A Little Help for Little Not-Sleepyheads

Melatonin for child sleep problems may slightly help kids with neurodevelopment disorders

(RxWiki News) Caring for a child with developmental or brain disorders presents challenges. One of these challenges may include sleeping problems. A common supplement may help a little.

A recent study found that melatonin helped children fall asleep faster if they had neurodevelopmental-related sleep problems. But they only got a little bit additional sleep overall.

"Ask your pediatrician about your child's sleep issues."

The study, led by Paul Gringras, a professor in pediatric sleep and neurodisability at King's College London and Evelina Children's Hospital in London, aimed to find out whether melatonin could help children with neurodevelopment disorders who had severe sleep issues as well.

The 12-week trial involved 146 children aged 3 to 15 who all had neurological or developmental disorders and some kind of severe sleep problem.

The children either did not fall asleep within an hour of lights out or else got less than 6 hours of continuous sleep and did not respond to sleep behavior suggestions provided to the parents before the study.

At 45 minutes before bedtime, half the children received melatonin, a manmade version of the hormone that human bodies release when it's bedtime, and half received a placebo (fake pill).

The children receiving melatonin initially got 0.5mg pills, which was gradually increased to 2 mg, 6 mg and/or 12 mg, depending on how they responded to the treatment.

Using parents' sleep diaries and actigraphs – watch-like devices to measure movement – the researchers assessed the children's total sleep time after three months.

Those taking melatonin gained an average 22 minutes according to parents' sleep diaries, or 13 minutes according to the actigraphs.

The melatonin also helped the children fall asleep faster by an average of 38 minutes according to the parents or an average 45 minutes according to the actigraphs.

The children who took melatonin, however, woke up an average 30 minutes earlier than those who took the placebo.

When the researchers assessed any changes in the children's behavior or family functioning, they found that both improved a little among the children who had taken melatonin, but the improvement was very small and possibly may have been due to chance.

The children were also very slightly less sleepy during the day, based on a standard sleepiness scale, but the improvement was again very small.

Although the sleep gains were not huge, they are a step in the right direction, according to William Kohler, the Medical Director of the Florida Sleep Institute in Spring Hill, Florida and Director of Pediatric Sleep Services at Florida Hospital Tampa.

"Children with neurodevelopment disorders are particularly prone to have sleep problems, typically insomnia," Dr. Kohler said. "This study is encouraging as far as showing improvement in children with these disorders."

He said that even though the authors downplayed the increased amount of sleep time, it is encouraging because this group of children is so difficult to treat.

The study's results mean that there may be potential for using melatonin successfully for these children. Perhaps tweaking the melatonin administration, such as giving it earlier, is a possibility.

Similar side effects were reported in both groups of children and were mild.

The study did not test slow-release melatonin pills or combined pills with other medications.

The study was published November 5 in the journal BMJ. The study was funded by the NIHR Health Technology Assessment program. The authors declared no conflicts of interest.

Review Date: 
November 8, 2012