Melatonin is an endogenous neurohormone made in the pineal gland of the brain. It is part of the brain’s internal clock system which tells the body when to go to sleep and when to be awake. Melatonin levels usually begin to rise in the early evening and are highest in the hours after midnight. By morning the levels start decreasing and remain low during the day. Melatonin production by the brain is dependent on the light in the outside environment. Therefore it is often referred to as the ‘hormone of darkness’, as it is high when light levels are low, like in the evening and low when light is high, like in the morning. Today, we have Dr Puja Kapoor, Paediatric Neurologist & Co-founder of Continua kids, to tell us the importance of melatonin for a child suffering from autism.
Autism Spectrum Disorder And Melatonin
Children with Autism Spectrum Disorder (ASD) often have problems with sleep; about two-thirds have sleep difficulties. This includes problems falling asleep (they take hours in the initiation of sleep), waking up overnight, waking too early in the morning, and getting up frequently at night, 2 to 3 times. Studies in ASD children indicate low or uneven melatonin levels may be the cause of the problem. Abnormalities in melatonin physiology and the circadian rhythm in individuals with autism spectrum disorders include lower night-time melatonin or melatonin metabolite concentrations in ASD compared to controls. Although this still needs more randomised control trials for verification.
Taking supplemental melatonin helps some children with ASD to sleep better. For children with poor sleep that did not get better with improved sleep routines, melatonin may decrease the time it takes to fall asleep. There is no information on the effect of melatonin on sleep in children with ASD younger than 2 years of age. Most of the clinical studies have reported improvements in sleep parameters with exogenous melatonin supplementation in ASD, including longer sleep duration, fewer nighttime awakenings and quicker sleep onset. Few studies also say that the nighttime administration of exogenous melatonin was associated with better daytime behaviours. There were minimal to no adverse effects in various treatment studies.
In some places in the world, melatonin is a medication prescribed by a doctor or licensed healthcare provider. In countries like Canada and the United States melatonin is a natural health product or a dietary supplement and is freely available over the counter without a prescription.
We have to make sure that the child does not use screen time at least 1 to 2 hours before bedtime, as screen time disrupts melatonin production and causes a delay in the initiation of sleep. Likewise, TV screens should not be installed in bedrooms. Also, before giving melatonin for sleep concerns, proper sleep hygiene should be maintained. It includes dim light in the sleeping room, no loud sound, slow music or lullaby could be used though. Make sure an ambient temperature is maintained and the room is not too cold or too hot.