褪黑素治疗神经发育障碍儿童的睡眠障碍：前瞻性观察性自然研究。
Melatonin for sleep disturbance in children with neurodevelopmental disorders: prospective observational naturalistic study.
作者信息
Ayyash Hani F, Preece Phillip, Morton Richard, Cortese Samuele
机构信息
Integrated Paediatrics, Child and Adolescent Mental Health Services, Cambridgeshire and Peterborough NHS Mental Health Foundation Trust, A Member of Cambridge University Health Partners, Winchester Place, Peterborough, PE3 6AP, UK.
出版信息
Expert Rev Neurother. 2015 Jun;15(6):711-7. doi: 10.1586/14737175.2015.1041511. Epub 2015 May 4.
BACKGROUND
Although melatonin is increasingly used for sleep disturbances in children with neurodevelopmental disorders, evidence on effective dose and impact on specific types of sleep disturbance is limited.
METHOD
We assessed 45 children (35 males, mean age: 6.3 ± 1.7 years) with neurodevelopmental disorders (n = 29: intellectual disability; n = 9: autism spectrum disorder; n = 7: attention-deficit/hyperactivity disorder) and sleep disturbances, treated with melatonin (mean duration: 326 days) with doses increased according to response.
RESULTS
Thirty-eight percent of children responded to low (2.5-3 mg), 31% to medium (5-6 mg) and 9% to high doses (9-10 mg) of melatonin, with a significant increase in total hours of sleep/night, decreased sleep onset delay and decreased number of awakenings/night (all: p = 0.001), as measured with sleep diaries. No serious adverse events were reported.
CONCLUSIONS
Melatonin is generally effective and safe in children with neurodevelopmental conditions. Increasing above 6 mg/night adds further benefit only in a small percentage of children.
背景
尽管褪黑素越来越多地用于治疗神经发育障碍儿童的睡眠障碍，但关于有效剂量以及对特定类型睡眠障碍影响的证据有限。
方法
我们评估了45名患有神经发育障碍（29名智力障碍；9名自闭症谱系障碍；7名注意力缺陷多动障碍）且有睡眠障碍的儿童（35名男性，平均年龄：6.3±1.7岁），他们接受了褪黑素治疗（平均疗程：326天），剂量根据反应增加。
结果
38%的儿童对低剂量（2.5 - 3毫克）褪黑素、31%对中等剂量（5 - 6毫克）、9%对高剂量（9 - 10毫克）有反应，根据睡眠日记测量，夜间总睡眠时间显著增加、入睡延迟减少且夜间觉醒次数减少（所有指标：p = 0.001）。未报告严重不良事件。
结论
褪黑素对患有神经发育疾病的儿童总体有效且安全。每晚剂量超过6毫克仅对一小部分儿童有进一步益处。
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