Department of Women's and Children's Health, Karolinska Institutet, SE, 171 76, Stockholm, Sweden; Region Stockholm, Health and Medical Care Administration, Box 6909, SE, 102 39, Stockholm, Sweden; Centre for Psychiatry Research, Stockholm Health Care Services, Region Stockholm, 113 30, Stockholm, Sweden.
Department of Neurology, Faculty of Medicine and Health, Örebro University, SE, 70182, Örebro, Sweden.
Eur J Paediatr Neurol. 2022 Jul;39:30-34. doi: 10.1016/j.ejpn.2022.05.007. Epub 2022 May 25.
Sleep disorder is common in children and adolescents, particularly in those with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). While non-pharmacological treatment is first line, occasionally an add-on of an oral drug is needed. The endogenous hormone melatonin is increasingly used for sleep disorders in children and adolescents. In this registry-based cohort study we follow dispensation of melatonin in young individuals, 0-25 years of age, in Stockholm, Sweden during 2016-2019. In all 9980 individuals, were dispensed melatonin in 2016 and followed for 3 years. Child psychiatrist was the most common prescribing specialty, 55% of all prescriptions. Only 20% had a recorded diagnosis of sleep disorder. The majority, 65% had a neuro psychiatric diagnose. Half of the individuals had at least 4 prescribed drugs dispensed during the follow-up. Almost half of our cohort were dispensed melatonin during the entire study period and doses and volumes of drug dispensed increased by 50 and 100%, respectively. Continuous medication was most common among children 6-12 years, where 7 out of 10 individuals were still adherent after three years. As long-term safety data is lacking, we find this concerning, and this illustrates the need of long-term follow-up of melatonin use in children and young individuals.
睡眠障碍在儿童和青少年中很常见，特别是在患有注意缺陷多动障碍（ADHD）或自闭症谱系障碍（ASD）的儿童中。虽然非药物治疗是首选，但偶尔需要添加口服药物。内源性激素褪黑素越来越多地用于治疗儿童和青少年的睡眠障碍。在这项基于登记的队列研究中，我们在 2016 年至 2019 年期间，在瑞典斯德哥尔摩观察了褪黑素在 0-25 岁年轻人中的使用情况。在所有 9980 名个体中，2016 年都有褪黑素处方，并随访了 3 年。儿童精神病医生是最常见的处方专科，占所有处方的 55%。只有 20%有睡眠障碍的记录诊断。大多数人（65%）有神经精神诊断。在随访期间，一半的人至少有 4 种处方药物。我们队列的近一半在整个研究期间都开了褪黑素，药物的剂量和用量分别增加了 50%和 100%。连续用药在 6-12 岁的儿童中最为常见，其中 10 个中有 7 个在 3 年后仍在坚持用药。由于缺乏长期安全性数据，我们对此表示担忧，这说明了需要对儿童和年轻人使用褪黑素进行长期随访。
