Melatonin for disordered sleep in individuals with autism spectrum disorders: Systematic review and discussion - 22/10/11

Doi : 10.1016/j.smrv.2011.02.001

Fabian Guénolé ^a,^⁎ , Roger Godbout ^b,^{^{h
Tel.: +1 514 323 7260; fax: +1 514 328 3504.}} , Alain Nicolas ^c,^{^{i
Tel.: +33 4 37 91 54 80; fax: +33 4 37 91 54 82.}} , Patricia Franco ^d,^{^{j
Tel.: +33 4 27 85 60 52; fax: +33 4 27 86 92 30.}} , Bruno Claustrat ^e,^{^{k
Tel.: +33 4 72 35 72 93; fax: +33 4 72 35 73 05.}} , Jean-Marc Baleyte ^f,^g,^{^{l
Tel.: +33 2 31 27 23 09; fax: +33 2 31 27 24 03.}}
^a CHU de Caen, Service de Psychiatrie de l’enfant et de l’adolescent, Avenue Clemenceau, Caen F-14000, France
^b Sleep Laboratory and Clinic, Hôpital Rivières-des-Prairies, 7070 Boulevard Perras, Montréal, Québec H1E1A4, Canada
^c Unité d’exploration Hypnologique, Service Hospitalo-Universitaire de Psychiatrie, Centre Hospitalier spécialisé Le Vinatier, 95 Boulevard Pinel, 69677 Bron Cedex, France
^d Unité de Sommeil Pédiatrique, Hôpital Femme-Mère-Enfant, 59 Boulevard Pinel, 69677 Bron Cedex, France
^e Centre de Médecine Nucléaire, Service d’hormonologie, Hôpital Neuro-Cardiologique, 59 Boulevard Pinel, 69394 Bron Cedex, France
^f CHU de Caen, Service de Psychiatrie de l’Enfant et de l’Adolescent, Avenue Clemenceau, Caen, F-14000, France
^g University of Caen, Faculty of Medicine, Caen F-14000, France

Corresponding author. Tel.: +33 2 31 27 23 09; fax: +33 2 31 27 24 03.

Summary

Sleep disturbance is common in autism spectrum disorders (ASD) and melatonin is widely prescribed in such cases despite a lack of guidelines. The aim of this paper is to provide a systematic review of efficacy and safety of exogenous melatonin for treating disordered sleep in individuals with ASD. We performed a Pubmed^® documentary search enlarged by a manual review of references, which finally supplied 12 citations (4 case reports, 3 retrospective studies, 2 open-label clinical trials, and 3 placebo-controlled trials). As a whole, we 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. However, considering the small number of studies and their methodological limits, these conclusions cannot yet be regarded as evidence-based. Randomized controlled trials and long-term follow-up data are still lacking to better assess efficacy and safety of exogenous melatonin for disordered sleep in individuals with ASD.

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Keywords : Asperger syndrome, Autistic disorder, Child development disorder, pervasive, Circadian rhythm, Drug chronotherapy, Hypnotics and sedatives, Melatonin, Sleep, Sleep initiation and maintenance disorders

Abbreviations : AA, AD, AS, ASD, CR, IR, PDDNOS