Melatonin and Autism

Many parents with an autistic child are quite aware that children with autism may have lower levels of melatonin. Your child rummaging through the house in the middle of the night could be a sign that your child is not producing enough melatonin or producing it at the wrong time.

Melatonin is an important hormone that is produced in the pineal gland in the brain that helps to regulate our internal clock. Melatonin is usually produced in response to lower levels of light around us. The amino acids L-Tryptophan and 5-HTP are precursors of melatonin.

Signs that something isn’t quite right with your child’s melatonin production could be the fact that your child often wakes up in the middle of the night and has trouble falling back asleep. Children who wake up during the night and don’t fall back asleep will have a tough time during school. This will often result in trouble focusing, increased levels of frustration and more intense tantrums.

An autistic child, who is older, may not wake up the rest of the family and you may notice at 7AM in the morning that your child has been downstairs in the living room watching TV and serving himself food for the last 2-3 hours. For parents, this scenario brings about security concerns, as you don’t want your young child operate kitchen equipment by him/herself.

Our child began to wake up in the middle of the night when he was 2 years old and he wasn’t even diagnosed yet. However, the cycle of repeated nocturnal awakenings and trouble falling asleep at bedtime was quickly becoming a burden to our family. We, as the parents, did not get enough sleep and all this resulted in us being overly stressed at times.

Another sign that something wasn’t quite right with our son’s circadian rhythm, was that he frequently fell asleep during the day, usually at the end of the morning (when he had been awake for more than 7 hours) and at the end of the afternoon right before dinner.

As a parent, you may notice that your child’s most severe tamper tantrums occur right before falling asleep. We usually kept a normal bedtime routine, but sometimes when we asked our son to get dressed for bed, he was too tired to cooperate and did not want to be touched. This resulted in some very severe tantrums.

As it had been reported that children with autism have decreased levels of melatonin, and after talking to our son’s pediatrician several times about our son’s sleeping difficulties, we asked if we could use melatonin to help our son’s sleep pattern. Although melatonin is available over-the-counter in many countries, giving your child melatonin should always be discussed with your pediatrician, as there are some contra-indications. One of these is if your child has asthma or if asthma runs in your family. Melatonin given to a patient with asthma can increase the risk of an asthma attack.

Once we received the OK from our son’s doctor, we started giving our son 1 mg melatonin at bedtime (regular tablets, that he chewed). We had high hopes, but it quickly became clear that a regular tablet of melatonin did not improve our son’s sleep cycle. He was still waking up early. However, years later, we decided to give our son extended-release melatonin (1 mg). The extended-release melatonin was allowing our son to wake up a little later (still too early for our taste), but it also resulted in longer un-interrupted sleep, which had a great effect on his mood during the day.

Why the extended-release melatonin tablet worked so much better, I will write about in my next post.

References

Melke, J., Botros, H.G., Chaste, P., Betancur, C. et al. (2008) Abnormal melatonin synthesis in autism spectrum disorders. Mol. Psych. 13, 90-98.

Giannotti, F., Cortesi, F., Cerquiglini, A. et al. (2006) An Open-Label Study of Controlled-Release Melatonin in Treatment of Sleep Disorders in Children with Autism. J. Autism Devel. Disord. 36, 741-752.

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