{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:40:03Z","timestamp":1790098803609,"version":"4.0.1"},"reference-count":58,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>\n                    Sleep disturbances are commonly reported in children with persistent post-concussion symptoms (PPCS). Melatonin treatment is often recommended, yet supporting evidence is scarce. We aimed to evaluate the efficacy of treatment with melatonin for sleep disturbance in youth with PPCS following mild traumatic brain injury (mTBI). This article is a secondary analysis of a clinical trial of melatonin compared with placebo to treat PPCS. Youth (8\u201318 years of age) with PPCS and significant sleep-related problems (SRPs) at 4\u20136 weeks post-injury were eligible. Exclusion criteria: significant medical\/psychiatric history; previous concussion\/mTBI within 3 months. Treatment groups were: placebo, melatonin 3\u2009mg, or melatonin 10\u2009mg. Primary outcome was change in SRPs measured using the Post-Concussion Symptom Inventory (PCSI) after 2 weeks of treatment. Secondary outcomes included change in actigraphy sleep efficiency, duration, onset latency, and wake-after-sleep-onset. Behavior was measured using Behaviour Assessment for Children (2nd edition). Seventy-two participants (mean age 14.0, standard deviation [SD]\u2009=\u20092.6) years; 60% female) with PPCS and significant sleep disturbance were included in the secondary analysis: placebo (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200922); melatonin 3\u2009mg (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200925); melatonin 10\u2009mg (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200925). Sixty-four participants had actigraphy data. SRPs decreased across all groups over time with a significant effect of melatonin 3\u2009mg (3.7; 95% confidence interval [CI]: 2.1, 5.4) compared with placebo (7.4; 95% CI: 4.2, 10.6) and melatonin 10\u2009mg (6.4; 95% CI: 3.6, 9.2). Sleep duration increased in the melatonin 3\u2009mg (43\u2009min; 95% CI: 6, 93) and melatonin 10\u2009mg groups (55\u2009min; 95% CI: 5, 104) compared with placebo. A per protocol analysis demonstrated improved sleep efficiency in the melatonin 10\u2009mg group (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.029). No serious adverse events were reported. Depressive symptoms significantly decreased with melatonin 3\u2009mg (-4.7; 95% CI: \u22129.2, \u2212.2) but not with melatonin 10\u2009mg (\u22121.4, 95% CI: \u22125.9, 3.2) treatment compared with placebo. Changes in cognition or behavior were otherwise not significantly different between treatment groups. Short-term melatonin is a well-tolerated treatment for sleep disturbance in youth with PPCS following mTBI. In this context, it may also be associated with a reduction in depressive symptoms.\n                  <\/jats:p>","DOI":"10.1089\/neu.2020.7154","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T03:07:03Z","timestamp":1601348823000},"page":"950-959","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Efficacy of Melatonin for Sleep Disturbance in Children with Persistent Post-Concussion Symptoms: Secondary Analysis of a Randomized Controlled Trial"],"prefix":"10.1177","volume":"38","author":[{"given":"Karen Maria","family":"Barlow","sequence":"first","affiliation":[{"name":"Child Health Research Centre, University of Queensland Faculty of Medicine and Biomedical Sciences, South Brisbane, Queensland, Australia."},{"name":"Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Kirk","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Clinical Neurosciences, and Psychology, Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Joachim","family":"Esser","sequence":"additional","affiliation":[{"name":"Department of Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith Owen","family":"Yeates","sequence":"additional","affiliation":[{"name":"Department of Psychology and University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kirton","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Mikrogianakis","sequence":"additional","affiliation":[{"name":"McMaster Children's Hospital, Hamilton, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"MacMaster","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Pediatrics, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Nettel-Aguirre","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hutchison","sequence":"additional","affiliation":[{"name":"Critical Care Medicine and Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Turley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Clinical Neurosciences, and Psychology, Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice","family":"Cameron","sequence":"additional","affiliation":[{"name":"Research Pharmacy, Alberta Health Services, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roslyn","family":"Boyd","sequence":"additional","affiliation":[{"name":"Children's Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Dewey","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,5]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"403","article-title":"Sleep, sleep disorders, and mild traumatic brain 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