Non-pharmacological and melatonin interventions for pediatric sleep initiation and maintenance problems: A systematic review and network meta-analysis

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#humans #child #melatonin #sleep #sleep-initiation-and-maintenance-disorders

Non-pharmacological and melatonin interventions for pediatric sleep initiation and maintenance problems: A systematic review and network meta-analysis

Mombelli et al., 2023 | Sleep Med Rev | Systematic Review

Citation

Mombelli Samantha, Bacaro Valeria, ... Baglioni Chiara. Non-pharmacological and melatonin interventions for pediatric sleep initiation and maintenance problems: A systematic review and network meta-analysis. Sleep Med Rev. 2023-Aug;70:101806. doi:10.1016/j.smrv.2023.101806

Abstract

Sleep initiation and maintenance problems are common in the pediatric population and while behavioral interventions are recommended, their efficacy remains to be evaluated in clinical trials. We conducted a systematic review and network meta-analysis to assess the efficacy of non-pharmacological treatments and melatonin for sleep initiation and maintenance problems in healthy pediatric populations. We included 30 studies in the systematic review and 15 in the meta-analysis. Three network meta-analyses were conducted for sleep onset latency (SOL), wake after sleep onset (WASO), and total sleep time (TST). For SOL variable, the results support greater effectiveness of light therapy and melatonin than evidence-based psychological interventions, whether implemented in combination with light therapy or not. Regarding WASO variable, evidence-based psychological interventions and a combination of those techniques plus light treatment were the most efficacious. Finally, for TST variable, a larger effect was shown for the combined treatment of evidence-based psychological intervention with light therapy in comparison to other interventions. In conclusion, we found a high variability between study protocols likely impacting the results of the meta-analysis. Future randomized control trials studies, stratified by pediatric age classes, are needed in order to provide clear suggestions in clinical settings.

Key Findings

Future randomized control trials studies, stratified by pediatric age classes, are needed in order to provide clear suggestions in clinical settings.

Outcomes Measured

  • sleep onset latency

Population

Field Value
Population healthy pediatric
Sample Size 30
Age Range See abstract
Condition sleep

MeSH Terms

  • Humans
  • Child
  • Melatonin
  • Sleep
  • Sleep Initiation and Maintenance Disorders
  • Cognitive Behavioral Therapy

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article, Network Meta-Analysis
  • Vertical: melatonin-children

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09