From the Guidelines
Melatonin should be considered for sleep problems in a 19-month-old with autism, but only under pediatrician supervision, with a typical starting dose of 0.5-1 mg given 30-60 minutes before bedtime. For this age, the liquid form is usually easiest to administer to toddlers. Before trying melatonin, it is essential to establish consistent bedtime routines, maintain a regular sleep schedule, create a calm sleep environment, and limit screen time before bed 1. Melatonin works by supplementing the body's natural sleep hormone, which helps regulate sleep-wake cycles and may be disrupted in children with autism. Some key points to consider when using melatonin for a 19-month-old with autism include:
- Starting with a low dose and gradually increasing as needed, under the guidance of a pediatrician
- Monitoring for side effects, which are generally mild but can include morning drowsiness, headaches, or increased bedwetting
- Using melatonin for short-term management of sleep difficulties, as it is not FDA-approved specifically for children with autism
- Considering behavioral strategies to improve sleep, such as establishing a consistent bedtime routine and creating a calm sleep environment, before trying melatonin 1. It is crucial to consult with the child's doctor for proper dosing guidance and to discuss the potential benefits and harms of melatonin use in this population, as the benefits/harms assessment is uncertain, and rigorous long-term data are lacking 1.
From the Research
Melatonin for 19-Month-Old Autism
- There are no studies directly addressing the use of melatonin in 19-month-old children with autism, as the available studies focus on older children and adults.
- However, the existing research suggests that melatonin can be effective in improving sleep problems in individuals with autism spectrum disorder (ASD) 2, 3, 4, 5, 6.
- A study published in the Journal of Autism and Developmental Disorders found that melatonin shortened sleep onset latency in children with ASD, with significant improvements in the 1-mg and 4-mg melatonin groups compared to the placebo group 2.
- Another study published in Sleep Medicine Reviews found that the literature supports the existence of a beneficial effect of melatonin on sleep in individuals with ASD, with only few and minor side effects 4.
- A systematic review of randomized clinical trials published in Cureus found that melatonin is a well-tolerated and safe medication in the dose range of 2-10 mg/day in the child and adolescent population, with statistically significant improvements in sleep duration and sleep latency onset compared to the placebo 5.
- A controlled trial published in the Journal of Autism and Developmental Disorders found that supplemental melatonin improved sleep latency in children with ASD, was well tolerated and safe, and showed improvement in sleep, behavior, and parenting stress 6.