Melatonin supplementation for children with atopic dermatitis and sleep disturbance: a randomized clinical trial.
Reviewer: Dr. Alan Gaby, MD
Author: Chang YS, et al
Reference: Melatonin supplementation for children with atopic dermatitis and sleep disturbance: a randomized clinical trial. JAMA Pediatr 2016;170:35-42.
Design: Randomized, double-blind, placebo-controlled crossover trial.
Participants: Seventy-three children and adolescents (aged 1-18 years; mean age, 7.5 years) with atopic dermatitis involving at least 5% of total body surface area and sleep disturbances.
Study Medication and Dosage: Melatonin (3 mg) or placebo every night at bedtime for 4 weeks. After a 2-week washout period, each child received the alternate treatment for an additional 4 weeks.
Primary Outcome Measures: Severity of atopic dermatitis and sleep-onset latency (i.e., the amount of time required to fall asleep).
Key Findings: During melatonin treatment, mean severity of atopic dermatitis decreased by 18% compared with baseline (p < 0.001 for the difference in the change between melatonin and placebo). Sleep-onset latency was 21 minutes shorter with melatonin than with placebo (p = 0.02).
Practice Implications: Sleep disturbances are common in children with atopic dermatitis. In the present study, administration of melatonin to children and adolescents with atopic dermatitis and sleep disturbances improved both the skin condition and the sleep problems. The safety of melatonin in children has not been well studied. However, one study found that treatment with melatonin for a mean duration of 3.1 years did not adversely affect sleep quality, puberty development, or mental health in prepubertal children.