Effectiveness of Melatonin in the Treatment of Sleep Disturbances in Children with Asperger Disorder Paavonen EJ,
Nieminen-Von Wendt T, Vanhala R, Aronen ET, Von Wendt L Abstract: J Child Adolesc Psychopharmacol. 2003 Spring;13(1):83-95 Findings As many as 65% of children with autistic disorder
have abnormal sleep patterns, and particularly, sleep disturbances are
common in individuals with Asperger disorder. Adequate sleep is particularly
important in these individuals because sleep disturbances may worsen other
symptoms. However, to date, there have been no studies on the treatment
of sleep disturbances in Asperger disorder. Dr. Paavonen and her colleagues
studied the effectiveness of the hormone melatonin
in treating sleep disturbances in children with Asperger disorder. Melatonin
is a hormone naturally secreted by the pineal gland in the body, which
functions to initiate sleep, and has been used in the past to promote
sleep in various sleep disturbances. For this study, the researchers studied both
sleep characteristics as well as daytime behavior of 15 children and adolescents
(13 boys, 2 girls) with Asperger disorder aged 6-17 years. Subjects were
given melatonin pills 3 mg/day for 14 days and sleep and daytime behavior
observed 1.5 weeks before, during (at the end of the 14 days), and 3 weeks
after the treatment period. Sleep patterns of all children improved during treatment. Time to fall asleep decreased by half (from about average 40 minutes to 21 minutes) in all children. The time they slept (about 8 hours) did not change with treatment, but decreased significantly after melatonin was stopped. Despite the short period of this study, most behavioral measures improved. Particularly, depression, anxiety, and withdrawal decreased during the period of treatment. Most of these effects disappeared 3 weeks after melatonin was discontinued. Only 2 children reported mild tiredness and one reported headache while taking melatonin, but these symptoms went away after the child stopped taking melatonin.
Conclusions This was the first clinical study using melatonin
in children with Asperger disorder. The results showed that melatonin
may be effective in treating sleep problems in children with Asperger
disorder. Also, the daytime behaviors and “internalizing problems”
(depression, anxiety, and withdrawal) improved in all children while taking
melatonin, but the researchers did not know whether this effect was a
result of improvement in sleep disturbances or whether it was an effect
of melatonin on some other aspect of the child’s functioning. The
authors state: “…the link between autistic spectrum disorders
and sleep is of particular concern, as it is likely that sleep problems
exacerbate [make worse] the disruptive daytime behavior typical of autistic
children and thereby increase parental stress.” The authors stress
that these results seen in this study with a small number of children
need to be confirmed in a larger study that is controlled (ie, a double-blind,
placebo-controlled study).
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