Melatonin in sleepless children : everything has a rhythm?
Abstract
Every living organism has an biological clock regulating endogenous melatonin production, synchronized by exogenous impulses like daylight, temperature and feeding. Inappropriately applied bright light disturbs this melatonin rhythm. Some large swine producers apply artificial light three times a day for three hours; we compared the 24 hour melatonin rhythm of pigs in a large swine production unit with pigs in a farm with natural light schemes (chapter two). No significant differences were found comparing mean melatonin levels of both farms of different light and feeding phases. We measured salivary melatonin concentrations after a single dose melatonin at 11 a.m. in three patients with worsening sleep quality after initial good response to melatonin treatment (chapter three). These levels remained above 50 pg/mL, in contrast to levels found in three controls with sustained response to melatonin. After resuming melatonin treatment with a considerably lower dose sleep problems disappeared, suggestive of slow melatonin hepatic CYP1A2 metabolisation. In patients with loss of response to melatonin, a melatonin clearance test and a considerably dose reduction is advised. In chapter four the meta-analysis of the efficacy and safety of exogenous melatonin in advancing sleep-wake rhythm in patients with delayed sleep phase disorder is described. Five trials including 91 adults and four trials including 226 children showed that melatonin treatment advanced mean DLMO by 1.18 hours and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 226 participants or records.
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