Efficacy on sleep parameters and tolerability of melatonin in individuals with sleep or mental disorders: A systematic review and meta-analysis

Matthew Salanitro; Torsten Wrigley; Hisham Ghabra; Edward de Haan; Catherine M Hill; Marco Solmi; Samuele Cortese

doi:10.1016/j.neubiorev.2022.104723

Efficacy on sleep parameters and tolerability of melatonin in individuals with sleep or mental disorders: A systematic review and meta-analysis

Neurosci Biobehav Rev. 2022 Aug:139:104723. doi: 10.1016/j.neubiorev.2022.104723. Epub 2022 Jun 9.

Authors

Matthew Salanitro¹, Torsten Wrigley², Hisham Ghabra², Edward de Haan³, Catherine M Hill⁴, Marco Solmi⁵, Samuele Cortese⁶

Affiliations

¹ University of Amsterdam, the Netherlands.
² University of Southampton, Southampton, UK.
³ Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain & Cognition (ABC) Center, University of Amsterdam, Amsterdam, the Netherland.
⁴ School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Sleep Medicine, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁵ Department of Psychiatry, University of Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, Ontario; Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
⁶ Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK. Electronic address: samuele.cortese@soton.ac.uk.

PMID: 35691474
DOI: 10.1016/j.neubiorev.2022.104723

Abstract

We conducted the first systematic review and series of meta-analyses to assess the efficacy and tolerability of melatonin in children/adolescents or adults with sleep or mental health disorders, using the same set of criteria across disorders and ages. Based on a pre-registered protocol (PROPSPERO: CRD42021289827), we searched a broad range of electronic databases up to 02.02.2021 for randomized control trials (RCTs) of melatonin. We assessed study quality using the Risk of Bias tool, v2. We included a total of 34 RCTs (21 in children/adolescents: N = 984; 13 in adults: N = 1014). We found evidence that melatonin significantly improved sleep onset latency and total sleep time, but not sleep awaking, in children and adolescents with a variety of neurodevelopmental disorders, and sleep onset latency (measured by diary) as well as total sleep time (measured with polysomnography) in adults with delayed sleep phase disorder. No evidence of significant differences between melatonin and placebo was found in terms of tolerability. We discuss clinical and research implications of our findings.

Keywords: ADHD; ASD; Melatonin; Neurodevelopmental; Sleep.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Adolescent
Child
Humans
Melatonin* / adverse effects
Neurodevelopmental Disorders*
Sleep
Sleep Wake Disorders* / drug therapy

Substances

Melatonin