A Question about Melatonin and Sleep | Autism PDD

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i feel for you i really do jack has been through some AWFUL sleep problems we had months where he would sleep for a couple of hours then from 10pm he'd be up wanting to play and this would go on all night i was a zombie since my dh works nights it was all on me this happend several times and he seems to be growing out of it now (knock on wood)he is 6 and a half now.we found that changing his routine helped some we got him atv/video for his bedroom at christam and now he watches one of his favorite films when he goes up and now knows that once that is finsihed it is sleep time and 9 times out of 10 he will sleep through.As for stopping his naps i wouldn't we realised that when jack had not had a nap he would sleep the 2 hours and wake up and it slowly dawned on us that he wasn't sleeping he was napping so once he has had a nap during the day he goes down better at night.This was a long time coming though.We had the added problem that tiredness is a trigger for his epilepsy and because of the drugs he takes we were reluctant to try anything to put him to sleep bear with it and hopefully this phase will pass

Well, DS had a great night last night!!  When I picked him up at school, he was sleeping; the teacher said he'd been napping for about half an hour (their naptime is at 12:40, and I picked him up at about 1:55), and he didn't fall back asleep in the car.  He went to bed at 8 and was asleep by 8:30.  I didn't give him any melatonin last night.  DH and I were talking, and realized that actually, the night waking coincided with us starting the melatonin.  When we didn't give it last night, he slept through the night!!  I was so excited!  Maybe the melatonin wasn't the answer.  I think this earlier naptime at school night help, too.  His naptime before school was from about 1:45/2:00 until 3 or 3:15.  I think that might have been too late for him and that's why he wouldn't settle down at night. 

I hope the problem is solved; keep your fingers crossed!!  He's been a great sleeper since he was 4 months old; this is so strange for him!

Jen

 

Jen I don't know much about melatonin but I can relate to what you are going through, my son's bus comes beteween 7:15 and 7:30 in the morning  and sometimes he is still awake at midnight. I am looking into getting him a weighted blanket to see if that helps settle him in at night. My son seems to deal fine with no sleep though, I think this is how he is gonna always be!!! Hope this helps some.

                                          Nita

Melatonin for Sleep Disturbances in Children

Melatonin is effective and safe for sleep disturbance in children with cerebral palsy, autism and learning problems

Issue No:
Child Health Monitor, Volume 3, Issue 6
June 2002

Background:

Melatonin, a hormone produced by the pineal gland in the brain, is increasingly being used to treat sleep disturbance in children. Melatonin is most commonly used for jet lag, but claims have been made that it also promotes general health and protects against the effects of ageing. Melatonin helps regulate the body's sleep-wake cycle and its production is determined by light and dark. When darkness falls, the pineal gland produces more melatonin, promoting sleep and regulating the body's sleep-wake cycle with the outside world. Because of its use in promoting sleep, melatonin is increasingly used in the treatment of sleep disturbance in children. However, this particular use of the drug has been studied very little and in fact, melatonin is not licensed as a drug in most countries. Although it's available without a prescription in the USA (where it's sold as a "dietary" substitute), melatonin is not available at all in the UK or Australia.

Sleep disturbance is common in childhood, and is particularly problematic in children with neurological problems such as learning difficulties, cerebral palsy, autism spectrum disorders and epilepsy, as well as children with visual impairment (partial or complete). This is probably because these children have difficulty recognising and attuning their sleep cycle to the outside world's sleep-wake cycle.

Little is known about how useful or safe melatonin really is as a treatment for childhood sleep disturbance. A number of reports describing the use of melatonin in small numbers of children, have suggested that it is useful and probably safe, but no studies have been published where the drug has been used on larger numbers of children. Additionally, no randomised controlled studies testing the safety and effectiveness of melatonin have been performed. These types of studies are necessary to properly establish the effectiveness and safety of the drug in treating paediatric sleep problems. Evidence from adult studies suggests that melatonin generally seems very safe, but potentially it can promote depression, worsen epilepsy and delay puberty. These authors report on one of the largest groups of children with neurological problems using melatonin. (Sadly it wasn't a randomised trial).

