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Rolling J, Rabot J, Schroder CM. Melatonin Treatment for Pediatric Patients with Insomnia: Is There a Place for It? Nat Sci Sleep 2022; 14:1927-1944. [PMID: 36325278 PMCID: PMC9621019 DOI: 10.2147/nss.s340944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/18/2022] [Indexed: 01/24/2023] Open
Abstract
Sleep is a vital physiological function that is impaired in ranges from 10% in the typically developing pediatric population to over 80% in populations of children with neurodevelopmental disorders and/or psychiatric comorbidities. Pediatric insomnia disorder is an increasing public health concern given its negative impact on synaptic plasticity involved in learning and memory consolidation but also on mood regulation, hormonal development and growth, and its significant impact on quality of life of the child, the adolescent and the family. While first-line treatment of pediatric insomnia should include parental education on sleep as well as sleep hygiene measures and behavioural treatment approaches, pharmacological interventions may be necessary if these strategies fail. Melatonin treatment has been increasingly used off-label in pediatric insomnia, given its benign safety profile. This article aims to identify the possible role of melatonin treatment for pediatric insomnia, considering its physiological role in sleep regulation and the differential effects of immediate release (IR) versus prolonged release (PR) melatonin. For the physician dealing with pediatric insomnia, it is particularly important to be able to distinguish treatment rationales implying different dosages and times of treatment intake. Finally, we discuss the benefit-risk ratio for melatonin treatment in different pediatric populations, ranging from the general pediatric population to children with different types of neurodevelopmental disorders, such as autism spectrum disorder or ADHD.
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Affiliation(s)
- Julie Rolling
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
- CNRS UPR3212- Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, Strasbourg, France
| | - Juliette Rabot
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
- CNRS UPR3212- Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, Strasbourg, France
- Expert Centre for High-Functioning Autism, Fondation FondaMental, Strasbourg, France
- Autism Resources Centre 67 for Children and Adolescents, Strasbourg, France
| | - Carmen M Schroder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
- CNRS UPR3212- Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, Strasbourg, France
- Expert Centre for High-Functioning Autism, Fondation FondaMental, Strasbourg, France
- Autism Resources Centre 67 for Children and Adolescents, Strasbourg, France
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Approches thérapeutiques des troubles du sommeil et des rythmes chez l’enfant avec TSA. Encephale 2022; 48:294-303. [DOI: 10.1016/j.encep.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/12/2021] [Accepted: 08/20/2021] [Indexed: 12/27/2022]
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Geoffroy PA, Micoulaud Franchi JA, Lopez R, Schroder CM. The use of melatonin in adult psychiatric disorders: Expert recommendations by the French institute of medical research on sleep (SFRMS). L'ENCEPHALE 2019; 45:413-423. [PMID: 31248601 DOI: 10.1016/j.encep.2019.04.068] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/08/2019] [Indexed: 12/11/2022]
Abstract
Melatonin is a hormone secreted by the pineal gland at night. This hormone has many physiological functions, the main one being to synchronise individuals' biological rhythms. Exogenous melatonin has the same chronobiotic action, even at small doses (0.125mg). In addition, a sleep-inducing (soporific) action appears to occur in a dose-effect relationship, i.e. as the dose increases. In psychiatric disorders, these two effects could have interesting applications in clinical practice. The French institute of medical research on sleep (SFRMS) appointed a group of experts to conduct a consensus conference to study the indications of melatonin and the conditions of its prescription. An account of the conclusions on adult psychiatric disorders (presented orally at the Congress on Sleep in Marseille, 23 November 2017) is given here. Exogenous melatonin proves to be useful among patients with a stabilized psychiatric disorder or in remission, to prevent relapse in case of associated complaints of insomnia, poor quality sleep or delayed sleep phase syndrome. During acute phases, melatonin could be used as an adjuvant treatment when there are insomnia symptoms, in mood disorders (bipolar disorder, major depressive disorder, seasonal affective disorder), in attention deficit hyperactivity disorder (ADHD), in peri-surgical anxiety and in schizophrenia. In somatoform disorders, melatonin is a possible treatment for painful symptoms in fibromyalgia, irritable bowel syndrome, functional dyspeptic syndrome and temporomandibular joint dysfunction.
