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KMJ : Kosin Medical Journal

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Review articles
Safety issues regarding melatonin use in child and adolescent patients with sleep problems
Eunsoo Moon, Jung Hyun Lee
Kosin Med J. 2022;37(4):264-270.   Published online December 23, 2022
DOI: https://doi.org/10.7180/kmj.22.142
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Abstract PDFPubReader   ePub   
Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.
Sleep and vaccine administration time as factors influencing vaccine immunogenicity
Eun Seok Kim, Chi Eun Oh
Kosin Med J. 2022;37(1):27-36.   Published online March 29, 2022
DOI: https://doi.org/10.7180/kmj.22.014
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Abstract PDFPubReader   ePub   
The immunogenicity of vaccines is affected by host, external, environmental, and vaccine factors; in addition, sleep or circadian rhythms may also have effects. With the use of vaccines to mitigate the coronavirus disease 2019 (COVID-19) pandemic, research is underway to clarify what time of the day is optimal for COVID-19 vaccination and how disturbances of circadian rhythms will affect the immunogenicity of the vaccine in shift workers. Studies on the relationship between sleep time and the immunogenicity of vaccines for influenza and hepatitis have demonstrated that less sleep time and sleep deprivation tended to adversely affect immunogenicity. In some studies, there were even sex differences in these effects. When comparing shift workers with disturbances in their circadian rhythms and those who only worked during the day, one study found less antibody formation in shift workers; however, further studies on the relationship between shift work and the immunogenicity of vaccines are needed. Studies on the relationship between vaccine administration time and immunogenicity have shown different results according to age and sex. Therefore, future studies on vaccine administration time and immunogenicity may require an individualized approach for each vaccine and each population to be vaccinated. There is accumulating evidence on the effects of sleep and vaccine administration time on the immunogenicity of vaccines. However, further studies are needed to determine whether the association between immunogenicity and circadian rhythms and vaccine administration time can be used as a basis to increase the immunogenicity for individual vaccines.
Original articles
Related factors of Sleep of adult patients in hospital
Young Sook Tae, Jae Haeng Baek
Kosin Med J. 2003;18(1):112-127.
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Combined Effects of Individual Background and Job Stress on the Development of Sleep Problems in Blue-Collar Workers
Jin Guhn Sohn, Jin Ha Kim, Ho Chan Kim
Kosin Med J. 2006;21(1):248-255.
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KMJ : Kosin Medical Journal