Melatonin for Autism Spectrum Disorder
- Sara L
- Mar 22, 2024
- 4 min read
Melatonin is produced naturally in our brains. However research shows that in children with ASD, their internal factories are unable to make melatonin they way they should, leading to issues with sleep¹. This has a negative knock-on effect to all other areas of their lives including how they behave, think and socialize with others.
In one study, children with ASD who took melatonin fell asleep 37 minutes earlier and sleep 48 minutes longer², which equates to an extra 1 hour and 25 minutes of sleep per day. Over the course of weeks, this could make a huge difference in terms of how they think and act the following morning. Research suggests that Melatonin supplementation can help children with ASD fall asleep faster and sleep for longer³.
Potential benefits of melatonin supplementation⁴
Melatonin Dosages
Start with the lowest dose for your child’s age and slowly increasing the dose every 2 nights until they are able to sleep or until the maximum recommended dose is reached.
Unfortunately there are still not very many studies on the long term use of melatonin in children with ASD.
Per the Autism Treatment Network, the dosing guidelines are as follows; start at a dose of 0.5-1 mg per night regardless of age or weight. The dose given may be increased up to 6mg if it is not improving your child’s sleep. Studies show that doses of 6 mg or less are helpful⁵.
Melatonin should be given no later than 30-60 minutes before bedtime. If your child takes some time to wind down, give it to them 60 mins before bed time.
In their book 'The ADHD and Autism Nutritional Supplement Handbook', Godbout Laake and Compart suggest that if your child wakes up during the night, you can give one additional dose of melatonin to help them get back to sleep. Do not give this dose after 4am as it could make your child feel sluggish that morning.
Melatonin daily dosing (Godbout Laake and Compart, 2013)
Age | Dose (mg) | How often? |
2-5 years | 0.5-1 | 30-60 minutes before bedtime |
6-10 years | 1-3 | 30-60 minutes before bedtime |
11+ years | 1-4 | 30-60 minutes before bedtime |
As melatonin is a hormone it is best to limit its use to a month or less if you can. Work on sleep hygiene (no screen time before bed, low lighting in bedroom pre-bedtime, blackout shades for sleep, no sugary snacks or drinks right before bed), encourage daily exercise, daily sunlight exposure, a balanced diet free of processed food continuing food dyes (especially red dye), and take melatonin vacations (not taking it for a few days) to see whether or not your child still needs this supplement.
Unfortunately there are few studies on children who take melatonin for long periods of time, but in the Child Medication Fact Book for Psychiatric Practice by Feder et al. (2023), they describe a Dutch study which followed children taking melatonin for over 3 years found no significant long term negative effects on the children (including on puberty which was one of the concerns). This is reassuring, given that in children with ASD, they may need to use it for longer periods of time.
Pro Tip: keep track of your child’s sleep for a week or two before starting melatonin using a sleep diary. Continue to monitor their sleep after starting melatonin. It is also helpful to think about how your child behaves during the day so see whether or not their behavior is improving with better sleep. All this information feeds into whether or not you decide to continue giving melatonin.
Side effects and toxicity of melatonin
It is considered safe and well tolerated.
Side effects include nightmares, vivid dreams, next day grogginess, headache, irritability, upset tummy, dizziness, low blood pressure, bedwetting.
According to US Poison Control, toxicity doesn't really occur with too much melatonin, but do not give more than the amount discussed with your child’s health care provider. If someone takes too much melatonin they might experience sleepiness, headaches, nausea and maybe agitation⁶. Loop your child's health care provider in so that they are aware of any increased dosages you would like to try, and so that they can double check on their end that it is a safe dose for your child’s weight and age.
There was the concern that melatonin might cause seizures in some children. New studies show that melatonin does not cause seizures. Ironically in a few children melatonin may actually cause insomnia, so monitor your child for this side effect.
Medications your child may be taking that melatonin interacts with:
This is quite a long list and may not include everything. So it is best to speak to your child's health care provider if you decide to try melatonin so that they can cross check what your child is taking currently with the melatonin guidelines they use. This will keep your child safe.
Antidepressant medications.
Antipsychotic medications.
Benzodiazepines.
Birth control pills.
Blood pressure medications.
Beta-blockers.
Blood-thinning medications (anticoagulants, like coumadin).
Interleukin-2.
Non-steroidal anti-inflammatory drugs (NSAIDs).
Steroids and immunosuppressant medications.
Tamoxifen.
Who shouldn't take melatonin without first talking to their health care provider⁷?
Those who are breastfeeding or pregnant
Those with autoimmune disorder
Those with depression
Those with Diabetes or high blood pressure
In the PDF here that I have attached I have provided a Cheat Sheet for Moms with a summary of melatonin's characteristics discussed above, as well as a ‘cut the dotted line’ section for when it comes time to shop for melatonin with steps and recommendations to keep in mind when purchasing, including checking for third party testing to ensure that what you are buying is high quality.
This site is for general informational purposes only and does not constitute the giving of medical advice. The contents do not constitute the practice of medicine, nursing, or other professional health care services. No provider–patient relationship is formed. Please consult with your child's healthcare provider when considering supplementation for children.
Godbout Laake, D. & Compart, P. J. MD (2013) The ADHD and Autism Nutritional Supplement Handbook. Fair Winds Press. To purchase on Amazon click here.
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