Findings:

The researchers identified all children with sleep disturbances in a large paediatric neurology clinic and offered them melatonin to treat the condition. 49 mothers agreed to give their children melatonin and keep diaries and records of the differences it made to their children's sleep patterns. The children were given 2.5mg of melatonin per night if they were under five years of age and 5mg if they were over five. The dose was increased, if necessary, to a maximum of 7.5mg in children under two years and 10mg over this age. The children with sleep problems also had either cerebral palsy, learning difficulties, epilepsy, autistic spectrum disorders or Down syndrome. Only seven children were also visually impaired.

They found that the melatonin significantly improved almost all aspects of sleep in most of the children and around 93% recorded significant benefits. The average number of hours sleep that the children had each week increased by around 10%, from 54 hours/week before taking the melatonin to 66 hours/week while taking the melatonin. The number of interruptions to sleep each week decreased by 50% from an average of seven interruptions per week before taking the melatonin, to 3.5 interruptions while taking the drug. Also, the number of hours of interrupted sleep decreased by 45%, from nine hours awake each week during a sleep interruption pre melatonin, to five hours per week while taking melatonin.

There were no major side effects from the medication in any of the children and importantly there was no change in the frequency or severity of seizures in children with epilepsy. Boys and girls were equally likely to respond well to melatonin. The visually impaired children were the most likely to have success with melatonin, but around three-quarters of the fully sighted children also responded very well.

Comments:

This is further support for the effectiveness and safety of melatonin in children with sleep problems, particularly in children with neurological problems. An impressive 93% of children responded positively. However the medical community still requires supporting evidence in the form of a randomised clinical trial before we can uniformly recommend melatonin for this purpose.

Reference:

Ross & Whitehouse. Melatonin treatment for sleep disorders in children with neurodevelopmental disorders: an observational study. Developmental Medicine & Child Neurology May 2002; 44: 339-44.

Action Points:

* Sleep disturbance is common in children with cerebral palsy, learning difficulties, intellectual disability, visual disability, autism and epilepsy. Melatonin at a dose of 2.5-10mg is a safe and probably effective treatment for sleep disturbance in these children.

Reproduced with permission of ChildHealthMonitor.org, which translates pediatric journal articles into everyday language providing comprehensive information on research breakthroughs ranging from general nutrition to rare diseases. A great resource for busy Pediatricians and also for parents who want to learn how best to care for their children's medical and parenting problems.

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Jen, try giving him less than the 1 mg you've been giving him. You'd
be surprised at how little you need for it to be effective. We crush it into
powder and give our kids just a little bit on our finger tip, and it works
beautifully, with no night time hallway walking!

Melatonin helps you fall asleep, it won't keep you asleep.  Some stores, like Kmart, have them in the mcg form versus the mg form.  But unfortunately with some of these kids it doesn't matter what you give them, they won't stay asleep.

Tammy

Seems like we've got a little bit of everything at our house!  We never had a sleeping problem and I was SO grateful for that.  He is 10 and he started partying in the middle of the night about 2 years ago.  TV, video, fishy crackers, green juice (7up) and running into my room screaming at the top of his lungs. 

I worked with our psych (who is awesome--we've been through several losers) and we tried 1mg melatonin and it did nothin'.  We upped to 2mg and it has worked very well for 2 years.  He still goes through short phases (3-4 days) of getting up and having his party but it isn't often.  Our kids have so much in common and yet are so different.  It's amazing.

Pat 

ps  Paul was 8 years old with the 2mg dosage.  I'm certainly not recommending it!  Nor would I ever.  I'm just sharing.  Good luck!

Pat

I have seen it in the mcg doses, the 1 mg., and the 3 mg. doses.  I have never seen it in the 2 mg ones.  It wouldn't surprise me if they skipped the 2 mg's here altogether.  I know I take it myself and sometimes it works and sometimes it doesn't.

