Melatonin in Children with Autism Spectrum Disorder
What is Melatonin?
At night, a part of your brain called the "pineal gland" releases melatonin to keep your sleep patterns normal. There are other parts of your body that release melatonin too, though: your intestines, your lungs, your kidneys, and even your eyes.
Melatonin seems to help in many different parts of our overall health, but first and foremost, it sets our sleep-wake routine: when there is no light, there is more melatonin, which tells the body to go to sleep. Conversely, when there is more light, there is less melatonin, which tells the body to wake up. Some people who struggle with sleep actually struggle with low melatonin, which is why melatonin supplements can help, including children with Autism Spectrum Disorder (ASD).
In fact, there is some evidence that melatonin can help with other ASD symptoms as well.
What Are Autism Spectrum Disorders (ASDs)?
ASD affects communication and behavior, and although we may recognize it any age, we call it a "developmental disorder" because its symptoms are visible in the first two years of life.
In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association says that symptoms of ASD include:
- Difficulty with communication and interaction with other people
- Restricted interests and repetitive behaviors
- Negative impact to school, work, and personal life
Autism is known as a “spectrum” disorder because of the wide variety of symptoms patients can show. It often occurs alongside issues with the stomach and intestines, issues with mood, epilepsy, and other difficult behaviors, but poor sleep is especially common, occurring in up to 80% of ASD patients.
Sleep Problems in ASD
Children with ASD often resemble any other insomnia patient. They struggle to break out of poor sleep routines, which can make other ASD symptoms (tantrums, aggression, self-harm) even more difficult to manage. Bedtime resistance, sleep anxiety, sleep-onset issues, and over-activity all occur frequently. We can connect the causes of these issues to biology, psychology, and socialization.
Melatonin and ASD Comorbidities
Melatonin can treat ASD symptoms such as anxiety, sensory processing, and intestine and stomach issues, all of which may affect sleep quality.
39.6% children with ASD experience anxiety, and among these children, 70-90% experience insomnia. Studies have shown that melatonin can lead to long-term anti-anxiety effects while also improving working memory and reducing stress reactions by cutting down on the proteins that seem connected with anxiety. This could, in turn, help reduce sleep problems.
Sensory Processing Problems
90% of children with ASD experience sensory processing problems, making it one of the primary clues to an ASD diagnosis. These problems can lead to poor sleep, and on studies of animals, melatonin seems to affect sensory processing positively through a combination of anti-oxidation and anti-inflammation, resulting in stronger sleep patterns By Mouth.
50% of children with ASD experience digestive problems – much higher than the rest of the population. Melatonin can help here as well, reducing inflammation in the intestines and stomach to help avoid diarrhea and irritable bowel syndrome. This could lead to lower pain levels, lower anxiety levels, and better sleep.
Melatonin dosing in children
- For disorders that affect when a person sleeps and when they are awake: 0.5-12 mg of melatonin daily for up to 12 weeks has been used in children and adolescents 3 months to 18 years old.
- For trouble falling asleep at a regular bedtime: 1-6 mg of melatonin before bedtime for up to one month has been used.
- For insomnia:
- For insomnia, 5 mg or 0.05-0.15 mg/kg of body weight taken at bedtime for 4 weeks has been used in children 6-12 years-old with primary insomnia.
- For insomnia occurring together with other conditions: 6-9 mg of melatonin taken before bedtime for 4 weeks, has been used in children with seizures 3-12 years old.
- For reducing anxiety before surgery: 0.05-0.5 mg/kg of body weight has been taken before anesthesia in children 1-14 years old.
Gagnon, K., & Godbout, R. (2018). Melatonin and Comorbidities in Children with Autism Spectrum Disorder. 197–206
Goldman, S. E., Adkins, K. W., Calcutt, M. W., Carter, M. D., Goodpaste, R. L., Wang, L., Shi, Y., Burgess, H. J., Hachey, D. L., & Malow, B. A. (2014). Melatonin in Children with Autism Spectrum Disorders: Endogenous and Pharmacokinetic Profiles in Relation to Sleep. Journal of Autism and Developmental Disorders, 44(10), 2525–2535
Veatch, O. J., Goldman, S. E., Adkins, K. W., & Malow, B. A. (2015). Melatonin in Children with Autism Spectrum Disorders: How Does the Evidence Fit Together? Journal of Nature and Science, 1(7), e125. http://www.ncbi.nlm.nih.gov/pubmed/26120597