Prolonged-Release Melatonin for Sleep Disturbances in Autism Spectrum Disorder

• 발행기관: 대한소아신경학회
• 저자명: Eva Arias Vivas Adrián García Ron Elena González Alguacil Marta Bote Gascón María Teresa de Santos Moreno Elsa Santana Cabrera Guillermo Ruiz-Ocaña de las Cuevas Juan José García Peñas Rafael Sánchez-del Hoyo Víctor Soto Insuga
• 간행물 정보: 『Annals of Child Neurology(구 대한소아신경학회지)』vol.33 no.1, 1~7쪽, 전체 7쪽
• 주제분류: 의약학 > 소아과학
• 파일형태: PDF
• 발행일자: 2025.01.31

국문 초록

Purpose: Patients with autism spectrum disorder (ASD) often present with sleep disturbances. We evaluated the effectiveness of pediatric prolonged-release melatonin (PedPRM) in real clinical practice, focusing on a population of complex neuropediatric patients with highly refractory insomnia in Spain. Methods: The patients were aged 2 to 18 years, diagnosed with ASD, had sleep maintenance insomnia and/or early morning awakening insomnia, and were refractory to prior therapy. The starting dose of PedPRM was 2 or 5 mg (increased to 10 mg, if necessary). Evaluation at 6 months consisted of a sleep diary, the Sleep Disturbance Scale for Children (SDSC), the Pediatric Daytime Sleepiness Scale (PDSS), and the Clinical Global Impression Scale of Improvement (CGI-I) and Severity (CGI-S). Results: The median age of the 23 patients was 11.0 years, 56.5% were male, 73.9% had epilepsy, and 78.3% had intellectual disability. One patient discontinued treatment. The mean total sleep time did not change significantly. PedPRM improved sleep latency (median 30.0 to 15.0 minutes; P=0.001) and reduced the number of nocturnal awakenings (median 3.00 to 1.0; P<0.001). PedPRM significantly improved PDSS scores (14.6±4.5 to 10.4±3.5; P<0.001) and SDSC total scores (75.1±12.9 to 61.6±10.9; P<0.001). The CGI-I scale improved in 73.3% of patients; 46.7% of patients were normal, borderline, or mildly ill per CGI-S scale at the end of treatment. Conclusion: In real clinical practice, PedPRM significantly improved sleep parameters in patients with ASD who were heavily medicated for comorbidities and were highly refractory to other insomnia treatments.

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Introduction

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키워드

Sleep initiation and maintenance disorders Autism spectrum disorder Melatonin Sleep latency Spain Sleep