Melatonin for Sleep

If your child or adolescent is not getting enough sleep, you may notice that there are increased emotional outbursts, trouble with cognitive tasks like schoolwork and behavioral difficulties, including having difficulty with keeping on task, failure to remain alert and focused or for some, even increased agitation and anxiety.  A study in 2003 (Gruber & Raviv) determined that lack of needed sleep for one hour per day for three days may lead to significant neurobehavioral problems.  Numerous researchers have presented evidence that there is indeed a relationship between sleep problems, neuro-developmental problems, psychiatric conditions and non psychiatric conditions among children and adults. Once the pattern is set, the sleep disorder and the co-morbid conditions actually serve to support both problems. 

The prevalence of sleep problems in children and adolescents with autistic spectrum disorders (ASD) are greater than in the typical population. Sleep issues and problems come up frequently in discussions with parents, many whom express dismay and sheer exhaustion from trying to manage.  Sometimes, the family physician may recommend anti anxiety drugs or other pharmaceutical prescription and non-prescription remedies, but most of the time these fall short in truly making a difference and helping the child establish good sleep patterns and restful sleep.  Recently, researchers have begun to address and realize that melatonin therapy may be a successful and practical help.

Melatonin is a  naturally occurring hormone (derived from serotonin) that is both endocrine (enters the bloodstream from a pineal gland) and paracrine (signaling cell phenomenon, as from the retina when light is low, when the signal is "time to sleep"). Melatonin has also been labeled an antioxidant, anti-aging agent, immunoregulator, and an  anti-depressant .  As a supplement, it is available over the counter in pill/capsule form.

What researchers are finding is that some individuals with autism spectrum disorders (ASD) may have lower than normal levels of melatonin. A 2008 study found that unaffected parents of children with ASD also have lower melatonin levels.  Multiple small studies have demonstrated that 2 to 10 mg of melatonin may benefit children with ASD who have trouble falling asleep and/or maintaining sleep.  It’s important to note that at this time, no official guidelines exist for the use of melatonin in children with ASD.  If you want to read  more about melatonin, here is one credible website http://nccam.nih.gov/health/sleep/ataglance.htm.   You may also want to check with your child’s physician, as many are knowledgeable about the possible benefits of Melatonin

Autism and Epilepsy

As a clinical health psychologist, when working with clients, I focus on the interrelationship between their behavioral, psychological and physical health problems. When working with individuals diagnosed on the Autism Spectrum, addressing any physical problems and disabilities is an important focus.   There is a unique interrelationship among behavioral, emotional, cognitive, social and biological components in health and disease and these components need to be addressed and examined in order to promote and help maintain health, prevent further problems and help to rehabilitate in the best way possible. 

With Autism, one of the more common co morbid conditions is epilepsy. Epilepsy is a common and diverse set of chronic neurological disorders characterized by seizures. Epilepsy occurs in almost one third of individuals diagnosed with ASD.  Some researchers say that this suggests an imbalance of neural excitation and inhibition.  If you are familiar with an individual with Autism, you may have noted that excitation and inhibition are two problematic areas and contribute to behavior challenges.

Management of epilepsy requires a multidisciplinary health care team effort and open and ongoing communication between the physician, psychologist and other health care providers. For the person diagnosed with Autism and Epilepsy, these co occurring conditions need to be taken into account with addressing behavioral and psychological issues.  If you are the parent, support and education about how to manage can make a huge difference in coping with the ongoing stress and challenges you face.