1392 Melatonin–Nutrition Synergy Resolving Chronic Sleep Maintenance Insomnia in a Child with Turner Syndrome
Abstract
Children with Turner syndrome are at elevated risk for sleep-disordered breathing and chronic insomnia due to craniofacial structure, developmental delay, and complex medical comorbidities. However, limited evidence exists on how basic physiological supports may modify sleep patterns in this population. We present a child with Turner syndrome whose years-long pattern of severe sleep fragmentation improved rapidly and unexpectedly following combined melatonin therapy and nutritional supplementation.
A 5-year-old girl with Turner syndrome, aortic coarctation, valvular heart disease, failure to thrive, and global developmental delay was referred for chronic sleep maintenance insomnia beginning in infancy. Her baseline sleep pattern involved frequent nighttime awakenings, prolonged nocturnal alertness, and an inverted schedule characterized by daytime sleep. Behavioral sleep routines had been attempted without improvement. Despite fragmented sleep, she displayed daytime hyperactivity without excessive sleepiness. Examination revealed craniofacial features typical of Turner syndrome—retrognathia, midface hypoplasia, high-arched palate, and webbed neck—contributing to elevated risk for sleep-disordered breathing. Snoring was mild and intermittent, with no witnessed apneas, parasomnias, or restless sleep behaviors. At the time of sleep evaluation, caregivers reported a striking and unexpected improvement. Two interventions initiated several weeks earlier—melatonin 2 mg nightly and…
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