Whether your child is a toddler or a teenager, chances are if they are having sleep difficulties you have been recommended melatonin by your pediatrician or other specialists. This is a very common recommendation for individuals who struggle to sleep, more specifically for people on the autism spectrum. It is usually the first step that medical professionals take before prescribing a sleep medication.
Some parents may not like the idea of using a synthetic hormone to help their child sleep, while others may be at the point of desperation in helping their child get just another hour or two of sleep. This article will give you everything you need to know as a parent and caretaker to help make the best decision for your child with autism.
What is melatonin?
Melatonin is a hormone that our bodies naturally produce in order to get to sleep. As the day comes to an end, our body will pump more melatonin into our systems making us feel sleepy. Levels of melatonin peak and then gradually decrease as the night goes on. Melatonin works together with our brain to let us know time of day, seasonal changes and more.
In some cases, supplementing with melatonin can help individuals who are temporarily having trouble getting to sleep due to environmental disturbances. This can include travel, stress, changes in daily schedules, and more. Melatonin is safe to use temporarily for children, both typically developing and children with neurodevelopmental diagnoses, like autism, and has been used to treat a number of sleep issues, including insomnia.
Is insomnia common with autism?
It is estimated that 50-80% of individuals diagnosed with autism have difficulties sleeping. Whether they have insomnia depends on the severity of the sleep disturbances.
If the following happens at least three times weekly for one month, this is usually considered insomnia: Difficulty getting to sleep or maintaining sleep at night, difficulty sleeping despite ideal circumstances (environment, routine, physical activity, etc.), impairment of daytime abilities due to lack of sleep.
These are common sleep struggles for children and adults with ASD, and there are a number of different ways that it can be treated, including the use of melatonin. Although the effects of long-term use have yet to be determined, studies have determined that for some individuals melatonin can be helpful.
Is melatonin safe to use with individuals with autism?
It is generally agreed that in the short-term, melatonin can help with sleep issues. It can be a very helpful tool to help your child reset after a bout of sleepless nights, in moments of high stress, and to get back on track after time zone changes.
However, it is often sold and recommended as a “quick fix” remedy. When you’re exhausted, you will do almost anything to get yourself, or your child sleeping better. Often, sleep hygiene recommendations are not even considered. Although maintaining good sleep hygiene takes time and patience, melatonin cannot replace good sleep habits. This is where behavioral approaches to helping children sleep can be more effective than just giving melatonin.
In a 2017 study, it was revealed that over the counter melatonin products in the United States may not contain the amount that was advertised. When tested, melatonin levels varied by -83% to a whopping 478% with regards to potency! For a child, that means that they could be getting almost no boost of melatonin, or significantly more than they should get for their age.
In one example, researchers tested a chewable tablet for kids that was supposed to have 1.5mg of melatonin. It actually had 9mg of melatonin. Without knowing the long term effects of melatonin use, it is understandable if you are skeptical about starting this treatment with your autistic child.
As a sleep specialist and coach, I’ve spoken to hundreds of families who have tried melatonin. In about half of the cases, it works well for their child at least to get to sleep. But very often, it actually made overall sleep at night worse. Most families I speak to find that it does help their child get to sleep easily, but then their child is up and raring to go at 2am and unable to get back to sleep for several hours.
What can I give my autistic child to sleep?
If your child is struggling to fall asleep and stay asleep each night, there are a few different options when it comes to supplementation. These can all be great options if you’re wary of trying melatonin, or if you did not see great results with it in the past.
If there is a concern your child is not producing enough melatonin, the first things to supplement with are the amino acids and vitamins the body needs to actually produce it naturally.
Tryptophan and calcium are vital for the body to create melatonin and serotonin for sleep. Tryptophan can easily be supplemented through foods like poultry, some fish, dairy products, oats and more. For additional calcium, you can also give your child dark leafy green vegetables, soy products, beans and legumes, etc.
For many children with sensory issues, these foods may not be an easy sell. Although I do not recommend supplementing with additional tryptophan, supplementing calcium can easily be done with gummies and chewable vitamins. Calcium is a mineral that many of us are deficient in and often needs additional supplementation.
Another incredible supplement for sleep is magnesium. Magnesium is a crucial mineral and similar to calcium, it is one that many of us are deficient in. Studies have shown that people diagnosed with insomnia and chronic sleep issues are often deficient in this essential mineral.
It can help us feel more relaxed and can help with different ailments, like constipation, which is common for many children with autism. There are many types of magnesium, and I recommend starting with magnesium citrate if given orally through powder, capsule, liquid or gummy. If your child is very sensitive to textures and tastes, using a topical magnesium cream or epsom salt baths are a great alternative.
What is the best option for my child?
Ultimately, as your child’s parent, caretaker, and advocate, you need to decide what is right for you and your child. There is absolutely nothing wrong if you are at your wit’s end and need to find a quick solution to get your child resting better. Again, in the short term, melatonin can be helpful as you dig deeper into your child’s sleep issues and what might be causing them.
However, you should not feel that melatonin or sleep medication is your only solution. So often, children can start sleeping significantly better with the right kind of nutritional changes as listed above, as well as behavioral and habit changes around the sleeping process.
A good night’s sleep is imperative for a child on the autism spectrum. Making sure that they are getting the rest they need will allow them to stay better regulated, more focused, and be successful in whatever therapy they are enrolled in.
If melatonin is something you feel your child needs to make this happen, be sure to check with your child’s pediatrician to get the correct amount of their age.
References:
Grigg-Damberger. M. and Ianakieva. D. Poor Quality Control of Over-the-Counter Melatonin: What They Say Is Often Not What You Get. J Clin Sleep Med. 2017 Feb 15; 13(2): 163–165. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5263069/
Gricvas, B. T. and Savvidou, D. O. Melatonin the “light of night” in human biology and adolescent idiopathic scoliosis, Scoliosis. 2007; 2: 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855314/#:~:text=Levels%20of%20melatonin,3).
Meadows, A. How Magnesium Can Help You Sleep. Sleep Foundation. https://www.sleepfoundation.org/magnesium
Sachin. R and Ekambaram. V. Pharmacological Approach to Sleep Disturbances in Autism Spectrum Disorders with Psychiatric Comorbidities: A Literature Review. Med Sci (Basel). 2018 Dec; 6(4): 95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313590/
Zhao D. et al. Melatonin Synthesis and Function: Evolutionary History in Animals and Plants. Front. Endocrinol., 17 April 2019. https://www.frontiersin.org/articles/10.3389/fendo.2019.00249/full
