Sajith S G, Clarke D
Lea Castle Centre, Kidderminster, UK.
J Intellect Disabil Res. 2007 Jan;51(Pt 1):2-13. doi: 10.1111/j.1365-2788.2006.00893.x.
Melatonin is used to treat sleep disorders in both children and adults with intellectual disability (ID), although it has no product license for such use. The evidence for its efficacy, potential adverse effects and drug interactions are reviewed in the context of prescribing to people with ID.
A literature search was performed using multiple electronic databases. More literature was obtained from the reference lists of papers gathered through the searches.
Most of the studies were uncontrolled and the few controlled trials available were of small size. Melatonin appears effective in reducing sleep onset latency and is probably effective in improving total sleep time in children and adolescents with ID. It appears to be ineffective in improving night-time awakenings. Melatonin is relatively safe for short-term use. Its safety for long-term use is not established. Potential drug interactions, possible effects on puberty and concerns regarding the use of melatonin in epilepsy, asthma and depressive disorders are discussed.
Melatonin appears to be an effective sleep-initiator for children and adolescents with ID and probably has a similar effect for adults. There may be heterogeneity of response depending on the nature of the sleep problem and cause of the ID or associated disabilities. Further studies are necessary before firm conclusions can be drawn and guidelines for the use of melatonin for people with ID formulated.
褪黑素用于治疗患有智力障碍（ID）的儿童和成人的睡眠障碍，尽管其并无此类用途的产品许可。在为ID患者开处方的背景下，对其疗效、潜在不良反应及药物相互作用的证据进行了综述。
使用多个电子数据库进行文献检索。通过检索收集的论文参考文献列表中获取了更多文献。
大多数研究为非对照研究，现有的少数对照试验规模较小。褪黑素似乎在缩短患有ID的儿童和青少年的入睡潜伏期方面有效，并且可能在改善总睡眠时间方面有效。它在改善夜间觉醒方面似乎无效。褪黑素短期使用相对安全。其长期使用的安全性尚未确立。讨论了潜在的药物相互作用、对青春期可能的影响以及关于在癫痫、哮喘和抑郁症中使用褪黑素的担忧。
褪黑素似乎是患有ID的儿童和青少年有效的促眠剂，对成年人可能也有类似效果。根据睡眠问题的性质以及ID或相关残疾的病因，反应可能存在异质性。在得出确切结论并制定针对ID患者使用褪黑素的指南之前，有必要进行进一步研究。
