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      Safety issues regarding melatonin use in child and adolescent patients with sleep problems

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      https://www.riss.kr/link?id=A108400013

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      다국어 초록 (Multilingual Abstract)

      Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.
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      Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warra...

      Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.

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      참고문헌 (Reference)

      1 Gitto E, "Update on the use of melatonin in pediatrics" 50 : 21-28, 2011

      2 Li J, "Trends in use of melatonin supplements among US adults, 1999-2018" 327 : 483-485, 2022

      3 Hamrick SE, "The injury response in the term newborn brain: can we neuroprotect?" 16 : 147-154, 2003

      4 Matsumoto M, "The amplitude of endogenous melatonin production is not affected by melatonin treatment in humans" 22 : 42-44, 1997

      5 Carmassi C, "Systematic review of sleep disturbances and circadian sleep desynchronization in autism spectrum disorder : toward an integrative model of a self-reinforcing loop" 10 : 366-, 2019

      6 Malow BA, "Sleep, growth, and puberty after 2 years of prolonged-release melatonin in children with autism spectrum disorder" 60 : 252-261, 2021

      7 Martinez-Cayuelas E, "Sleep, chronotype, and behavior in adolescents with attention-deficit/hyperactivity disorder" 29 : 277-280, 2022

      8 Martinez-Cayuelas E, "Sleep problems and circadian functioning in children and adolescents with autism spectrum disorder" 126 : 57-64, 2022

      9 Weiss MD, "Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia" 45 : 512-519, 2006

      10 Moon E, "Role of melatonin in the management of sleep and circadian disorders in the context of psychiatric illness" 24 : 623-634, 2022

      1 Gitto E, "Update on the use of melatonin in pediatrics" 50 : 21-28, 2011

      2 Li J, "Trends in use of melatonin supplements among US adults, 1999-2018" 327 : 483-485, 2022

      3 Hamrick SE, "The injury response in the term newborn brain: can we neuroprotect?" 16 : 147-154, 2003

      4 Matsumoto M, "The amplitude of endogenous melatonin production is not affected by melatonin treatment in humans" 22 : 42-44, 1997

      5 Carmassi C, "Systematic review of sleep disturbances and circadian sleep desynchronization in autism spectrum disorder : toward an integrative model of a self-reinforcing loop" 10 : 366-, 2019

      6 Malow BA, "Sleep, growth, and puberty after 2 years of prolonged-release melatonin in children with autism spectrum disorder" 60 : 252-261, 2021

      7 Martinez-Cayuelas E, "Sleep, chronotype, and behavior in adolescents with attention-deficit/hyperactivity disorder" 29 : 277-280, 2022

      8 Martinez-Cayuelas E, "Sleep problems and circadian functioning in children and adolescents with autism spectrum disorder" 126 : 57-64, 2022

      9 Weiss MD, "Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia" 45 : 512-519, 2006

      10 Moon E, "Role of melatonin in the management of sleep and circadian disorders in the context of psychiatric illness" 24 : 623-634, 2022

      11 Walters AS, "Review of the possible relationship and hypothetical links between attention deficit hyperactivity disorder(ADHD)and the simple sleep related movement disorders, parasomnias, hypersomnias, and circadian rhythm disorders" 4 : 591-600, 2008

      12 Van Cauter E, "Physiology of growth hormone secretion during sleep" 128 (128): S32-S37, 1996

      13 Parvataneni T, "Perspective on melatonin use for sleep problems in autism and attention-deficit hyperactivity disorder : a systematic review of randomized clinical trials" 12 : e8335-, 2020

      14 Esposito S, "Pediatric sleep disturbances and treatment with melatonin" 17 : 77-, 2019

      15 Tauman R, "Melatonin production in infants" 26 : 379-382, 2002

      16 Erland LA, "Melatonin natural health products and supplements : presence of serotonin and significant variability of melatonin content" 13 : 275-281, 2017

      17 Abdelgadir IS, "Melatonin for the management of sleep problems in children with neurodevelopmental disorders : a systematic review and meta-analysis" 103 : 1155-1162, 2018

      18 Huysmans S, "Melatonin and sleep disorders : overview of literature and testing in psychiatric practice" 61 : 854-861, 2019

