Checa-Ros Ana, Muñoz-Hoyos Antonio, Molina-Carballo Antonio, Viejo-Boyano Iris, Chacín Maricarmen, Bermúdez Valmore, D'Marco Luis
Grupo de Investigación en Enfermedades Cardiorrenales y Metabólicas, Departamento de Medicina y Cirugía, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Santiago Ramón y Cajal s/n, Alfara del Patriarca, 46115 Valencia, Spain.
Aston Institute of Health & Neurodevelopment, School of Life & Health Sciences, Aston University, The Aston Triangle, Birmingham B4 7ET, UK.
Children (Basel). 2023 Jun 28;10(7):1121. doi: 10.3390/children10071121.
Only a few studies assessing the sleep effects of low doses of melatonin (aMT) have been performed in the past, most of them in adults, and only one in subjects with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to provide evidence of the changes induced by aMT doses as low as 1 mg in the sleep pattern of pediatric patients with ADHD under treatment with methylphenidate (MPH).
Children and adolescents (7-15 years) with ADHD who were receiving extended-release MPH were recruited. A seven-week sleep diary was collected prior to starting a four-week treatment with 1 mg of aMT (30 min before bedtime). Seven-day actigraphic assessments of sleep were performed before and after treatment.
Twenty-seven patients (17 males, 62.96%) participated in the study, who had been receiving MPH for 1.57 (1.11) months. A significant increase in sleep duration (TST) was observed after one month of treatment (463 (49) min to 485 (41) min; < 0.040), with nonsignificant improvements in sleep-onset latency (SOL), nocturnal awakenings, or sleep efficiency. Only minor adverse effects were reported.
Low doses of melatonin (1 mg) are able to increase TST in children and adolescents with ADHD receiving treatment with psychostimulants, with an adequate tolerability profile. Further placebo-controlled trials adjusting the time of aMT administration to the individual circadian profile should explore the effects of low doses of this hormone to shorten SOL in this population of patients.
过去仅有少数研究评估低剂量褪黑素（aMT）对睡眠的影响，其中大多数研究针对成年人，仅有一项研究针对注意力缺陷/多动障碍（ADHD）患者。本研究的目的是提供证据，证明低至1毫克的aMT剂量对正在接受哌甲酯（MPH）治疗的ADHD儿科患者睡眠模式的影响。
招募正在接受缓释MPH治疗的ADHD儿童和青少年（7 - 15岁）。在开始为期四周的1毫克aMT治疗（睡前30分钟）之前，收集为期七周的睡眠日记。在治疗前后进行为期七天的睡眠活动记录仪评估。
27名患者（17名男性，62.96%）参与了研究，他们接受MPH治疗的时间为1.57（1.11）个月。治疗一个月后观察到睡眠时间（TST）显著增加（从463（49）分钟增加到485（41）分钟；P<0.040），而入睡潜伏期（SOL）、夜间觉醒或睡眠效率无显著改善。仅报告了轻微的不良反应。
低剂量褪黑素（1毫克）能够增加接受精神兴奋剂治疗的ADHD儿童和青少年的TST，且耐受性良好。进一步的安慰剂对照试验，根据个体昼夜节律调整aMT给药时间，应探索低剂量这种激素对缩短该患者群体SOL的影响。
