TOPLINE:

Melatonin use had inconsistent results in improving sleep and relieving itching among children with atopic dermatitis (AD), a caregiver survey found. 

METHODOLOGY:

• Researchers conducted a cross-sectional survey of 102 caregivers of children with AD (median age, 5.5 years; 43.1% girls; 54.9% White, 14.7% Black, and 15.7% multiracial) at Boston Children’s Hospital, Boston, from April to December 2024.
• The median age at AD diagnosis was less than 1 year, and sleep disturbance scores of children with AD were significantly higher than those of the general pediatric population.
• Comorbidities included anxiety (11.8%), attention-deficit/hyperactivity disorder (7.8%), mood disorder (2.9%), autism spectrum disorder (2.0%), other behavioral disorders (2.0%), and sleep disorder (0.98%).
• Melatonin efficacy was assessed using the Patient-Oriented Eczema Measure, the Patient-Reported Outcomes Measurement Information System Early Childhood Parent Report Sleep Problems-Disturbance, and sleep questionnaires.

TAKEAWAY:

• Overall, 27.5% of children with AD reported melatonin use, with lifetime use being the highest in children aged 5-9 years (46.4%) and 14-17 years (38.5%; P = .01) and those with vs without comorbidities (56.3% vs 22.1%; P = .012).
• All melatonin products were purchased over the counter, and gummies were the most common formulation (85.7%); the dose range was 0.5-10 mg (median, 3 mg).
• Only 32.1% of caregivers followed professional advice to start melatonin compared with 50.0% who started it independently. 53.5% and 32.2% caregivers reported melatonin as very or somewhat effective for sleep and itch, respectively.
• Melatonin users had significantly higher sleep disturbance scores than nonusers (P < .001) and were less likely to go to bed at the same time each night than those who had never used it (P = .039).

IN PRACTICE:

“Melatonin is widely used in children with AD, with high rates of self-directed initiation, considerable variability in dosing, and mixed caregiver perceptions of effectiveness,” the authors wrote. “Further research — including RCTs [randomized controlled trials] and longitudinal studies — is needed to clarify melatonin’s effect on sleep disturbance and to better define its potential role in the management of children with AD,” they added.

SOURCE:

The study was led by Sarah Lee of Harvard Medical School, Boston, and was published online on September 9 in Pediatric Dermatology.

LIMITATIONS:

The single-center design and reliance on caregiver report limited the generalizability of the findings. Sleep outcomes were not objectively measured, and reasons for discontinuation were not captured. Selection bias may also have influenced results.

DISCLOSURES:

The study received no specific funding. Three authors reportedserving as consultants and investigators and being on advisory boards for Global Parents for Eczema Research; Regeneron Pharmaceuticals, Inc.; Emerald Innovations; Triveni Bio; and the National Eczema Association. The remaining authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.