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Lack of sleep in children is a very difficult stress factor, especially in the case of children with disabilities. This can have severe detrimental effects on the family, particularly when already experiencing the stresses related to caring for a disabled child. Several approaches are available comprising both pharmacological and behavioural techniques. The exogenous use of melatonin, a hormone that is naturally found in the brain, has recently been gaining increasing attention in the treatment of many sleep disorders.1 The following review has been prepared exploring the current uses of melatonin in the paediatric population. A literature search in Medline and the Cochrane Library was conducted, utilising keywords such as “melatonin”, “children”, “paediatrics”, “uses”, “sleep disorders”, “EEG”, and “epilepsy”, and produced 61 references that were useful in compiling this review.
MELATONIN: A NATURAL HORMONE
Melatonin is a natural hormone that is synthesised in the pineal gland in the brain. Described as the “Dark Force”,2 melatonin is heavily dependent on the circadian rhythm generated by the light/dark cycle.3 This endogenous clock in the human brain induces the secretion of melatonin at night, reaching maximum plasma concentrations at 3–4 am. When the retinas in the eyes detect light, melatonin synthesis is inhibited, leading to secretion only when the subject is in darkness. In humans, melatonin is first detected in babies of 3–6 months. Production increases to a maximum at 1–5 years, and begins to decrease around the beginning of puberty.4
Melatonin was first isolated in the 1960s by Lerner5 who documented its hypnotic effects. Interest in this substance gradually began to increase, reaching a peak in the 1990s when melatonin was described as a “miracle drug” used to treat everything from jetlag to cancer as well as possessing an anti-aging effect.6 Although many of these claims were disputed,7 its hypnotic …