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Lookup NU author(s): Dr Arabella Scantlebury, Gemma Spiers, Dr Matthew Thomas, Dr Kathleen Wright
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Aim: To evaluate the effectiveness of pharmacological interventions for managing non-respiratory sleep disturbances in children with neurodisabilities. Methods: Systematic review and meta-analyses of randomised controlled trials (RCTs). We searched 16 databases, grey literature and reference lists of included papers up to February 2017. Data were extracted and quality assessed by two researchers. Results: Thirteen RCTs were included, all evaluating oral melatonin. All except one were at high or unclear risk of bias. There was a statistically significant increase in diary-reported total sleep time (TST) for melatonin compared with placebo (pooled mean difference 29.6 minutes, 95% CI 6.9 to 52.4, p=0.01). Statistical heterogeneity was high (97%). For the single RCT with low risk of bias, the unadjusted mean difference in TST was 13.2 minutes (95% CI -13.3 to 39.7) favouring melatonin, while the mean difference adjusted for baseline TST was statistically significant (22.4 minutes, 95% CI 0.5 to 44.3, p=0.04). Adverse event profile suggested that melatonin was well-tolerated. Interpretation: There is limited evidence on managing sleep disturbances in children with neurodisabilities, and it is mostly of limited scope and poor quality. There is evidence of benefit and safety of melatonin compared with placebo, though the extent of this benefit is unclear.
Author(s): Parker A, Beresford B, Dawson V, Elphick H, Fairhurst C, Hewitt C, Scantlebury A, Spiers G, Thomas M, Wright K, McDaid C
Publication type: Article
Publication status: Published
Journal: Developmental Medicine and Child Neurology
Year: 2019
Volume: 61
Issue: 8
Pages: 880-890
Print publication date: 01/08/2019
Online publication date: 01/02/2019
Acceptance date: 01/11/2018
Date deposited: 15/02/2019
ISSN (print): 0012-1622
ISSN (electronic): 1469-8749
Publisher: Wiley-Blackwell Publishing Ltd
URL: https://doi.org/10.1111/dmcn.14157
DOI: 10.1111/dmcn.14157
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