Surveys show that the majority of children with ASD (Autism spectrum disorder) experience lifelong sleep disturbances which are most stressful for them, their caregivers, and the entire family. Usually these sleep difficulties are falling asleep, frequent awakenings and early morning awakenings, therefore, they are circadian rhythm sleep disturbances. Several studies have shown that melatonin therapy has a high success rate and the treatment is now accepted worldwide.
For children with ASD, melatonin supplementation was most effective for delayed sleep onset, but it also promoted longer sleep maintenance without any melatonin side effects. Better sleep was associated with parent-reported improvements in health, behavior and learning. Occasionally a reduction in anxiety and self-stimulating mannerisms was also noted because melatonin has anti-anxiety properties. Sleep promotion techniques were generally ineffective in our 10 children before melatonin therapy but afterward they responded better to sleep hygiene.
Parental observations were the best methods of diagnosing and following the children’s sleep difficulties. Blood, saliva, and urine tests for melatonin levels were available, but they did not offer practical benefits since even a short melatonin trial was more informative. Sleep diaries, actigraphs, which measure movements, or video tapes, were useful in documenting sleep patterns, but polysomnography was almost never necessary.
The labeling of some over-the-counter products indicates that melatonin should not be given to children or to pregnant women. This warning is due to melatonin overdoses that can occur and possibly affecting fetal development in pregnant women. In fact, over the years melatonin treatment in numerous studies has not caused a significant adverse effect in children.
The medical community still wants more clinical trials for supporting evidence that melatonin works for children before it will recognize this as a viable form of sleep therapy. Several years ago, a letter to a medical journal suggested that melatonin therapy might trigger seizures. This was an incorrect observation; in fact melatonin has anticonvulsant properties. It was also claimed that this therapy during puberty is dangerous but in actuality many teens stay up late at night and sleep in till noon if they could. Melatonin therapy would help them to get their sleep cycle back into a regular sleep pattern during this time in their life. As would regular bedtime habits.
Melatonin has not been evaluated for safety or effectiveness by the FDA, and is not recommended for use by children under twelve without the advisement of a physician. Still, there have been encouraging studies on its safe use in helping kids become attuned to recognizing their sleep-cycle pattern. In particular, melatonin has been shown to be of service to children—free from any major side effects—with cerebral palsy, autism, learning difficulties, and ADHD. In a June 2002 study published in the Child Health Monitor, forty-nine kids in a pediatric neurology clinic were given melatonin to treat sleep disturbance. Children under the age of five were given 2.5 mg of melatonin before bedtime; those over five years took 5 mg. The dosages were slowly increased as needed to 7.5 mg and 10 mg, respectively, for each age group. The study showed that quality of sleep improved for 93 percent of the children. The number of sleep hours increased, and the number of sleep interruptions decreased. A 2003 study showed similar benefits for insomniac children with ADHD. Those kids who took the melatonin before going to bed at night fell asleep thirty minutes faster than the kids who were taking a placebo instead of the melatonin. Even without the medical community behind melatonin supplementation, seek your child’s physician for proper melatonin dosage for your child and find out if there would be any interactions with drugs your child may be taking.