HormonesMelatonin

Outpatient melatonin use is associated with a small reduction in REM sleep percentage in children

In a propensity score-matched cross-sectional study of 684 children, melatonin users had a lower median percentage of REM sleep than nonusers (16.7% vs 19.0%, Hedges g = -0.22, FDR-corrected P = .003). No significant differences were found in total sleep time, non-REM sleep stages, respiratory indices, arousal index, periodic limb movements, or oxygen desaturation index.

Last updated: Aug 20, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Melatonin Use and Polysomnographic Sleep Architecture in Children.

observational

Juginovic A, Rodman L · JAMA network open (2026)

Participants: 684
Duration: N/A
Intervention: Outpatient melatonin use (prescription documented in medication list)
Outcome: REM sleep percentage (primary), plus 14 exploratory PSG parameters including total sleep time, sleep stages, respiratory indices, arousal index, periodic limb movements, oxygen desaturation index
Effect Size: Hedges g = -0.22 (95% CI, -0.32 to -0.11) for REM sleep percentage
Population: Children (mean age 8.0 years, 56.7% male) evaluated at a pediatric sleep laboratory, propensity-matched cohort of 684 children (342 users, 342 nonusers)

Result: In a propensity score-matched cross-sectional study of 684 children, melatonin users had a lower median percentage of REM sleep than nonusers (16.7% vs 19.0%, Hedges g = -0.22, FDR-corrected P = .003). No significant differences were found in total sleep time, non-REM sleep stages, respiratory indices, arousal index, periodic limb movements, or oxygen desaturation index.

PubMed: 42560676DOI: 10.1001/jamanetworkopen.2026.26983

Mechanism Graph

Melatonin may act on melatonin receptors in the suprachiasmatic nucleus to alter circadian timing
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Melatonin may influence REM sleep regulation through effects on neurotransmitter systems
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Melatonin may reduce REM sleep by altering the timing of sleep onset and REM latency
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Result: Reduced REM sleep percentage

Limitations

  • ⚠Cross-sectional design cannot establish causality
  • ⚠Residual confounding cannot be excluded, especially from psychiatric diagnoses and other unmeasured factors
  • ⚠Dose, timing, and adherence of melatonin use were not documented

Frequently Asked Questions

Does melatonin reduce REM sleep in children?▼

Yes, this study found a small reduction in REM sleep percentage (median 16.7% vs 19.0%) in children using melatonin compared to matched nonusers.

What other sleep parameters are affected by melatonin in children?▼

No significant differences were found in total sleep time, non-REM sleep stages, respiratory indices, arousal index, periodic limb movements, or oxygen desaturation index.

Is the reduction in REM sleep clinically significant?▼

The effect size was small (Hedges g = -0.22), and the clinical significance is uncertain. The association was attenuated when psychiatric diagnoses were added to the model.

What type of study was this?▼

This was a cross-sectional, propensity score-matched study using data from a pediatric sleep clinic population.

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References

  1. 1.Juginovic A, Rodman L. "Melatonin Use and Polysomnographic Sleep Architecture in Children.." JAMA network open, 2026. PMID: 42560676 DOI: 10.1001/jamanetworkopen.2026.26983
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.