Exposure to Secondhand Aerosol From Electronic Cigarettes Among US Youth From 2015 to 2018.

Introduction:
This text summarizes a cross-sectional study on the association between sleep problems and melatonin use in school-aged children. The study found a significant relationship between subjectively reported and objectively estimated sleep problems and melatonin use in this population. However, the authors raise two major methodological concerns, including the failure to account for nonpharmacologic interventions and the potential influence of unmeasured confounding factors.

Key Points:

* The study used a cross-sectional design to examine the association between sleep problems and melatonin use in school-aged children.
* The study found a significant association between subjectively reported and objectively estimated sleep problems and melatonin use in school-aged children.
* The authors raise two major methodological concerns, including the failure to account for nonpharmacologic interventions and the potential influence of unmeasured confounding factors.
* The study did not account for nonpharmacologic interventions such as brief behavioral interventions and internet-based cognitive behavioral therapy, which may have led to biased associations between sleep problems and melatonin use.
* Unmeasured confounding factors, such as parental education level and family income, may also have influenced the results.
* The study highlights the importance of close and enhanced monitoring of currently freely available melatonin, as an estimated 1 in 17 children are likely to take melatonin at least once a week.
* The study did not assess the long-term safety and efficacy of melatonin use in children, and further research is needed to determine the potential risks and benefits of melatonin use in this population.

Main Message:

The study highlights the importance of considering nonpharmacologic interventions and accounting for potential confounding factors when examining the association between sleep problems and melatonin use in school-aged children. While the study found a significant association between sleep problems and melatonin use, further research is needed to determine the long-term safety and efficacy of melatonin use in this population. Healthcare providers should exercise caution when recommending melatonin for sleep problems in children, and close and enhanced monitoring of currently freely available melatonin is warranted.

Dai H. Exposure to Secondhand Aerosol From Electronic Cigarettes Among US Youth From 2015 to 2018. JAMA pediatrics. 2020;174(3):298-300. doi:10.1001/jamapediatrics.2019.5665