The current prevalence of autism spectrum disorder is alarmingly high. Although there is no cure for autism, it is possible to manage and treat the comorbid medical conditions associated with autism. One of these conditions, sleeping disturbance, can be challenging to treat. A new study published in Developmental Medicine and Child Neurology by Dr. Daniel Rossignol (International Child Development Resource Center, Melbourne, FL) and Dr. Richard Frye (University of Texas), sheds some light on sleep problems in children with autism and treatment of this problem.
These investigators found that, in general, children with autism had abnormally low levels of the hormone melatonin, a hormone that is necessary for the regulation and maintenance of sleep. The review points out that although investigators have identified some children with autism with genetic problems in producing melatonin, the number of children with this problem was very low. Importantly, the investigators identified 18 studies of melatonin treatment in autism, with 5 studies comparing melatonin to a placebo, and found that melatonin improved several aspects of sleep in the placebo-controlled studies. Specifically, melatonin significantly increased sleep duration by an average of 73 minutes compared to baseline and lowered the amount of time it took for the children to fall asleep by 66 minutes compared to baseline. Melatonin was well tolerated by most children and side effects were minimal.
One intriguing finding of the review was that some studies reported better daytime behavior in some children with autism when they took melatonin at night. "This was not surprising," states Dr. Rossignol, "when children sleep better at night, their behavior is usually better in the daytime. These findings are important because something as simple as a nutritional supplement could greatly improve both the lives of the children and their parents." Dr. Frye adds, "Our article provides evidence for dysfunction for an important metabolic pathway in autism spectrum disorder, the melatonin pathway, and further demonstrates that appropriate treatment to correct dysfunction of this pathway can be helpful to improving sleep and daytime behavior in children with autism. Hopefully, further studies can identify defects in pathways that can be easily corrected just like the melatonin pathway."