מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Children with developmental disabilities who have chronic sleep problems, fall asleep more quickly when they are given melatonin at bedtime, two physicians report.
Dr. Nancy N. Dodge, of the University of Texas Southwestern Medical Center at Dallas, and Dr. Gregory A. Wilson, of the Indiana University School of Medicine in Indianapolis, recruited 20 children ages 1 to 12 years for whom sleep problems were a major presenting complaint. Fifteen were diagnosed with cerebral palsy, two with autism, two with a genetic syndrome, and one with mental retardation.
In a randomized, double-blind, placebo-controlled trial, reported in the Journal of Child Neurology for August, patients were treated with melatonin 5 mg or with placebo for a 2-week period each, separated by a 1-week washout period.
Mean sleep latency decreased significantly while subjects were receiving melatonin (p < 0.05), with 18 children falling asleep more quickly. "Overall, the greater the sleep latency…was at baseline or when receiving placebo, the more pronounced was the decrease in sleep latency with melatonin," the investigators write.
Parents reported no significant side effects. Fifteen of the patients were prone to epileptic seizures, but no increase in seizure activity was reported during the course of the trial.
Dr. Dodge and Dr. Wilson point out that their results add to the impression offered by four other studies that melatonin positively affects sleep in at least some children with disabilities without causing significant adverse effects.
The physicians are careful, however, when recommending melatonin to parents to add the caveat that melatonin is treated as a supplement in the US rather than a pharmaceutical, and that they cannot vouch for any particular melatonin product.
Commenting to Reuters Health on these findings, Dr. Carl E. Hunt, director of the National Center on Sleep Disorders Research in Bethesda, Maryland, noted that the "benefits were modest at best, with unknown long-term consequences."
"In the short term, [melatonin] did help the children get to sleep more easily, but it did not change their total sleep time," he pointed out.
Dr. Hunt added that "we have no information in any age group as to negative aspects associated with taking melatonin long term, so my personal recommendation is that to pursue melatonin use in children or adults as part of a clinical research protocol is worthy of consideration."
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