      19 Moon E, "Melatonergic agents influence the sleep-wake and circadian rhythms in healthy and psychiatric participants : a systematic review and meta-analysis of randomized controlled trials" 47 : 1523-1536, 2022

      20 Boafo A, "Medications for sleep disturbance in children and adolescents with depression : a survey of Canadian child and adolescent psychiatrists" 14 : 10-, 2020

      21 Sivan Y, "Low melatonin production in infants with a life-threatening event" 42 : 487-491, 2000

      22 Palm L, "Long-term melatonin treatment in blind children and young adults with circadian sleepwake disturbances" 39 : 319-325, 1997

      23 Yuge K, "Long-term melatonin treatment for the sleep problems and aberrant behaviors of children with neurodevelopmental disorders" 20 : 445-, 2020

      24 Hoebert M, "Long-term follow-up of melatonin treatment in children with ADHD and chronic sleep onset insomnia" 47 : 1-7, 2009

      25 Maras A, "Long-term efficacy and safety of pediatric prolonged-release melatonin for insomnia in children with autism spectrum disorder" 28 : 699-710, 2018

      26 Carr R, "Long-term effectiveness outcome of melatonin therapy in children with treatment-resistant circadian rhythm sleep disorders" 43 : 351-359, 2007

      27 de Zambotti M, "Insomnia disorder in adolescence : diagnosis, impact, and treatment" 39 : 12-24, 2018

      28 Badin E, "Insomnia : the sleeping giant of pediatric public health" 18 : 47-, 2016

      29 Fulia F, "Increased levels of malondialdehyde and nitrite/nitrate in the blood of asphyxiated newborns : reduction by melatonin" 31 : 343-349, 2001

      30 Fernandez E, "Factors and mechanisms for pharmacokinetic differences between pediatric population and adults" 3 : 53-72, 2011

      31 Johnson EO, "Epidemiology of DSM-IV insomnia in adolescence : lifetime prevalence, chronicity, and an emergent gender difference" 117 : e247-e256, 2006

      32 Ma ZR, "Efficacy of cognitive behavioral therapy in children and adolescents with insomnia : a systematic review and meta-analysis" 51 : e7070-, 2018

      33 Rzepka-Migut B, "Efficacy and safety of melatonin treatment in children with autism spectrum disorder and attention-deficit/hyperactivity disorder : a review of the literature" 10 : 219-, 2020

      34 Brandenberger G, "Effect of sleep deprivation on overall 24 h growth-hormone secretion" 356 : 1408-, 2000

      35 Kennaway DJ, "Development of melatonin production in infants and the impact of prematurity" 75 : 367-369, 1992

      36 Sonnier M, "Delayed ontogenesis of CYP1A2 in the human liver" 251 : 893-898, 1998

      37 Halder S, "Cognitive behavior therapy for children and adolescents : challenges and gaps in practice" 41 : 279-283, 2019

      38 Chellappa SL, "Circadian misalignment increases mood vulnerability in simulated shift work" 10 : 18614-, 2020

      39 Baron KG, "Circadian misalignment and health" 26 : 139-154, 2014

      40 Roberts RE, "Chronic insomnia and its negative consequences for health and functioning of adolescents : a 12-month prospective study" 42 : 294-302, 2008

      41 Friedrich JM, "Child and adolescent benzodiazepine exposure and overdose in the United States: 16 years of poison center data" 58 : 725-731, 2020

      42 이정현 ; 문은수, "Changes Caused by the Melatonergic System in Young Patients with Mood Disorders: A Literature Review" 대한우울조울병학회 19 (19): 1-10, 2021

      43 Zisapel N, "Assessing the potential for drug interactions and long term safety of melatonin for the treatment of insomnia in children with autism spectrum disorder" 15 : 175-185, 2022

      44 Crowley SJ, "An update on adolescent sleep : new evidence informing the perfect storm model" 67 : 55-65, 2018

      45 Hagenauer MH, "Adolescent changes in the homeostatic and circadian regulation of sleep" 31 : 276-284, 2009

      46 Bondopadhyay U, "A systematic review of sleep and circadian rhythms in children with attention deficit hyperactivity disorder" 26 : 149-224, 2022

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