Melatonin for Insomnia in Children With Autism Spectrum Disorders

[Guest guest]

J Child Neurol. 2008 Jan 8 [Epub ahead of print]

Melatonin for Insomnia in Children With Autism Spectrum Disorders.

Andersen IM, Kaczmarska J, McGrew SG, Malow BA.

Vanderbilt Children’s Hospital, Vanderbilt University School of

Medicine, Nashville, Tennessee.

We describe our experience in using melatonin to treat insomnia, a

common sleep concern, in children with autism spectrum disorders. One

hundred seven children (2-18 years of age) with a confirmed diagnosis of

autism spectrum disorders who received melatonin were identified by

reviewing the electronic medical records of a single pediatrician. All

parents were counseled on sleep hygiene techniques. Clinical response to

melatonin, based on parental report, was categorized as (1) sleep no

longer a concern, (2) improved sleep but continued parental concerns,

(3) sleep continues to be a major concern, and (4) worsened sleep. The

melatonin dose varied from 0.75 to 6 mg. After initiation of melatonin,

parents of 27 children (25%) no longer reported sleep concerns at

follow-up visits. Parents of 64 children (60%) reported improved sleep,

although continued to have concerns regarding sleep. Parents of 14

children (13%) continued to report sleep problems as a major concern,

with only 1 child having worse sleep after starting melatonin (1%), and

1 child having undetermined response (1%). Only 3 children had mild

side-effects after starting melatonin, which included morning sleepiness

and increased enuresis. There was no reported increase in seizures after

starting melatonin in children with pre-existing epilepsy and no

new-onset seizures. The majority of children were taking psychotropic

medications. Melatonin appears to be a safe and well-tolerated treatment

for insomnia in children with autism spectrum disorders. Controlled

trials to determine efficacy appear warranted.

PMID: 18182647