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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.

Happy sleeping!

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We try to review a research article each week. Because we are both in Las Vegas this week for 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.

As if having a child with autism isn’t stressful enough, the condition brings along many other issues as well. For example, many children with autism also have gastrointestinal (GI) issues. Many children with autism also have feeding problems. And if those don’t wreak havoc on a family, try having all of that plus a child who won’t sleep.

Sleeping issues may be brought on by a number of variables including medical issues. Before trying any sleeping program with your child, be sure to rule out any underlying medical issue that may be affecting the sleep disorder. For example, some antibiotics cause insomnia. If your child is taking antibiotics, the medication could be causing the sleep issue.

Some environmental factors may be contributing to the sleep dysfunction. And that is the topic of today’s research review. The study we will review is titled, “Does television viewing cause delayed and/or irregular sleep–wake patterns?” The study authors are Asaoka, Fukuda, Tsutsui, and Yamazaki. The study was published in the Journal of Sleep and Biological Rhythms in 2007.

I like this study because they did not focus on participants with disabilities. Instead, they studied people from the random population. Eight participants were college age and the other eight were elderly. The researchers studied the participants for 2 weeks while the participants wore a wrist recorder and they self-recorded notes about their activities. The first week of the study, the researchers asked the participants to behave normally. The second week of the study, the researchers limited television watching to just 30 minutes per day.

The researchers reported that for elderly participants, their sleep-awake patterns did not change. However, for the college-age participants, sleep increased significantly. The researchers noted that while the sleep for elderly participants did not change, the motor movements at 1am decreased when television was limited and the researchers associated that with the decrease in television.

The researchers noted that “previous studies have revealed that exciting video display terminal tasks with a bright display suppresses the concentration of melatonin” which is definitely related to sleep. They also discussed the association with increasing body temperature and increased sleep so they stressed the importance of an evening bath.

In summary, if your child is having difficulty sleeping, we suggest that you cut out television, iPad, and video games at least 2 hours before bed time. Instead, use that time to settle in to a comfortable bedtime routine of bathing, reading, and family time.

Happy Sleeping!

 

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