# Effectiveness of melatonin supplementation for improving sleep quality and disease severity in children with atopic dermatitis: a systematic review and meta-analysis

## TL;DR

This study finds that melatonin helps children with eczema fall asleep faster and may slightly improve their skin condition, but more research is needed to confirm its long-term benefits.

## Contribution

A meta-analysis showing melatonin improves sleep onset and slightly reduces eczema severity in children, with no adverse effects.

## Key findings

- Melatonin reduced sleep onset latency in children with atopic dermatitis.
- Melatonin modestly improved disease severity scores but did not exceed the minimum clinically important difference.
- No significant effects on IgE levels or total sleep duration were observed.

## Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin condition causing pruritus, leading to sleep disturbance and poor quality of life, particularly in children. Effective adjunctive treatments addressing these issues are crucially needed.

To evaluate the effects of melatonin supplementation on sleep quality and disease severity in children with atopic dermatitis through a systematic review and meta-analysis.

A systematic review with meta-analysis was conducted using three randomized controlled trials (RCTs). Eligible studies compared melatonin supplementation (3–6 mg/day) to placebo. Data was analyzed using a random-effects model with mean differences and standardized mean differences reported at 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane Risk of Bias Tool 2.0, and heterogeneity was evaluated using I2 statistics.

Melatonin significantly reduced sleep onset latency with a pooled standard mean difference of −0.63 (95% CI: −1.00 to −0.26, p = 0.0009) and improved disease severity with a pooled mean difference in SCORAD scores of −6.60 (95% CI: −10.11 to −3.10, p = 0.0002), but this did not exceed the MCID and total SCORAD was non-significant. Heterogeneity for these outcomes was minimal (I2 = 0–4%). However, melatonin had no significant effect on IgE levels (SMD = −0.19, 95% CI: −0.46 to 0.09, p = 0.18) or total sleep duration (mean difference = 18.29 min, 95% CI: −10.31 to 46.88, p = 0.21). No adverse events were reported, confirming its safety profile.

Melatonin effectively improves sleep initiation in children with atopic dermatitis and may have modest effects on clinician-rated signs; the clinical importance remains uncertain. It appears safe, but further long-term studies are needed.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42023439385.