Melatonin medication helpful for sleep problems in children with autism, Fragile X syndrome

A study in the April 15 issue of the Journal of Clinical Sleep Medicine determined that over-the-counter melatonin medication can shorted the length of time it takes for children with autistic spectrum disorder (ASD), Fragile X Syndrome (FXS), or both to fall asleep at the beginning of the night.

Results of the study indicated that children who received over-the-counter melatonin treatments experienced significant improvements in total night sleep durations, sleep latency times, and sleep-onset times. Mean sleep duration was longer on melatonin than placebo by 21 minutes, sleep-onset latency was shorter by 28 minutes and sleep-onset time was earlier by 42 minutes.

According to the senior author, Beth L. Goodlin-Jones, PhD of the M.I.N.D Institute at the University of California Davis Health System in Sacramento, Calif., treatment with over-the-counter melatonin supplements benefits children of all ages, which helps alleviate some of the additional stress that parents of special-needs children experience.

"Sleep onset problems at the beginning of the night are very troublesome for children and their families," said Goodlin-Jones. "Sometimes children may take one to two hours to fall asleep and often they disrupt the household during this time."

Authors report that sleep problems are reported in up to 89 percent of children with autism and 77 percent of children with FXS, the most common form of inherited mental impairment ranging from learning problems to mental retardation, and also the most commonly known cause of autism. Dyssomnia (difficulty falling asleep and frequent nighttime awakenings) are among the most commonly reported problems. Researchers hypothesize that difficulty sleeping in these children is increased due to abnormal levels of melatonin, a natural hormone secreted from the pineal gland that is believed to promote sleep at night.

The study included information from 12 children between the ages of 2 to 15.25 years. Sleep quality and quantity were measured both objectively and subjectively. Five participants met diagnostic criteria for autism, 3 for FXS, 3 for FXS and ASD, and 1 for FXS alone.

Participants were given two weeks' supply of either melatonin or a placebo. After they completed the two week dosage they were then crossed over to the alternate treatment for an additional two weeks. All participants were assessed for autism and received DNA testing for the diagnosis of FXS.

Authors recommend that in addition to the use of over-the-counter melatonin supplements, behavior therapies and sleep hygiene practices should be used to manage sleep problems in children with autism and FXS.