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Investigating the Use of Melatonin in Children With Atopic Dermatitis: A Cross-Sectional Study
Sarah Lee1, Eun Jae Kim1, Jennifer LeBovidge1,2
1Harvard Medical School, Boston, Massachusetts, USA.
Insights
Many children with atopic dermatitis (AD) use melatonin, often without professional guidance. Caregiver-reported effectiveness for sleep and itch is mixed, warranting further research into its role in AD management.
Area of Science:
- Pediatric Dermatology
- Sleep Medicine
- Pharmacology
Background:
- Atopic dermatitis (AD) commonly causes sleep disturbances in children.
- Melatonin, an over-the-counter sleep aid, is increasingly used in pediatric populations.
- The prevalence and effectiveness of melatonin in children with AD are not well-established.
Purpose of the Study:
- To investigate the prevalence of melatonin use in children with AD.
- To assess caregiver-reported reasons for initiating melatonin use.
- To evaluate the perceived effectiveness of melatonin for sleep and itch in pediatric AD.
Main Methods:
- Caregivers of children (ages 1-17) with diagnosed AD completed surveys.
- Surveys included questions on melatonin use, Patient Oriented Eczema Measure (POEM), and sleep quality.
- Data analysis compared melatonin users and non-users, considering comorbidities and sleep scores.
Main Results:
- 27.5% of caregivers reported prior melatonin use; 10.8% used it in the past month.
- Gummies were the most common form; dosages varied widely (0.5-10mg).
- Melatonin use was higher in children with behavioral comorbidities and associated with poorer sleep scores. Perceived effectiveness was mixed.
Conclusions:
- Melatonin use is prevalent in children with AD, often initiated without healthcare professional guidance.
- Dosage and formulation of melatonin vary significantly.
- Further research is needed to determine melatonin's efficacy and safety in managing sleep disturbances and itch in pediatric AD.
Background/Objectives:
Children with atopic dermatitis (AD) frequently experience sleep disturbances. Melatonin, an over-the-counter supplement, is increasingly used in the general pediatric population; however, its prevalence and perceived effectiveness in children with AD remain unclear.
Methods:
Caregivers of pediatric patients (ages 1-17 years) with physician-diagnosed AD completed surveys on melatonin use, Patient Oriented Eczema Measure (POEM), and age-appropriate sleep questionnaires.
Results:
Among 102 total respondents, 27.5% reported a history of melatonin use, with 10.8% using it in the past 30 days. Gummies were the most common formulation (85.7%), though brands and dosages varied widely (0.5-10 mg; median: 3 mg). 32.1% of caregivers initiated melatonin based on a healthcare professional's recommendations, while the majority initiated use independently (50.0%) or based on recommendations from friends/family (21.4%) or online resources (7.1%). Melatonin use was significantly more common among children with behavioral or psychological comorbidities compared to those without (56.3% vs. 22.1%; p = 0.012). Children ages 6-17 who used melatonin had significantly higher PROMIS Sleep Disturbance scores than nonusers (p < 0.001). Perceived effectiveness varied: for sleep, 21.4% of caregivers found melatonin very useful, 32.1% somewhat useful, and 39.3% of little or no use. For nocturnal itch, 14.3% found melatonin very useful, 17.9% somewhat useful, and 50.0% of little or no use.
Conclusions:
There is a high prevalence of melatonin use among children with AD. Most caregivers are initiating melatonin independently, and dosage varies widely. Given mixed caregiver-reported effectiveness of melatonin and limited long-term safety data, it is imperative that further studies are performed to evaluate melatonin's role in children with AD.
