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Melatonin is the hormone naturally produced by the body at nighttime to regulate sleep.3 Medical, behavioral, and neurological issues are some of the potential reasons for sleep problems being a common occurrence in individuals on the autism spectrum.54 According to past research, sleep problems occur in 50-80% of children with autism spectrum disorders.55 The use of melatonin should only be considered when other methods for enhancing sleep fail. Some tips to improve your child’s sleep include creating a sleep routine, keeping a consistent sleep/wake schedule that doesn’t differentiate on weekends, exercising during the daytime, avoiding caffeine, and tailoring his/her sleep environment to provide maximum comfort and avoid possible sensory issues by making sure the bedroom is dark, quiet, and cool.54 Parents should meet with a sleep specialist or pediatrician to determine if there are any other possible medical issues affecting the child’s sleep besides a lack of melatonin production. Parents should not implement a melatonin regiment before consulting a physician. Melatonin was awarded a Grade A from a review of emerging treatments of ASD by the Annals of Clinical Psychiatry in 2009.22
Past research has shown that melatonin levels are indeed lower for individuals with ASD and that the use of melatonin supplements is effective for treating sleep problems of individuals on the autism spectrum. A 2005 study that centered on melatonin production in individuals on the autism spectrum found that nocturnal melatonin production is reduced in individuals on the autism spectrum and that it negatively affected verbal communication and play.56 A study of 100 patients with a sleep disorder and a neurologic or developmental disability found that melatonin “benefited slightly over 80% of our patients, appears to be safe, inexpensive, and a very effective treatment of sleep-wake cycle disorders.”57 A 2009 study that successfully collected data from 12 of their 18 participants with autism and/or fragile X syndrome concluded the use of melatonin was effective and tolerable for children with autism spectrum disorders and fragile X syndrome.58 Although these studies demonstrated some procedural flaws, their positive results have paved the way for more methodologically sound studies.
Research on the effects of melatonin for individuals on the autism spectrum is not limited to only children. A 2001 study on 6 adults on the autism spectrum with circadian sleep-wake disturbances received a daily dose of melatonin, and results showed that melatonin “appears to be promising as an efficient and seemingly safe alternative for treatment of severe circadian sleep disturbances in adults with autism.”59 Clearly the sample size of this study was small, but these results demonstrate that randomized, double-blind studies into the effects of melatonin for adults with ASD are warranted. Those interested in learning about completed and ongoing studies involving autism and melatonin should visit Clinicaltrials.gov.