My Autism Insights

A conversation with my yoga client, a licensed dietitian, brought up this question.  She specializes in working with children with special needs, particularly those on the autism spectrum, and recommended to one parent to try melatonin for her daughter.  The daughter is sleep deprived and suffering quite a bit because of it.  Yet, Mom’s pediatrician warned her against using melatonin , saying it is addictive.  So I decided to do some looking into the subject…again.

A search for the long term side effects of melatonin mostly produced results that said the same thing: no one really knows the long-term effects because sufficient studies have not been done.  There was one study that seemed to indicate that the levels of melatonin produced by the brain over an extended time could be reduced with the use of the supplement.  Again, no one knows for sure, as it is also thought that melatonin levels decrease in the body naturally with age (also not studied extensively).

Gus has been taking .5 mg every night since mid-November, so for a little over 2 months.  I did a little experiment to see if he’d sleep without it now, since many people use it to regulate the sleep cycle and then stop using it.  Last night he had none and slept just fine.  No dependency! I wasn’t really concerned.

I generally err on the side of “use as little as possible for the least amount of time possible.”   Since the jury is still out on long-term use, perhaps that should be a consideration when trying it with children.  Certainly think twice if your child is on any kind of medication, as the two may react poorly together.  But a very low dosage for a while just to try to get your child’s sleep cycle regulated will probably not do any harm.  That being said, I’m not a doctor, so you may want to check with a medical professional first.

Further reading:

Mayo Clinic

University of Maryland Medical Center

Long-term study (full article only available via purchase - this links to the abstract)

If you’ve got any further information about the long range safety of melatonin that I haven’t uncovered, by all means, please share!

Amazing how I’ve been up since 4:30, got up at 5 to make this post, and it’s almost 6 and I’m just starting.  I blame my new toy, Twitter.  Anyway, on to thankfulness:

I am thankful that Gus got dressed this morning without me having to ask more than three times.  No fuss, no drama - that’s the way I like to start the day!  Of course, now he’s pretending to be a rock star, Reggie Rockout, complete with green shades, blue striped hat, my clogs and acoustic guitar (he’s in disguise).  His first song will be entitled Rock it Out, and the first album will be The Best Rock Tunes Ever!  I may have to get some t-shirts and hats printed.  Is it possible I can get him out of his disguise before school time?  Can I at least get my shoes back?

I am thankful that my kids love music so much.  Even if one of them doesn’t have the most melodic voice in the world, she makes up for it with enthusiasm and incredible creativity.  Some of MM’s lyrics are pretty cool!  So at any given time, one of them is always bursting into song as long as they think no one is paying attention.  Yesterday, Gus’s song was What a Day for a Daydream. There’s a voice and acting school somewhere nearby, I think.  If things pick up economically, I may just sign these guys up.

Finally, I am thankful that I have an extremely patient husband because I think the vegetarian experiment is really wearing on him.  I won’t even discuss last night’s meal right now except to say that I did cave in and we had salmon.   It was maybe a step above the veggie meat(less) loaf.

Oh, and one of the reasons I joined Twitter was to take part in Autism Twitter Day on Tuesday, December 16th organized by Bonnie Sayer of Autism Family Adventures .  So if you’re on Twitter and connected to the autism community in some way, check it out!  And thank you, Bonnie, for such a great idea!!

Comment with your gratitude, please!

image courtesy of Jannagraphics

‘Tis the season for Seasonal Affective Disorder!  Thanks to Mo of Manic Monday for the prompt, which made something click in my brain this morning that may explain some things about Gus’s recent behavior.

Seasonal Affective Disorder or SAD is a type of depression that usually strikes during the winter months.  More younger people and women are affected, and it can have an impact on children as well as adults.  This condition is likely caused by the reduction in daylight hours, which alters the body’s circadian rhythms (sleep/wake cycles) and levels of melatonin and serotonin in the body - hormones that affect sleep and mood respectively.