Tammy

Pat,

            I can relate to the party in the middle of the night!!!! My son has had many of those he used to turn on all the lights so he could see all of the stuff he was getting into. I have woke up more times with the soda or milk and box of cereal in bed with me!!!! He has since he started school stopped doing this THANK GOD!!! I like how you call it a party in the middle of the night that is cute!!

                                                          Nita

A little over a month ago, we started giving my 3-year-old about 1 mg of melatonin to help him get to sleep at night.  Basically, he would go to bed and stay awake for close to two hours - even if he was completely exhausted, and the melatonin helped him get to sleep.  Now we are running into another set of issues; he gets to sleep within an hour of us putting him down, but he is waking up anywhere between 1 and 3 a.m.  and not going back to sleep for a good 2 - 2 1/2 hours.  He has started a new specialized preschool just for kids on the spectrum and has to be up no later than 7 AM so we can leave by 7:15 AM, so you can see where this is really messing up his routine.  They give the kids an hour of rest time, but being that this is a new school, it will probably take him a while to feel comfortable enough to actually sleep there.  Yesterday, he fell asleep in the car on the way home at about 2:15 and slept for about an hour; I woke him up because I was afraid we wouldn't be able to get him to bed. 

I don't know what to do; this is a relatively new problem - he always slept through the night up until about a month ago.  I am not going to let him nap anymore if I can avoid it, but Sunday night he was up for HOURS and it was very hard to wake him when he fell asleep yesterday afternoon.  It's becoming a vicious cycle.  I hope that once his body adjusts to his new school routine that the problem will resolve itself.  He is going from 8 - 2 every day which is a HUGE change for him.

Thanks for any input!

Jen

Just a word of caution:  Melatonin should not be taken by prenant or lactating women, nor should it be taken by women thinking of getting pregnant.  I'm guessing it may have some bad effects on the fetus/baby, but I don't know what.  I just know that I took melatonin a long time ago before I learned that women who may get pregnant should not take the drug.

Just thought I should share that info.

Thanks for the reply verginia,

I'm acually goin to the docs today in about 2 hrs... I'm so glad my friend sent me this site last night. I'm goin to mention it to him... I know I'm far away from you, but are those white noise machines hard to find???  I heard about those machines before(His old daycare uses them for nap time)

 

Thanks

Jen

Here's the link where I got my white noise from.

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&ssPageName =ADME:B:EOIBSAA:US:11&Item=110092928781

You'll have to check and see if they ship to Canada...but I don't see why not.

My older dd (NT) has been taking melatonin for a few months now, & it seems to help her (although, me, forever the skeptic isn't sure if it's a placebo effect for her!).  But, even with her, there are nights it doesn't seem to work (we've changed--lowered--doses to see if it helps) & she does wake up in the middle of the night quite a bit.  Still working on that... 

One thing I would advise--has your child been to a neurologist?  Our younger dd had horrible sleep issues from the time she was 9 mos or so.  She would be up at all hours of night--major stim time, etc.  We even moved her crib BACK to our room around 15 mos or so until 7 mos ago.  We discovered our dd was having seizures--and this was part of her night-waking.  Since going on seizure med, she sleeps most nights (relief!!).  She still stirs & does wake up several times per week--but is easier to put back to sleep.  Her small size, we're able to still have her in a crib (a blessing!).  Anyway, I'd rule out seizures just to be sure.

White noise also works GREAT for our dd, also we just got her a neat Thomas nightlight from WalMart--it has this soft blue light that glows from it.  I hope you're able to get some sleep--it just makes everything else more difficult when you are sleep-deprived. 

I personally cannot take melatonin for the exact same reason.  I fall asleep promptly, but after a few hours I wake up.  If I can go back to sleep, then I keep waking up all night.  In the morning I am even more exhausted than I was before I started taking the melatonin.  So, I don't take it...I just wait until 2AM or whenever I usually am able to finally go to sleep.  I figure I'm better off with 5 solid hours of sleep than I am with a whole night of not really sleeping well at all.Wow Julia!!  That sounds like Caleb to... that's nutts!!  What A very nice pic of you two!  How is your little boy @ sleeping??
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