How can melatonin be useful to school age children and adolescents with sleep onset delay?

Authors’ conclusions: melatonin demonstrated efficacy (sleep parameters) in school aged children and adolescents whit delayed sleep phase disorders: advancing sleep onset time, delayed latency, and others. An earlier time of administration could increase the effect. The adverse events rates were: low (none serious). Results in waking hours (cognition, general health, mood…): few improvements.

Reviewers' commentary: the results evidenced that melatonin did better than placebo. It could be used in selected cases of chronic sleep onset insomnia. Small benefit (doubtful clinical significance) that disappears after short-term treatment periods. Remain unproved: prolonged treatments (safety…); benefits in waking hours; recommendation of earlier time of administration. Patients with longer times of delay: not specifically investigated.

Evidences coming from few studies of small sample size, most of them not from healthy children (high percentages of: ADHD, comorbidities and stimulants drugs).