Melatonin Applications in Pediatric Sleep Disorders

Melatonin, an endogenously produced indoleamine, plays a central role in synchronising the sleep–wake cycle in children. Its secretion by the pineal gland under dim-light conditions facilitates the onset of sleep and the progression of normal sleep architecture. In paediatric populations, exogenous melatonin has been used to correct delayed sleep phase disorders, reduce sleep onset latency, and improve total sleep time, particularly in children with neurodevelopmental disorders, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Clinical guidelines advocate a stepped approach, with behavioural and environmental interventions as first-line therapies and melatonin as an adjunct where these measures prove insufficient. Dosage regimens are tailored according to age, body weight and individual sleep disturbance profiles, with evening administration typically 30–60 minutes before bedtime. Short-term studies report minimal adverse effects, while emerging long-term data suggest sustained efficacy without significant impacts on pubertal development or neuroendocrine function. Nevertheless, standardisation of dosing protocols, rigorous safety monitoring and structured follow-up remain priorities to optimise outcomes and guide international practice.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Melatonin Applications in Pediatric Sleep Disorders publication trend

The graph below shows the total number of articles in melatonin applications in pediatric sleep disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Circadian rhythm: The endogenous 24-hour biological cycle that governs sleep–wake timing and hormone secretion.

Sleep onset latency: The interval between “lights out” and the transition to sleep, used to assess insomnia severity.

Delayed sleep–wake phase disorder: A circadian rhythm disruption characterised by a persistent delay in sleep timing relative to societal norms.

Neurodevelopmental disorders: A group of conditions, including ASD and ADHD, marked by atypical brain development and associated behavioural or cognitive impairments.

Chronobiotic: An agent that can shift the timing of internal biological rhythms, such as melatonin’s phase-advancing effect on the sleep–wake cycle.

References

1. Interventions for Disrupted Sleep Patterns and Insomnia in Pediatric and Adolescent Populations Diagnosed with ASD. Journal of Biomedical and Sustainable Healthcare Applications (2023).
2. Pediatric sleep disturbances and treatment with melatonin. Journal of Translational Medicine (2019).
3. Pediatric use of prescribed melatonin in Sweden 2006–2017: a register based study. European Child & Adolescent Psychiatry (2020).
4. Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review. Health Technology Assessment (2018).
5. Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder—A Review of the Literature. Brain Sciences (2020).
6. Long-term melatonin treatment for the sleep problems and aberrant behaviors of children with neurodevelopmental disorders. BMC Psychiatry (2020).
7. Efficacy and safety of supplemental melatonin for delayed sleep–wake phase disorder in children: an overview. Sleep Medicine X (2020).
8. Efficacy on sleep parameters and tolerability of melatonin in individuals with sleep or mental disorders: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews (2022).