Use of Melatonin as Sleep Aid for Children with Autism

Sleep disorders in children with autism are a consistent and pervasive problem. According to most studies, approximately 80 percent of children with autism have some sort of sleep disorder. (According to the University of California at Davis MIND Institute, up to 89 percent of autistic children have a sleep disorder.) There a number of different theories on ways to ease the transition into sleep for autistic children: having a nighttime ritual, consistent bedtime, and sensory integration, among others.

One way to aid sleep that is gaining traction is the use of melatonin. Melatonin is a natural hormone produced by the pineal gland (and regulated by serotonin) that governs a person’s sleep pattern. There has been some research that shows that many people with autism have a significant imbalance in their serotonin levels. When these serotonin levels are off, the body will have difficulty regulating the amount of melatonin produced by the pineal gland. This may be one reason why many children with autism have difficulties sleeping.

Recently, there was a small study (12 children) regarding the potential use of melatonin as a sleep aid published in the Journal of Clinical Sleep Medicine (April 15, 2009) that showed some potential. For this small sample, children ranging from 2 to 15 years old took melatonin for two weeks and a placebo for two weeks. Overall, the study showed some promise.

While taking the melatonin, the children’s overall length sleep increased by 21 minutes and the length of time it took for the child to fall asleep decreased by 42 minutes. Dosage levels ranged from 0.5 mg to 10 mg depending on age, body weight, etc. Melatonin was given approximately 30 to 60 minutes before bedtime to increase its effectiveness.

Although promising, there are caveats to this—and other studies—regarding the use of melatonin:

First, the study mentioned here has an extremely small sample and was not a blind study; the parents knew when they were giving their child a placebo and the melatonin.
Secondly, there have been no long-term studies to determine how prolonged use of melatonin affects children—adversely or positively.

Significantly, a number of scholarly journals as well as Medline Plus—a website run by the National Library of Medicine and the National Institutes of Health—all say essentially the same thing: “Well-designed controlled trials in select patient populations are needed before a stronger or more specific recommendation can be made.” (www.nlh.nih.gov/medlineplus)

Parents want what is best for their children, and there is a possibility that melatonin could be an answer to their autistic child’s sleep problems. However, it is likely that melatonin isn’t the only answer; rather it might be one piece to a jigsaw puzzle that improves an autistic child’s sleep. Even though melatonin is classified as an herbal supplement in the United States, you should always consult with a doctor before beginning use.