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Clinical research: Melatonin relieves sleep problems in autism

by  /  4 July 2012

Sweet dreams: Children with autism have trouble falling asleep and spend less time in the rapid eye movement phase than typically developing children do.

Children who receive a combination of melatonin and behavioral therapy fall asleep faster and have better sleep quality than those who get either treatment alone or those on placebo, according to a study published 22 May in the Journal of Sleep Research1.

Many children with autism have difficulty falling asleep and sleeping through the night, and a study last year showed that children with the disorder spend less time in the rapid eye movement phase of sleep than controls do.

Lack of sleep can aggravate behavioral problems in children with the disorder. Sleep is also crucial for healthy brain development, underscoring the importance of sleep for these children.

A study published 19 May in Psychoneuroendocrinology built on these results by looking at the levels of melatonin in the urine of 46 teenagers with autism and 26 controls in a 24-hour period2.

Melatonin levels are known to be about three times higher at night than during the day. Teenagers with autism have a similar ratio, but have less melatonin in their urine than do controls at all times, the study found. This suggests that it is the production of the hormone, and not the circadian rhythm, that is disrupted in teenagers with the disorder.

In the new study, researchers treated 134 children with autism from 4 to 10 years of age for sleep problems. They divided the children into four groups: behavioral therapy alone, controlled-release melatonin alone, both melatonin and therapy, or placebo.

The therapy involved training parents during four weekly 50-minute sessions to help them manage negative behaviors surrounding sleep. For example, parents were taught how to maintain consistent sleep schedules and avoid late-day naps.

The researchers evaluated the children before and after 12 weeks of treatment, using a sleep monitoring system that uses movement to track how long it took them to fall asleep, how long they slept in total, how many times they woke during the night, and their sleep efficiency, defined as the ratio of sleep to time spent in bed. They also gave parents the Children’s Sleep Habits Questionnaire, and used a parental sleep diary to discard data from unusual nights, such as when the child was sick.

Melatonin or behavioral therapy alone each improves sleep, the study found. However, a combination of the two is the most effective. For example, on average, the children fell asleep about 52 minutes earlier after combined therapy, 36 minutes earlier after melatonin treatment and 17 minutes earlier after therapy alone. In contrast, those who got the placebo took, on average, 78 minutes to fall asleep before treatment and 80 minutes after.

Responses to the questionnaire suggest that melatonin affects the onset of sleep, night waking and sleep duration, whereas cognitive therapy alleviates sleep-related anxiety.

References:

1: Cortesi F. et al. J. Sleep Res. Epub ahead of print (2012) PubMed

2: Tordjman S. et al. Psychoneuroendocrinology Epub ahead of print (2012) PubMed


5 responses to “Clinical research: Melatonin relieves sleep problems in autism”

  1. savannah grove says:

    I have a three year old son that is autistic and I have been having a lot of trouble with him sleeping through the night I don’t know what to do and I need more the four hours a sleep he goes to a special school for half days and doesn’t take naps so after reading this I am going to try the melatonin but how much?help me

    • Lindsay B. says:

      Savannah i have a 4 year old daughter who is autistic and non verbal. I to havent slept more than 4 hrs at a time if that since she was born. I have been trying melatonin for the past couple weeks. It has made a huge difference. Not perfect but so much better. I only give .5 ml 30 mins before bed time.i give it in liquid form

  2. ZachHerbst10 says:

    Yes my 6 year old son fell asleep quicker

  3. Dr. Bernards says:

    It seems medical science have a lot more research to do on Melatonin but reading various research focusing on Melatonin’s benefits and side effects, I could say that too much light at night and genetic reasons for lower melatonin levels could be a key reason for autism and many other modern illnesses. Melatonin could also be the most important natural chemical/antioxidant that repairs cells including brain cells as it is the only antioxidant that passes through the blood/brain barrier. You can get a bottle of Melatonin at Trader Joes for $3.50. 5 MGm. You can probably keep the autistic child on it for indefinite periods without any side effects. At night and at nap time, please make sure he sleeps in a room with light blocking curtains.

  4. Paulette says:

    Because the gut produces most of the precursor to melatonin, called serotonin, getting the gut right will often lead to better sleep patterns. That was our experience. It took us years, but now at 14 our son has a healthy gut flora and sleeps 9 hours a night. When we did use melatonin in the early years, we cut a 3 mb tab in half. It’s a chewable. There is also a liquid version that makes dosing super easy. Start low and work up to the dose that works best for your child. Talk to your doc and follow directions on the bottle.

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