Abstract

Intrauterine exposure to maternal hyperglycemia increases the risk of pediatric obesity. While lifestyle modifications are standard interventions, they are often insufficient, particularly when accompanied by sleep disturbances. An 11-year-old boy, born to a mother with type 2 diabetes, presented with rapid weight gain and severe overeating starting at age 10. Despite strict dietary guidance and physical activity, his weight increased to 62 kg (BMI z-score: 2.44) within one month. Endocrine evaluations were normal, but severe sleep disturbances were observed. Suspecting that sleep dysregulation exacerbated his appetite control, melatonin (1 mg/day) was initiated to target sleep quality. Following treatment, parental reports noted marked improvements in sleep posture and nighttime awakenings, alongside a secondary reduction in overeating episodes and gradual weight reduction without adverse events. Melatonin improves sleep quality and circadian alignment, which may favorably influence energy balance and metabolic regulation. Melatonin administration may serve as a useful adjunct in managing pediatric obesity by optimizing sleep behavior, especially in children with prenatal vulnerabilities and secondary appetite dysregulation. Further studies are required to confirm these observations.