention-deficit hyperactivity disorder (ADHD), autism spectrum disease (ASD), anxiety disorders, and major depressive disorder (MDD) [2]. Non-pharmacologic treatment for sleep problems in children with psychiatric disorders includes behavioral therapy, like graduated extinction, bedtime routine, scheduled awakening, positive routine, and parent education [11,12,13]. We will do a qualitative synthesis of past randomized controlled trials (RCTs) conducted on melatonin in the pediatric population and to evaluate the overall efficacy and safety of melatonin for managing insomnia in ASD and neurodevelopmental disorder. How to cite this article Parvataneni T, Srinivas S, Shah K, et al (May 28, 2020) Perspective on Melatonin Use for Sleep Problems in Autism and Attention-Deficit Hyperactivity Disorder: A Systematic Review of Randomized Clinical Trials.

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Conclusions

Findings

Disclosures