School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand.
School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand; School of Clinical Medicine, Primary Care Clinical Unit, The University of Queensland, Brisbane, Australia.
Sleep Med. 2021 Apr;80:184-192. doi: 10.1016/j.sleep.2021.01.028. Epub 2021 Jan 22.
OBJECTIVE/BACKGROUND: Sleep problems in children on the autism spectrum are prevalent and persistent. Such problems are the result of a combination of biopsychosocial factors, including abnormal melatonin secretion. Exogenous melatonin is an empirically supported and popular treatment for sleep problems. However, we know little about rates of melatonin dispensing and associated variables. This study investigated rates of melatonin dispensing and the sociodemographic and child characteristics associated with its use in New Zealand.
This nationwide cross-sectional study used linked administrative health data obtained via the Integrated Data Infrastructure (IDI). Data were obtained for 11,202, 0-18 year old children on the autism spectrum. Descriptive data, and adjusted and unadjusted risk ratios, were calculated for sociodemographic and child characteristics.
Melatonin is accessed by almost one quarter of children on the autism spectrum in New Zealand, with higher observed rates among females and those aged between 5 and 11 years, of European ethnicity, and presenting with co-occurring mental health conditions.
Findings are largely consistent with research investigating both sleep disturbances and psychotropic drug use among children on the autism spectrum. High rates of melatonin use, age- and sex-related differences in its use, and the complexity associated with the presence of co-occurring conditions necessitates development of practice guidelines for melatonin dispensing. Further investigation into the duration of melatonin use and the interaction between child characteristics, co-occurring conditions, sociodemographic variables and melatonin dispensing is warranted.
目的/背景：自闭症谱系儿童普遍存在且持续存在睡眠问题。这些问题是生物心理社会因素综合作用的结果，包括褪黑素分泌异常。外源性褪黑素是一种经验证的、流行的治疗睡眠问题的方法。然而，我们对褪黑素的配药率及其相关变量知之甚少。本研究调查了新西兰褪黑素配药率及其与使用相关的社会人口学和儿童特征。
本全国性横断面研究使用通过综合数据基础设施（IDI）获得的关联行政健康数据。对 11202 名 0-18 岁自闭症谱系儿童进行了数据收集。对社会人口学和儿童特征进行了描述性数据以及调整和未调整的风险比计算。
新西兰近四分之一的自闭症谱系儿童使用褪黑素，女性和 5-11 岁、欧洲裔、伴有共病精神健康状况的儿童观察到的使用率较高。
这些发现与研究自闭症谱系儿童睡眠障碍和精神药物使用的研究基本一致。褪黑素使用率高、使用与年龄和性别相关的差异，以及与共病状况相关的复杂性，需要制定褪黑素配药的实践指南。进一步研究褪黑素的使用时间以及儿童特征、共病状况、社会人口学变量和褪黑素配药之间的相互作用是必要的。
