Effects of Melatonin and Bright Light Treatment in Childhood Chronic Sleep Onset Insomnia With Late Melatonin Onset: A Randomized Controlled Study

Apr 2, 2017Sleep

Melatonin and Bright Light Treatments for Children with Chronic Late Sleep Onset Insomnia: A Randomized Study

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Eighty-four children participated in a comparison of melatonin and bright light treatment for chronic sleep onset insomnia.

Both melatonin and light therapy reduced the time it took for children to fall asleep, as measured by sleep diaries.
Melatonin treatment resulted in greater advancements in sleep onset compared to light therapy.
Melatonin also advanced the Dim Light Melatonin Onset (DLMO) and improved sleep latency and sleep efficiency.
Light therapy did not show significant differences in chronic sleep reduction compared to placebo.
Wake after sleep onset was found to increase with melatonin treatment, indicating a potential side effect.

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STUDY OBJECTIVES: Chronic sleep onset insomnia with late melatonin onset is prevalent in childhood, and has negative daytime consequences. Melatonin treatment is known to be effective in treating these sleep problems. Bright light therapy might be an alternative treatment, with potential advantages over melatonin treatment. In this study, we compare the effects of melatonin and bright light treatment with a placebo condition in children with chronic sleep onset insomnia and late melatonin onset.

METHODS: Eighty-four children (mean age 10.0 years, 61% boys) first entered a baseline week, after which they received melatonin (N = 26), light (N = 30), or placebo pills (N = 28) for 3 to 4 weeks. Sleep was measured daily with sleep diaries and actigraphy. Before and after treatment children completed a questionnaire on chronic sleep reduction, and Dim Light Melatonin Onset (DLMO) was measured. Results were analyzed with linear mixed model analyses.

RESULTS: Melatonin treatment and light therapy decreased sleep latency (sleep diary) and advanced sleep onset (sleep diary and actigraphy), although for sleep onset the effects of melatonin were stronger. In addition, melatonin treatment advanced DLMO and had positive effects on sleep latency and sleep efficiency (actigraphy data), and sleep time (sleep diary and actigraphy data). However, wake after sleep onset (actigraphy) increased with melatonin treatment. No effects on chronic sleep reduction were found.

CONCLUSIONS: We found positive effects of both melatonin and light treatment on various sleep outcomes, but more and stronger effects were found for melatonin treatment.

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Effects of Melatonin and Bright Light Treatment in Childhood Chronic Sleep Onset Insomnia With Late Melatonin Onset: A Randomized Controlled Study

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