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

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

Authors
Mombelli, S. Bacaro, V. Curati, S. Berra, F. Sforza, M. Castronovo, V. Ferini-Strambi, L. Galbiati, A. Baglioni, C.
Year
2023
Journal
Sleep Medicine Reviews
Volume
70
Pages
101806
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.

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Type of intervention

Preventive- and Promotive Health Interventions

Early Intervention

Treatment and Child Welfare Interventions

Topic

Mental Health Problems and Disorders

Other Problems

Sleep Disorders

Intervention

Psychological Treatments

Cognitive Behavioral Therapy, Behavioral Therapy and Cognitive Therapy

Psychoeducational Interventions

Alternative Treatment

Nutritional Supplements and Nutrition

Age group

Infants and Toddlers (0-2 years)

Preschool Aged Children (3-5 years)

School Aged Children (6-12 years)

Adolescents (13-18 years)

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