23 Nov Could Melatonin Improve Both Sleep and Skin in Atopic Dermatitis?
MedicalResearch.com Interview with:
Prof. Bor-Luen Chiang
Vice Superintendent, National Taiwan University Hospital
Professor of Graduate Institute of Clinical Medicine and Pediatrics
National Taiwan University
Attending Physician, Department of Medical research
National Taiwan University Hospital and
Yung-Sen Chang, MD MPH
Attending physician, Department of Pediatrics,
Taipei City Hospital Renai Br.
Adjunct Attending Physician, Department of Pediatrics
National Taiwan University Children’s Hospital
Adjunct Instructor, School of Medicine, National Yang-Ming University
Medical Research: What is the background for this study?
Prof. Chang: Sleep disturbance is a common disorder in the children with atopic dermatitis (AD) (reported in 47 to 60%), but no effective way of managing this problem had been established. In our preceding study, we found that lower nocturnal melatonin level was significantly associated with sleep disturbance in the patients with AD. Melatonin is a hormone secreted by the pineal gland which plays an important role in sleep regulation. In addition to sleep-inducing effects, melatonin also has anti-inflammatory and immunomodulatory properties which might be helpful for the management o fatopic dermatitis. Furthermore, melatonin has an excellent safety profile with minimal adverse effects, making it a good choice for children. Therefore, we aimed to evaluate whether melatonin is effective for improving the sleep problems and the dermatitis severity in children with atopic dermatitis.
Medical Research: What are the main findings?
Prof. Chang: From our double-blind, placebo-controlled crossover study, we found that after melatonin treatment, the sleep onset latency shortened by 21.4 minutes compared with placebo (from a mean of 44.9 minutes to 21.6 minutes). The Scoring Atopic Dermatitis Index (higher scores representing more severe dermatitis) also decreased by 9.9 compared with placebo (from a mean of 49.1 to 40.2). No adverse events were reported throughout the study.
Medical Research: What should clinicians and patients take away from your report?
Prof. Chang: Melatonin supplementation both shortened the sleep-onset latency and improved the dermatitis severity in children with atopic dermatitis, therefore it could be very helpful for the management of children with AD and sleep problems, especially those who have difficulty falling asleep. Although melatonin is available over the counter in many parts of the world, we would recommend parents to discuss with a doctor before putting kids with atopic dermatitis on melatonin. We would also like to remind parents that while melatonin might be helpful, adequate control of the dermatitis (with their medication and moisturizers) is still crucial if they want to improve their child’s sleep problems.
Medical Research: What recommendations do you have for future research as a result of this study?
Prof. Chang: Further studies are needed to find the optimal dose and duration of melatonin treatment for patients with atopic dermatitis. It would also be interesting to know if melatonin is also helpful for patients with sleep disturbance due to other allergic diseases (such as asthma and allergic rhinitis).
Chang Y, Lin M, Lee J, et al. Melatonin Supplementation for Children With Atopic Dermatitis and Sleep Disturbance: A Randomized Clinical Trial. JAMA Pediatr.Published online November 16, 2015. doi:10.1001/jamapediatrics.2015.3092.
Prof. Bor-Luen Chiang (2015). Could Melatonin Improve Both Sleep and Skin in Atopic Dermatitis?