A study published in the Journal of the American Academy of Child and Adolescent Psychiatry disclosed that children with autism spectrum disorder (ASD) who have refractory insomnia will benefit from prolonged release melatonin (PEDPRM). The trial conducted was random, placebo-controlled, and double-blind.
Profiles of participants
There were 125 participants in the trial aged 2 to 17.5 years. These were patients whose insomnia continued even after behavioral intervention. Such children were administered with 2 mg of PEDPRM once daily; the dosage was increased to 5 mg or placebo for the succeeding thirteen weeks. Trial participants included children who were diagnosed by physicians of ASD regardless whether or not they had attention deficit and hyperactive disorder (ADHD) and other neurogenetic disorders. The common factor among all participants was sleep issues.
How Sleep Was Measured
There were different sleep measures used in the trial and these included: Sleep and Nap Diary (SND) which was validated by the caregiver, and Composite Sleep Disturbance Index (CSDI). The end point of the measurements is the SND-reported total sleep time after thirteen weeks of being under the trial.
The baseline sleep time was 457.2 minutes for those in the PEDPRM group and 459.9 minutes for those in the placebo group. At the end of the 13-week trial, it was observed that the PEDPRM-treated children slept an average of 57.5 minutes longer than those in the placebo group who slept only 9.14 minutes longer.
Sleep latency, or sleep onset latency (SOL), the amount of time it takes to fall asleep, was observed to have decreased by 39.6 on average for those with the PEDPRM treatment, while it was only 12.5 minutes for those under the placebo treatment. Sleep latency was not linked to any earlier wake-up time. It was evident that the rate attaining a more beneficial response towards sleep latency was higher among those under the PEDPRM group than the placebo group. Sleep disturbance was also observed to have declined among the PEDPRM group members.
Based on previous studies conducted on the effects of supplemental melatonin, it has a favorable profile as regards to side effects and its low cost. The majority of parents who have children with ASD find melatonin a beneficial alternative to FDA-approved medications.
The Prevalence of Sleep Problems Among ASD Children
Sleep problems are not unusual for children, but they are more prevalent among those diagnosed with ASD and Asperger’s syndrome. Some of the issues often experienced by these patients are difficulty in sleeping, in staying asleep, and waking up too early.
The sleep problems that children with ASD experience may be due to several reasons. Children with autism are sensitive to stimuli. This can interfere with falling asleep easily and can disrupt them in the middle of the night. They are also quite dependent on routine and controlled conditions and struggle with any changes in their environment.
Scientifically Tested Reasons for Sleep Problems
Children with autism can also have difficulty with emotional regulation and the ability to self-soothe. These are essential elements for establishing bedtime routine. Co-sleeping with parents may also prove to be challenging for ASD children.
There are additional remedies for children with autism who have sleep issues. The first among them is to set up a sleep routine, a series of activities done in a similar manner every night leading up to bedtime.
A sleep schedule is also helpful for children with ASD who have insomnia. With this, you have to determine the number of sleep hours the child needs and work to attain those hours. It is also important to ensure a comfortable sleeping environment by blocking all possible sources of noise and finding the right temperature for your child. It’s also important to avoid any kind of sleep disruptor such as caffeine. Some medical issues such as eczema, sleep apnea, allergies, restless leg syndrome, and heartburn may also disrupt sleep which should be treated by a pediatrician. Remember to always consult with a doctor before starting any new regimen.