Abstract
Background/purpose
Melatonin, an indoleamine secreted by the pineal gland, plays a key role in regulating
circadian rhythm. It has chronobiotic, antioxidant, anti-inflammatory and free radical
scavenging properties.
Methods
A conference in Rome in 2014 aimed to establish consensus on the roles of melatonin
in children and on treatment guidelines.
Results and Conclusion
The best evidence for efficacy is in sleep onset insomnia and delayed sleep phase
syndrome. It is most effective when administered 3–5 h before physiological dim light
melatonin onset. There is no evidence that extended-release melatonin confers advantage
over immediate release. Many children with developmental disorders, such as autism
spectrum disorder, attention-deficit/hyperactivity disorder and intellectual disability
have sleep disturbance and can benefit from melatonin treatment. Melatonin decreases
sleep onset latency and increases total sleep time but does not decrease night awakenings.
Decreased CYP 1A2 activity, genetically determined or from concomitant medication,
can slow metabolism, with loss of variation in melatonin level and loss of effect.
Decreasing the dose can remedy this. Animal work and limited human data suggest that
melatonin does not exacerbate seizures and might decrease them. Melatonin has been
used successfully in treating headache. Animal work has confirmed a neuroprotective
effect of melatonin, suggesting a role in minimising neuronal damage from birth asphyxia;
results from human studies are awaited. Melatonin can also be of value in the performance
of sleep EEGs and as sedation for brainstem auditory evoked potential assessments.
No serious adverse effects of melatonin in humans have been identified.
Keywords
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Article info
Publication history
Published online: December 17, 2014
Accepted:
December 9,
2014
Received:
November 30,
2014
Identification
Copyright
© 2014 European Paediatric Neurology Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Paediatric use of melatoninEuropean Journal of Paediatric NeurologyVol. 19Issue 4
- PreviewA recent review in the European Journal of Paediatric Neurology by Bruni et al.,1 discussed the current role of melatonin in paediatric neurology and offered clinical recommendations. The authors wrote in the abstract that melatonin decreases sleep onset latency and increases total sleep time. Furthermore they wrote that no serious adverse effects of melatonin in humans have been identified.
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