Melatonin Use and Polysomnographic Sleep Architecture in Children
Abstract
Importance: Melatonin is the most widely used sleep aid in children, yet no large study has examined its association with objective sleep architecture measured by polysomnography (PSG).
Objective: To assess whether outpatient melatonin use is associated with differences in PSG-derived sleep architecture in a pediatric sleep clinic population.
Design, setting, and participants: This cross-sectional, propensity score-matched study used the Nationwide Children's Hospital Sleep DataBank, a deidentified dataset of PSG recordings and linked electronic health record data from children evaluated at a single academic pediatric sleep laboratory between 2017 and 2019. Children with at least 1 technically adequate PSG and complete electronic health record data were included; children older than 18 years were excluded. Data were analyzed from January to March 2026.
Exposures: Outpatient melatonin prescription documented in the medication list.
Main outcomes and measures: The prespecified primary outcome was percentage of rapid eye movement (REM) sleep. Fourteen additional PSG parameters (sleep stages, respiratory indices, arousal index, periodic limb movements, oxygen desaturation index) were exploratory. Propensity score matching (1:1 nearest-neighbor, caliper 0.2 SD of the logit propensity score) on age, sex, body mass index percentile, comorbidity burden, obstructive sleep apnea, and epilepsy yielded 342 matched pairs (684 children). Outcomes were compared with 2-sided Wilcoxon…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 3,392 participants or records.
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