Melatonin for Sleep in Children with Autism: A Controlled Trial Examining Dose, Tolerability, and Outcomes

Sleep Disorders Division, Department of Neurology and Kennedy Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Journal of Autism and Developmental Disorders (Impact Factor: 3.06). 12/2011; 42(8):1729-37; author reply 1738. DOI: 10.1007/s10803-011-1418-3
Source: PubMed


Supplemental melatonin has shown promise in treating sleep onset insomnia in children with autism spectrum disorders (ASD). Twenty-four children, free of psychotropic medications, completed an open-label dose-escalation study to assess dose-response, tolerability, safety, feasibility of collecting actigraphy data, and ability of outcome measures to detect change during a 14-week intervention. Supplemental melatonin improved sleep latency, as measured by actigraphy, in most children at 1 or 3 mg dosages. It was effective in week 1 of treatment, maintained effects over several months, was well tolerated and safe, and showed improvement in sleep, behavior, and parenting stress. Our findings contribute to the growing literature on supplemental melatonin for insomnia in ASD and inform planning for a large randomized trial in this population.

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Available from: Diane Fawkes, Mar 26, 2014
    • "These findings have been challenged by a recent study that found normal endogenous melatonin secretion patterns in children with autism (Goldman et al., 2014). Nonetheless, clinical research suggests that melatonin intake might be a helpful component of intervention for children with autism (Cortesi, Giannotti, Sebastiani, Panunzi, & Valente, 2012; Malow et al., 2012). "
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    • "Furthermore, there is a direct relationship between a reduction in the hours of night sleep and the severity of behavioral stereotypes, difficulties in social interactions, communication disorders and family stress (Richdale, 1999; Elia et al., 2000; Gregory and O'Connor, 2002; Thunström, 2002; O'Brien and Gozal, 2004; Hoffman et al., 2008; Miano and Ferri, 2010; Minkel et al., 2012). Because several studies have indicated that sleep quality influences aspects of behavior (Malow et al., 2006; Giannotti et al., 2008; Maski and Kothare, 2013) and that the treatment of sleep disturbances can improve daytime behavior, including less irritability, anxiety, withdrawal and hyperactivity; fewer affective problems, attention deficits, and stereotyped and compulsive behaviors; and better mood and communication, in children with ASD and in children who are neurologically multiply disabled (Jan et al., 1994; Horrigan and Barnhill, 1997; Ishizaki et al., 1999; Paavonen et al., 2003; Garstang and Wallis, 2006; Giannotti et al., 2006; De Leersnyder et al., 2011; Wright et al., 2011; Malow et al., 2012), the aim of this study was to investigate the patterns of sleep, behavioral profiles and the correlation between sleep disorders and behavior in children and adolescents with ASD. This study provided pilot data toward a new study, in which we intend to expand the sample, use pharmacological treatment to improve sleep quality in this population and investigate whether there was consequent improvement in behavioral and cognitive parameters. "
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    • "Two DNA samples were extracted from buccal swabs, the remaining 13 DNA samples were extracted from patient blood, using QIagen Puregene Ò chemistry on the Autopure Ò platform at the Vanderbilt DNA Resources Core. Eleven of these 15 children were subsequently enrolled in the melatonin trial (Malow et al. 2012) and were initially started on liquid placebo for 2 weeks to obtain baseline data (Table 1). Individuals were then treated with 1 mg of supplemental liquid melatonin (Natrol Ò ) for 3 weeks. "
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