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Oral Melatonin for Non-Respiratory Sleep Disturbance in Children with Neurodisabilities: Systematic Review and Meta-Analyses

Lookup NU author(s): Dr Arabella Scantlebury, Gemma Spiers, Dr Matthew Thomas, Dr Kathleen Wright

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Aim: To evaluate the effectiveness of pharmacological interventions for managing non-respiratory sleep disturbances in children with neurodisabilities. Methods: Systematic review and meta-analyses of randomised controlled trials (RCTs). We searched 16 databases, grey literature and reference lists of included papers up to February 2017. Data were extracted and quality assessed by two researchers. Results: Thirteen RCTs were included, all evaluating oral melatonin. All except one were at high or unclear risk of bias. There was a statistically significant increase in diary-reported total sleep time (TST) for melatonin compared with placebo (pooled mean difference 29.6 minutes, 95% CI 6.9 to 52.4, p=0.01). Statistical heterogeneity was high (97%). For the single RCT with low risk of bias, the unadjusted mean difference in TST was 13.2 minutes (95% CI -13.3 to 39.7) favouring melatonin, while the mean difference adjusted for baseline TST was statistically significant (22.4 minutes, 95% CI 0.5 to 44.3, p=0.04). Adverse event profile suggested that melatonin was well-tolerated. Interpretation: There is limited evidence on managing sleep disturbances in children with neurodisabilities, and it is mostly of limited scope and poor quality. There is evidence of benefit and safety of melatonin compared with placebo, though the extent of this benefit is unclear.


Publication metadata

Author(s): Parker A, Beresford B, Dawson V, Elphick H, Fairhurst C, Hewitt C, Scantlebury A, Spiers G, Thomas M, Wright K, McDaid C

Publication type: Article

Publication status: Published

Journal: Developmental Medicine and Child Neurology

Year: 2019

Volume: 61

Issue: 8

Pages: 880-890

Print publication date: 01/08/2019

Online publication date: 01/02/2019

Acceptance date: 01/11/2018

Date deposited: 15/02/2019

ISSN (print): 0012-1622

ISSN (electronic): 1469-8749

Publisher: Wiley-Blackwell Publishing Ltd

URL: https://doi.org/10.1111/dmcn.14157

DOI: 10.1111/dmcn.14157


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