Common symptoms in children may include: mood changes, changes in appetite, sleep disturbances, low energy, and trouble concentrating among others.

I bring up the symptoms for children because I think this could be the answer to some of the issues Gus has been having lately and tends to have every winter.  I always knew that he was affected in some way by the colder months, but I never related it to the light, I always thought it was a matter of cold.  However, it’s all making perfect sense - the sudden sleep problems, his waning ability to focus in school, his increasing irritability (especially this past weekend), his disinterest in going out….These could all be individual and unrelated problems, but they could also be related to SAD.  Unfortunately, I was unable to locate studies or statistics about how SAD in autistic individuals.

One of the most common treatments for Seasonal Affective Disorder is light therapy.  If light boxes are too expensive, or if it’s not practical to think your child can sit in front of a light box for 30 minutes or so, there are also light visors (also pricey), or you could try full spectrum lighting.  While there is no evidence that this will cure SAD, they are closer to natural lights than standard light bulbs or CFLs.  And they do make full spectrum CFLs if you are energy and environmentally conscientious.

Other means of relief to try: melatonin to help with sleep disturbances (it’s been working pretty well for us so far), outdoor exercise, proper diet (cravings for sweets and carbs is also common), talk therapy, or antidepressants prescribed by a doctor.

Now, if you’ll excuse me, I’m going to hide this bag of chips, and I’m going to find some full spectrum lights.  Gus may or may not be  seasonally effected, but I definitely am.  Funny how I’m only motivated to do something about it when it might be causing my son a problem.

Have a great day and Happy Monday!

After two straight nights of middle-of-the-night wake-ups, I finally decided to do some further research into the use of melatonin for sleep disturbances in children.  Gus falls asleep fine, but wakes up in the middle of the night.  Sunday night, he got some water and went right back to sleep.  Last night he got up about three times and did not want to stay in his room.  He’s not complaining of nightmares.  Last night he was sweating, so he was clearly too warm (don’t know why - it got cold last night) but the night before he wasn’t - he just woke up.  This has been an ongoing problem, and I’m starting to wonder if it’s not just waking up, but if he’s really not getting good quality sleep, which might  effect his performance at school.  Hence the decision to try melatonin.  That and I need to sleep.

There were dozens of articles that came up in my search.  I mainly looked for possible side-effects, appropriate dosages, whether or not age is a factor, and for a general overview of what exactly the stuff does in the body.

Melatonin is a a hormone that occurs naturally in the body, usually secreted by the pineal gland when the brain perceives darkness.  It basically regulates the body’s internal clock, among other functions that are not sleep related.

While the bottle says that it is only to be used for adults, almost everything I’ve read suggested that in very low dosages, it’s fine for children and teens for a short period of time.  I also noted that many of the studies done on its effectiveness/safety in children were done with children having special needs.  In children under 15, the recommended starting dose (according to one site that was the most conservative starting dose) is under .3 mg per day given at bedtime.  More than 1 mg per day may create problems, like seizures, so if you really felt the need to use that amount or more, you should consult a doctor.  Melatonin also interacts with certain medications(for good or ill)  - another reason to consult a doctor before using it.

Some resources for further reading:

University of Maryland Medical Center

USA Today

Keep Kids Healthy.com (2002 article)

Anthony Kane, MD

Andrew Weil, MD

PubMed

These are just a few articles to start you off.  I also wanted to note that we do use behavioral means of helping Gus sleep, which is the main reason he falls asleep fairly easily.  Television goes off an hour before bedtime, and we have a very consistent bedtime routine.  So, we’re going to try a very low dose - about .25 mg for a few days to see how it goes.  The goal is to get him sleeping through the night again to see if his body will regulate itself.  I doubt we’d use the supplement for more than a couple of weeks at most.

If there’s anything I’ve missed or gotten wrong, or if you’d like to share any additional advice/thoughts on melatonin use, please feel free to comment!  And wish us luck (or sleep even)!