Is It a Mistake to Give Melatonin to Children with Autism?

Dr. David Clark, the Director of the Center for Autism Recovery in Dallas, TX believes that it is a mistake to give melatonin to children with autism.

Melatonin has received recent attention for helping people get to sleep easier. It is made by a gland in the brain that seems to elicit sleep hormones and provide some relief for insomniacs.

However, Dr. Clark believes that giving melatonin to a child with autism could be a disaster. As Clark explains, melatonin is a hormone and whenever you give the body hormones from the outside, there can be disastrous effects on the body.

First of all, any time that you introduce a hormone from outside the body, the body itself may decide that it doesn't need to produce so much of the hormone anymore and may begin to atrophy (or cease production).

Second, the body may begin to lose feedback and coordination between the gland that should be producing the hormone and the hypothalamus.

Third, the body can build up a tolerance over time against the introduced hormone and require you to take larger and larger doses.

Another reason why Dr. Clark believes that melatonin should be avoided is that it does not work alone. Melatonin requires a second hormone, cortisol, to work properly. It is the dual production of both cortisol and melatonin that are responsible for allowing a person to sleep normally.

Unfortunately, as Dr. Clark suggests, once you start giving a child melatonin, the child may develop a long-term dependency on the hormone.

The Benefits of Melatonin

Dr. Sonya Doherty believes just the opposite: Melatonin is safe and helpful for children with autism. Of all children diagnosed with autism, 83 percent of them have sleep disorders. When a child is diagnosed with autism or lands on the autism spectrum, the chances are high that the child also has issues falling or staying asleep.

Research conducted at the Arkansas Children's Research Institute has concluded that 90 percent of children with autism also have methylation impairments. Methylation impairments can alter the manner in which the body produces essential brain chemicals such as norepinephrine, glutamate, GABA, dopamine, and serotonin. Serotonin is an essential chemical for helping to induce sleep and up to 90 percent of serotonin is developed by the gastrointestinal tract.

Nearly 85 percent of children with autism also have digestive issues, which include gut flora imbalance, pain, diarrhea, and constipation. Vitamin D helps the serotonin become converted to melatonin. Research has steadily pointed to vitamin D deficiency as a risk factor of autism. Also, many of the children who have autism or ADHD also have magnesium deficiencies and appropriate magnesium levels are needed to fall and stay asleep.

Methylation impairment, digestive problems, and nutrient deficiencies have all been found to contribute to sleep issues in children with autism. Also at a high risk for developing sleep issues are children who experience developmental concerns. Research points to a disturbing pattern: the very children who need sleep the most experience the most problems with getting to sleep and staying asleep.

Research Suggests Melatonin Could Help Children with Autism Sleep

Another study suggests that low doses of melatonin could help children who have autism fall and stay asleep better. Eleven children with autism participated in the study and ranged between the ages of 4 and 10. When the researchers gave the children low doses of melatonin, the children were able to fall asleep quicker and stay asleep longer, according to one of the lead researchers, Beth Malow, the director of the Sleep Disorders Center of Vanderbilt University in Nashville, TN.

According to the researchers, no negative side effects were noted which lead the researchers to conclude that given in small doses, melatonin may be a safe aid in helping autistic children fall and stay asleep.

Dr. Andrew Zimmerman of the Kennedy Krieger Institute in Baltimore, MD believes that over 70 percent of children who have been diagnosed with autism also suffer from sleep issues, ranging from trouble falling asleep to trouble staying asleep. Krieger is a specialist in treating autism.

Malow states that a deficiency of the body's natural sleep hormone, melatonin, may be a likely culprit for autistic children having trouble with sleep. The pineal gland secretes melatonin at night which is thought to help control and maintain sleep cycles. Malow says that sleep cycles are often disturbed in the elderly and in kids with autism.

Malow and several colleagues are currently studying children with autism who have a difficult time falling asleep at least 3 nights in a row and trying to determine if low doses of supplemental melatonin can help these children get better rest.

In the current study, researchers are guiding the parents of autistic children with insomnia through lessons on good sleep hygiene. The parents are being taught to ensure that their children have a consistent bedtime routine, such as going to bed at the same time each night. The parents are also being told to put their children right back in their beds if they wake up in the middle of the night, versus letting them sleep in bed with the parents.

In addition to ensuring that the parents maintain a good sleep routine for their children, the children are being given supplemental melatonin which is administered in liquid form about a half hour prior to bedtime. The researchers have instructed the parents to gradually increase the doses every three weeks up until the children can fall asleep within 30 minutes of their bed team for a minimum of five nights a week.

The researchers chose to administer the melatonin in liquid form because many children with autism have a difficult time swallowing pills.

So far in this study, 11 of the kids have finished with the first, four-month stage. After 16 weeks were completed, the parents reported that the average time that it took for the children to fall asleep went from 38 minutes down to 22 minutes.

While two of the children required 6 milligrams of melatonin, six of the children required 3 milligrams and 11 of them only required one milligram. All of the parents reported that they had an easier time helping their children to fall asleep and that they were less likely to wake up in the middle of the night and were able to get a full night of sleep.

The children were also reported to have less of the ritualistic and compulsive behaviors often associated with autism, which may be a direct link to the melatonin or due to the children getting more sleep.

It may be important to note that larger doses of melatonin may induce bed-wetting, daytime drowsiness, and seizures. However, given in small doses, such as in this study, have not presented any of these side-effects.

References

Clark, D. (2011, January 21). Are You Making This Melatonin Mistake with Your Autistic Child? [Web]. Clark Learning Systems. Retrieved on 09/17/2017 from: http://drclark.typepad.com/dr_david_clark/2011/01/are-you-making-this-melatonin-mistake-with-your-autistic-child.html

Doherty, S. (2014, June 16). Sleep Disorders Affect 83% of Children Diagnosed with Autism. [Web]. In Treat Autism. Retrieved from: http://treatautism.ca/2014/06/16/sleep-disorders-affect-83-of-children-diagnosed-with-autism/

Laino, C. (2009, October 12). Melatonin Helps Autistic Kids Sleep. [Web]. In Web MD. Retrieved from: http://www.webmd.com/brain/autism/news/20091012/melatonin-helps-autistic-kids-sleep#1