Farmacoriflessioni
La melatonina: quale ruolo in Pediatria?
MELATONIN AND ITS PAEDIATRIC USE
ELENA VERUCCI, TANIA GERARDUZZI, FEDERICO MARCHETTI
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Università di Trieste
Giugno 2003 - pagg. 389 -392
Abstract
Melatonin is an hormone secreted by the pineal gland in relation to exposure to light. It regulates
sleep and circadian rhythm in mammals. Melatonin therapy in humans was first successfully
used in blind adults with sleep disturbances. More recently melatonin has been used
to treat jet-lag. We performed a review of the literature about the efficacy of melatonin in sleep
disorders in children with and without neurological impairment. In the former, melatonin
seems to be effective to treat difficulties in getting asleep but not fragmented sleep or early
morning wakening. Melatonin should be used with caution in any child with epilepsy in view
of the increased seizure frequency, which was shown in one study, although not confirmed
by other studies. In healthy children with chronic severe sleep problems the experience with
melatonin therapy is still insufficient, and further studies are needed.
Parole chiave
Classificazione MeSH
Bibliografia
1. Brzezinski A. Melatonin in humans. N Engl
J Med 1997;336:186-95.
2. Shocat T, Haimov I, Lavie P. Melatonin: the key to the gate of sleep. Ann Med1998;30:109- 14.
3. Middleton B, Arendt J, Stone BM. Complex effects of melatonin on human circadian rhythms in constant dim light. J Biol Rhytms 1997;12:467-77.
4. Lockley SW, Skene DJ, Arendt J, et al. Relationship between melatonin rhythms and visual loss in the blind. J Clin Endocrinol Metab 1997;82:3763-70.
5. Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev 2002;(2):CD001520.
6. Jan JE, Espezel H, Appleton RE. The treatment of sleep disorders with melatonin. Dev Med Child Neurol 1994;36:97-107.
7. Willey C, Phillips B. Is melatonin likely to help children with neurodevelopmental disability and chronic severe sleep problems? Arch Dis Child 2002;87:260.
8. Camfield P, Gordon K, Dooley J, et al. Melatonin appears ineffective in children with intellectual deficit and fragmented sleep: six “Nof- 1” trial. J Clin Neurol 1996;11:341-3.
9. Palm L, Blennow G, Wetterberg L. Longterm melatonin treatment in blind children and young adults with circadian sleep-wake disturbances. Dev Med Child Neurol 1997; 39:319-25.
10. Sheldon SH. Pro-convulsant effects of oral melatonin in neurologically disabled children. Lancet 1998;351:1254.
11. O’Callaghan FJ, Clarke AA, Hancock E, et al. Use of melatonin to treat sleep disorders in tuberous sclerosis. Dev Med Child Neurol 1999;41:123-6.
12. Dodge NN, Wilson GA. Melatonin for treatment of sleep disorders in children with developmental disabilities. J Clin Neurol 2001; 16:581-4.
13. McArthur AJ, Budden SS. Sleep dysfunction in Rett syndrome: a trial of exogenous melatonin treatment. Dev Med Child Neurol 1998;40(3):186-92.
14. Smits MG, Nagtegaal EE, van der Heijden J, et al. Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 2001;16(2):86-92.
15. Ivanenko A, Crabtree VM, Tauman R, Gozal D. Melatonin in children and adolescent with insomnia: a retrospective study. Clin Pediatr 2003;42(1):51-8
16. Peled N, Shorer Z, Peled E, Pillar G. Melatonin effect on seizures in children with severe neurologic deficit disorders. Epilepsia 2001; 42(9):1208-10.
2. Shocat T, Haimov I, Lavie P. Melatonin: the key to the gate of sleep. Ann Med1998;30:109- 14.
3. Middleton B, Arendt J, Stone BM. Complex effects of melatonin on human circadian rhythms in constant dim light. J Biol Rhytms 1997;12:467-77.
4. Lockley SW, Skene DJ, Arendt J, et al. Relationship between melatonin rhythms and visual loss in the blind. J Clin Endocrinol Metab 1997;82:3763-70.
5. Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev 2002;(2):CD001520.
6. Jan JE, Espezel H, Appleton RE. The treatment of sleep disorders with melatonin. Dev Med Child Neurol 1994;36:97-107.
7. Willey C, Phillips B. Is melatonin likely to help children with neurodevelopmental disability and chronic severe sleep problems? Arch Dis Child 2002;87:260.
8. Camfield P, Gordon K, Dooley J, et al. Melatonin appears ineffective in children with intellectual deficit and fragmented sleep: six “Nof- 1” trial. J Clin Neurol 1996;11:341-3.
9. Palm L, Blennow G, Wetterberg L. Longterm melatonin treatment in blind children and young adults with circadian sleep-wake disturbances. Dev Med Child Neurol 1997; 39:319-25.
10. Sheldon SH. Pro-convulsant effects of oral melatonin in neurologically disabled children. Lancet 1998;351:1254.
11. O’Callaghan FJ, Clarke AA, Hancock E, et al. Use of melatonin to treat sleep disorders in tuberous sclerosis. Dev Med Child Neurol 1999;41:123-6.
12. Dodge NN, Wilson GA. Melatonin for treatment of sleep disorders in children with developmental disabilities. J Clin Neurol 2001; 16:581-4.
13. McArthur AJ, Budden SS. Sleep dysfunction in Rett syndrome: a trial of exogenous melatonin treatment. Dev Med Child Neurol 1998;40(3):186-92.
14. Smits MG, Nagtegaal EE, van der Heijden J, et al. Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 2001;16(2):86-92.
15. Ivanenko A, Crabtree VM, Tauman R, Gozal D. Melatonin in children and adolescent with insomnia: a retrospective study. Clin Pediatr 2003;42(1):51-8
16. Peled N, Shorer Z, Peled E, Pillar G. Melatonin effect on seizures in children with severe neurologic deficit disorders. Epilepsia 2001; 42(9):1208-10.