Melatonin treatment and light therapy for chronic sleep onset insomnia in children Effects on sleep, cognition, health, and psychosocial functioning

Melatonin treatment is known to be an effective treatment for chronic sleep onset problems in children, as it can advance the sleep-wake rhythm and improve sleep. However, it is currently not known how long melatonin treatment should be continued, while especially in young children, short term treatment is favourable over long term treatment.
This thesis discusses alternatives to long term melatonin use by describing the consequences of gradual termination of short term melatonin treatment, and applying a classical conditioning experiment to see whether this would help preserving the effects. Results showed that although melatonin indeed is effective in reducing sleep onset problems, effects disappear after treatment discontinuation.
Light therapy was examined as an alternative treatment to melatonin, by conducting a meta-analysis about the effects of light therapy on sleep. Results showed that light therapy was effective in the treatment of different types of sleep problems and for sleep problems in general, although most effect sizes were small to medium.
A randomised controlled trial was conducted to compare the effects of light therapy and melatonin with a placebo treatment. In addition, direct and indirect effects of melatonin treatment and light therapy on cognition, health and psychosocial functioning were examined. Results showed that both treatments positively influenced various sleep outcomes, but melatonin affected more outcomes and its effects were generally stronger. Health improved after melatonin treatment, and behaviour problems reduced after light therapy. Surprisingly, there was no evidence to support the hypothesis that these effects were caused by sleep improvement.