Real-life course and effectiveness of melatonin treatment for sleep disturbances in children with autism spectrum disorder
Abstract
Objective: Melatonin is considered the most effective pharmacological treatment for the sleep disturbances that are reported in >50% of children with autism spectrum disorder (ASD). However, real-life data about the long-term course and effectiveness of melatonin treatment in children with ASD is lacking. Methods: In this retrospective cohort study, we assessed the adherence to melatonin treatment and its effect on sleep quality and daytime behavior in children with ASD via a parental phone questionnaire of children in the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) database. Cox regression analysis was used to assess the effect of key demographic and clinical characteristics on treatment adherence. Results: Melatonin was recommended for ~8% of children in the ANCAN database. These children were characterized by more severe autistic symptomatology. The median adherence time for melatonin treatment exceeded 88 months, with the most common reason for discontinuation being a lack of effectiveness (14%). Mild side-effects were reported in 14% of children, and 86%, 54%, and 45% experienced improvements in sleep onset, sleep duration and night awakenings, respectively. Notably, melatonin also improved the daytime behaviors of >28% of the children. Adherence to treatment was independently associated with improvements in night awakenings and educational functioning (aHR=0.142, 95%CI=0.036-0.565; and aHR=0.195, 95%CI=0.047-0.806, respectively).…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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