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Affiliation(s)
- P A Geoffroy
- Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), University Hospital, 1, place de l'hôpital, 67000 Strasbourg, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5, rue Blaise-Pascal, 67000 Strasbourg, France; Paris Diderot University - Paris VII, 5, rue Thomas-Mann, 75013 Paris, France.
| | - J-A Micoulaud Franchi
- Services d'explorations fonctionnelles du système nerveux, clinique du sommeil, CHU de Bordeaux, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, université de Bordeaux, CHU de Pellegrin, 33076 Bordeaux, France
| | - R Lopez
- Unité des troubles du sommeil, département de neurologie, centre national de référence narcolepsie, hypersomnies rares, hôpital Gui de Chauliac, 34000 Montpellier, France; Inserm U1061, 34000 Montpellier, France
| | - C M Schroder
- Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), University Hospital, 1, place de l'hôpital, 67000 Strasbourg, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5, rue Blaise-Pascal, 67000 Strasbourg, France; Department of Child and Adolescent Psychiatry, Strasbourg University Hospital, 1, place de l'hôpital, 67091 Strasbourg cedex, France
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Peter-Derex L. Sonno normale. Neurologia 2018. [DOI: 10.1016/s1634-7072(18)91374-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Martin T, Gauthier A, Ying Z, Benguigui N, Moussay S, Bulla J, Davenne D, Bessot N. Effect of sleep deprivation on diurnal variation of vertical perception and postural control. J Appl Physiol (1985) 2018. [PMID: 29543136 DOI: 10.1152/japplphysiol.00595.2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to test the effect of total sleep deprivation on performance and time-of-day pattern of subjective visual vertical (SVV) and postural control. Nineteen healthy, young participants (4 women and 15 men 21.9 ± 1.2 yr) were engaged in two counterbalanced experimental sessions with or without total sleep deprivation. Oral temperature, Karolinska Sleepiness Scale, and visual analogic scale for fatigue, postural control, and SVV were randomly measured every 4 h, from 0600 to 2200. A linear mixed model was used to capture the effect of time of day and sleep condition as factors. A classical adjusted COSINOR function was then used to modelize this daily variation. After the control night of sleep, SVV as well as oral temperature, sleepiness, and fatigue showed significant time-of-day variation, contrasting with measures of postural control which remained stable across the day. After sleep deprivation, SVV showed no diurnal variation, but its mean deviation value increased by 29%. Postural control capability also decreased after sleep deprivation, with a higher center of pressure surface (+70.4%) and total length (+7.37%) but remained stable throughout the day. These results further confirm the negative effect of sleep loss on postural control capability. Even if a direct relationship cannot be confirmed, the disruption of SVV capacity after sleep deprivation could strongly play a role in postural control capacity changes. Sleep deprivation should be considered as a potent factor involved in balance loss and subsequent fall. NEW & NOTEWORTHY The topic of sleep deprivation and postural control is not understood, with discrepancy among results. This study described that postural control displays a stable level throughout the day and that sleep deprivation, even if it increases postural sway, does not affect this stable diurnal pattern. The modification of the perception of the vertical level after sleep deprivation could strongly play a role in the observed changes in postural control capacity.
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Affiliation(s)
- T Martin
- Normandie University, UNICAEN, INSERM, COMETE, Caen , France
| | - A Gauthier
- Normandie University, UNICAEN, INSERM, COMETE, Caen , France
| | - Z Ying
- Normandie University, UNICAEN, INSERM, COMETE, Caen , France
| | - N Benguigui
- Université de Caen Basse-Normandie, EA4260 CESAMS, Caen, France
| | - S Moussay
- Normandie University, UNICAEN, INSERM, COMETE, Caen , France
| | - J Bulla
- Department of Mathematics, University of Bergen , Bergen , Norway
| | - D Davenne
- Normandie University, UNICAEN, INSERM, COMETE, Caen , France
| | - N Bessot
- Normandie University, UNICAEN, INSERM, COMETE, Caen , France
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La mélatonine et ses agonistes : un traitement adjuvant d’intérêt dans le trouble bipolaire ? ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.msom.2016.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gronfier C. Physiologie de l’horloge circadienne endogène : des gènes horloges aux applications cliniques. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.msom.2009.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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