From the Guidelines
Melatonin can be used for sleep difficulties in young children with suspected autism, but should only be given under pediatrician guidance. For a 19-month-old with possible autism, the typical starting dose is very low, around 0.5-1 mg given 30-60 minutes before bedtime 1. Liquid formulations are often easier to administer to toddlers. Sleep problems are common in children with autism spectrum disorder, and melatonin may help regulate sleep-wake cycles as it's a hormone naturally produced by the pineal gland in response to darkness.
Key Considerations
- Before trying melatonin, establish consistent bedtime routines, limit screen time before bed, maintain a dark and quiet sleep environment, and ensure regular nap and sleep schedules.
- Potential side effects include morning drowsiness, increased urination at night, and rarely headaches or increased agitation.
- If melatonin is used, start with the lowest possible dose and monitor your child's response closely, as recommended by studies on the use of melatonin in children with autism spectrum disorders 1.
Important Reminders
- Remember that melatonin is a supplement, not a long-term solution, and addressing underlying sleep habits remains important for sustainable sleep improvement.
- It is crucial to follow the guidance of a pediatrician when using melatonin for a child with suspected autism, given the potential for side effects and the importance of proper dosage and administration 1.
From the Research
Melatonin for 19-Month-Old Possible Autism
- The use of melatonin for sleep problems in children with autism spectrum disorder (ASD) has been studied in several clinical trials 2, 3, 4, 5, 6.
- A randomized controlled trial found that 1-mg and 4-mg melatonin significantly shortened sleep onset latency in children with ASD compared to a placebo group 2.
- A systematic review of 12 studies found that melatonin had a beneficial effect on sleep in individuals with ASD, with few and minor side effects 3.
- Another systematic review of six randomized clinical trials found that melatonin improved sleep duration and sleep latency onset in children with ASD and/or attention-deficit hyperactivity disorder (ADHD) 4.
- A review of melatonin's effects in ASD found that it may also have a role in improving autistic behavioral impairments, in addition to its therapeutic benefits on sleep disorders 5.
- A controlled trial examining dose, tolerability, and outcomes of melatonin in children with autism found that supplemental melatonin improved sleep latency, was well tolerated and safe, and showed improvement in sleep, behavior, and parenting stress 6.
Dosage and Safety
- The studies suggest that melatonin is well-tolerated and safe in the dose range of 1-4 mg/day in children with ASD 2, 6.
- One study found that melatonin was effective in improving sleep latency at dosages of 1 or 3 mg 6.
- Another study found that melatonin was well-tolerated and safe in the dose range of 2-10 mg/day in the child and adolescent population 4.
Age Considerations
- The studies included children with ASD ranging in age from 2 to 18 years 2, 4, 6.
- However, there is limited information available on the use of melatonin in children as young as 19 months with possible autism.
- Further research is needed to determine the safety and efficacy of melatonin in this age group 3, 5.