Melatonin Helps Autistic Kids Sleep
Study Shows No Side Effects From Low-Dose Supplements of Melatonin
By
Charlene Laino
WebMD Health News
Reviewed By
Louise Chang, MD
Oct. 12, 2009 (Baltimore) -- Low doses of melatonin may help children with autism get a better night's
rest, researchers report.
Eleven youngsters with autism ages 4 to 10 fell asleep more quickly and
slept longer when given low-dose supplements of melatonin, says Beth Malow, MD, director
of the Sleep Disorders Center at Vanderbilt University in Nashville, Tenn.
The supplements didn't appear to cause any side effects, suggesting parents
can continue to give them to their kids as long as needed, she tells WebMD.
Studies have shown that as many as 70% of children with autism suffer from
sleep problems, according to Andrew Zimmerman, MD, of the Kennedy Krieger
Institute in Baltimore, who specializes in treating autism.
Other research points to a deficiency of melatonin -- the body's natural
sleep hormone -- as the culprit, Malow says. Secreted at night by the pineal
gland in the brain, melatonin is thought to
control sleep cycles, which are frequently disturbed in the elderly -- and kids
with autism, she says.
Importance of Good Sleep Habits
To determine whether supplemental melatonin can overcome the problem, Malow
and colleagues are studying children with autism who toss and turn for at least
30 minutes a night, three nights a week, before falling asleep.
In the ongoing study, parents go through an educational program on good
sleep habits. They're taught to make sure their offspring maintain a bedtime
routine, going to bed at the same time every night, for example. And if
youngsters do get up in the middle of the night, parents are told to tuck them
back into their own beds, not let them slip under the covers between mom and
dad.
Then, the children are given melatonin in liquid form, a half hour before
bedtime, every night. Doses are increased every three weeks until the
youngsters can fall asleep within 30 minutes of bedtime at least five nights a
week.
"We give it as a liquid because not all children with autism can swallow
pills easily," Malow says.
So far, 11 kids have completed the first, four-month phase of the study.
After 16 weeks of supplementation, the average time it took for them to fall
asleep dropped from 38 minutes to 22 minutes.
One milligram a night did the trick for three of the 11 youngsters, Malow
says. Six required 3 milligrams, and only two children needed 6 milligrams, she
says.
They also slept longer, and parents reported they had less trouble getting
their kids to agree to go to sleep, Malow reports.
Additionally, the children exhibited fewer of the compulsive and ritualistic
behaviors that can accompany autism, she says.
The findings were presented here at the annual meeting of the American
Neurological Association.
Synchronizing Natural Sleep Patterns
While there have been reports of bed-wetting, seizures, and daytime
drowsiness among children given melatonin supplements, "we didn't see any of
those problems. These are relatively small doses and they seem benign," Malow
says.
The children are continuing to take the supplements, and the researchers
plan to see how they're sleeping after six months.
"There's some evidence that the melatonin supplements synchronize the
natural sleep pattern and you can stop giving it after six months to a year,"
Malow says.
Proper sleep hygiene is a huge part of the equation, Malow stresses. "If
kids watch videos late at night, that's going to interfere with their sleep.
They'll be all hyped up, and the light will interfere with the body's own
melatonin," she says.
The researchers also plan to collect blood and urine samples to confirm
whether children with autism are deficient in melatonin and whether
supplementation brings levels back to normal.
Zimmerman, who was not involved with the work, tells WebMD that he often
prescribes supplemental melatonin to his young patients with autism.
"It's readily available and easy to use," he says. "My experience is that it
helps to get them to sleep, but doesn't always help them stay asleep. I'm glad
to see the children in the study had longer sleep duration."
The big question is how long to give melatonin to children, he says. "This
is important work as it helps answer that question."
Once the safety and effectiveness of supplemental melatonin is confirmed in
more children, the researchers plan to conduct a larger trial pitting melatonin
and behavioral therapy against behavioral therapy alone, Malow says.
SOURCES: 134th Annual Meeting of the American Neurological Association, Oct. 11-14, 2009, Baltimore.
Beth Malow, MD, director, Sleep Disorders Center, Vanderbilt University, Nashville, Tenn.
Andrew Zimmerman, MD, pediatric neurologist, Kennedy Krieger Institute, Baltimore.
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