We try to review a research article each week. Because we were both recently at the Autism Research Institute (ARI) conference, we picked a research article related to one of our presentations: sleep–or the lack thereof. We are not talking about OUR lack of sleep (there is not much sleeping going on out here), we are talking about sleep issues for children with autism.
Missy was lucky enough to present alongside Dr. Rosignol. He presented on the medical aspects of treating sleep and she presented on the behavioral aspects of sleep programs.
Thus, we are going to review his recent article on the use of melatonin to aid with sleep for children with autism. He co-authored the article with Dr. Richard Frye. The article was published in Developmental Medicine and Child Neurology in April, 2011. The authors set out to review the research on the use of melatonin for children with autism. The authors conducted a meta-analysis which is simply analyzing the results from a group of studies to determine if a consistent outcome was observed.
A total of 35 studies were included in the review. However, the meta-analysis (statistical analysis) was performed on five studies which were considered to be highly experimental. Specifically, the five studies included random assignment to treatment groups, the use of double-blind procedures (which means the researchers and the participants were blind to treatment groups), and treatment groups received treatment or a placebo.
The authors reported some very interesting results across the studies. First 9 studies individually reported that melatonin or its metabolites were abnormal for the children with autism in the studies. Seven additional studies reported that the melatonin (or its derivates) levels were below average for participants. Five studies reported gene abnomalities that could have contributed to the decreased melatonin production.
In terms of outcomes following melatonin supplement use, the authors reported that six studies indicated improved daytime behavior following melatonin use. Eighteen studies reported improvements in “sleep duration, sleep onset latency, and night-time awakenings.The authors went on to report large effect sizes (which means that the studies consistently showed positive outcomes) for increases in sleep duration. However, there were no significant findings related to nighttime awakenings. Additionally, side effects were reportedly minimal to none.
In summary, many children with autism present with sleep difficulties including later onset, shorter duration of sleep, and frequent night awakenings. This meta-analysis showed that children with autism may have a lower level of melatonin or they may have an underlying condition that affects melatonin production. However, the use of melatonin as a supplement improved the overall duration of sleep for children. Additional studies are needed to determine how to address frequent awakenings during the night.
We want to know, does your child have sleep issues? What are they? Have you tried melatonin? Was it effective?
If you have a research topic that you would like for us to review, please let us know.