Abstract
Aim: The aim of this study was to investigate melatonin-related findings in autism spectrum disorders (ASD), including autistic disorder, Asperger syndrome, Rett syndrome, and pervasive developmental disorders, not otherwise specified.
Method: Comprehensive searches were conducted in the PubMed, Google Scholar, CINAHL, EMBASE, Scopus, and ERIC databases from their inception to October 2010. Two reviewers independently assessed 35 studies that met the inclusion criteria. Of these, meta-analysis was performed on five randomized double-blind, placebo-controlled studies, and the quality of these trials was assessed using the Downs and Black checklist.
Results: Nine studies measured melatonin or melatonin metabolites in ASD and all reported at least one abnormality, including an abnormal melatonin circadian rhythm in four studies, below average physiological levels of melatonin and/or melatonin derivates in seven studies, and a positive correlation between these levels and autistic behaviors in four studies. Five studies reported gene abnormalities that could contribute to decreased melatonin production or adversely affect melatonin receptor function in a small percentage of children with ASD. Six studies reported improved daytime behavior with melatonin use. Eighteen studies on melatonin treatment in ASD were identified; these studies reported improvements in sleep duration, sleep onset latency, and night-time awakenings. Five of these studies were randomized double-blind, placebo-controlled crossover studies; two of the studies contained blended samples of children with ASD and other developmental disorders, but only data for children with ASD were used in the meta-analysis. The meta-analysis found significant improvements with large effect sizes in sleep duration (73 min compared with baseline, Hedge's g 1.97 [95% confidence interval {CI} CI 1.10-2.84], Glass's Δ 1.54 [95% CI 0.64-2.44]; 44 min compared with placebo, Hedge's g 1.07 [95% CI 0.49-1.65], Glass's Δ 0.93 [95% CI 0.33-1.53]) and sleep onset latency (66 min compared with baseline, Hedge's g-2.42 [95% CI -1.67 to -3.17], Glass's Δ-2.18 [95% CI -1.58 to -2.76]; 39 min compared with placebo, Hedge's g-2.46 [95% CI -1.96 to -2.98], Glass's Δ-1.28 [95% CI -0.67 to -1.89]) but not in night-time awakenings. The effect size varied significantly across studies but funnel plots did not indicate publication bias. The reported side effects of melatonin were minimal to none. Some studies were affected by limitations, including small sample sizes and variability in the protocols that measured changes in sleep parameters.
Interpretation: Melatonin administration in ASD is associated with improved sleep parameters, better daytime behavior, and minimal side effects. Additional studies of melatonin would be helpful to confirm and expand on these findings.
https://pubmed.ncbi.nlm.nih.gov/21518346/
Autism
Autism is a congenital and predominantly hereditary mental developmental disorder and can be divided into several diagnoses. People with autism typically experience challenges with communication, behaviour and being social. People with autism have different ways of communicating, interacting and learning than most other people.
Description
Symptoms of autism
Autism is typically diagnosed in childhood, when you experience that the child deviates from the development pattern of his peers. The diagnosis is sometimes not made until adulthood.
Autism is also referred to as ASD (Autism Spectrum Disorder).
Autism can be divided into the following diagnoses: Infantile autism, Asperger's Disease, Atypical Autism, PDD (Pervasive Developmental Disorder) and NOS (Not Otherwise Specified).
One or two persons per thousand of the population have a diagnosis of infantile autism, and if you include the other autism diagnoses, you arrive at approximately one percent of the population. There are about four boys/men for every one girl/woman with the diagnosis.
There is no medical treatment to cure autism. Possible medical treatment only becomes relevant in the case of any subsequent psychological disturbances and complications such as ADHD, depression and severe externalising behaviour. In recent years, there has been a greater focus on individual psychotherapy.
People with autism have a high probability that sleep disturbances can become chronic, long-term or intermittent.
Autism and sleep problems
The latest research shows that most children with autism will have sleep problems. These are typically problems with falling asleep and frequent waking.
Sleep problems can be a major burden for children with autism and generally also affects the rest of the family.
If children with autism get too little sleep or sleep poorly, it can lead to reduced learning, poor concentration and can promote aggression, irritability, stress, anxiety and lead to depression. In addition, the children may experience increased restlessness in the body, be overweight, in addition to reduced body growth and immune defences.
A good sleep promotes well-being and health.
Autism and sleep glasses
An alternative solution, is to let the child with autism wear sleep glasses for approximately 90 minutes before bedtime. This can reduce the time the child spends falling asleep and can promote deep sleep.
It is important that the child is motivated to wear sleep glasses, and here you as parents can agree a reward with the child.
Research regarding autism
Melatonin in autism spectrum disorders: a systematic review and meta-analysis
Dev Med Child Neurol. 2011 Sep;53(9):783-792. doi: 10.1111/j.1469-8749.2011.03980.x. Epub 2011 Apr 19.Daniel A Rossignol, Richard E FryePMID: 21518346 / DOI: 10.1111/j.1469-8749.2011.03980.x
The purpose of this trial was to examine the new discoveries made in autism spectrum disorders (ASD), autism disorders, Asperger's syndrome, Rett syndrome and pervasive developmental disorders. Trial interpretation: Controlling...
Melatonin in autism spectrum disorders: a systematic review and meta-analysis
The purpose of this trial was to examine the new discoveries made in autism spectrum disorders (ASD), autism disorders, Asperger's syndrome, Rett syndrome and pervasive developmental disorders. Trial interpretation: Controlling the amount of melatonin in ASD is associated with improvement in sleep parameters, better daytime behaviour and minimal side effects.
Melatonin in autism spectrum disorders: a systematic review and meta-analysis
Dev Med Child Neurol. 2011 Sep;53(9):783-792. doi: 10.1111/j.1469-8749.2011.03980.x. Epub 2011 Apr 19.
PMID: 21518346 / DOI: 10.1111/j.1469-8749.2011.03980.x