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Melatonin for Insomnia in Children With Autism Spectrum Disorders

Sleep Disorders Division Department of Neurology and Kennedy Center, Vanderbilt University School of Medicine

JoAnna Kaczmarska, MD

Sleep Disorders Division Department of Neurology and Kennedy Center, Vanderbilt University School of Medicine

Susan G. McGrew, MD

Department of Pediatrics Vanderbilt Children's Hospital, Vanderbilt University School of Medicine, Nashville, Tennessee

Beth A. Malow, MD, MS

Sleep Disorders Division Department of Neurology and Kennedy Center, Vanderbilt University School of Medicine, beth.malow{at}vanderbilt.edu

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.

Key Words: sleep • pervasive developmental disorder—not otherwise specified • Asperger syndrome • melatonin

This version was published on May 1, 2008

Journal of Child Neurology, Vol. 23, No. 5, 482-485 (2008)
DOI: 10.1177/0883073807309783


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