Dados do Trabalho

Título

Use of Melatonin for the Treatment of Sleep Disorders in Autistic Patients

Introdução

Autism Spectrum Disorder (ASD) is a neurodevelopmental deficiency characterized by difficulties in learning, communication and social interaction, with limited interests and stereotyped behaviors. In addition, the patient can commonly present sleep alterations, especially in childhood, due to reduced levels of secretion of melatonin, a hormone that functions as a biomarker of circadian rhythms. Its chronobiotic effect consists in regulating the sleep-wake rhythm, which in individuals with ASD may be altered from the first year of life.

Objetivo

To analyze the effects of exogenous melatonin administration for autistic patients with sleep disorders, and its contribution to the treatment of these patients.

Métodos

Systematic review conducted in August 2024, in the PubMed database, based on the keywords "autism AND sleep AND melatonin". There were 76 articles, published between 2015 and 2024, and after analysis of the studies, only 12 were included in the research.

Resultados

Melatonin treatment for sleep disorders in autistic patients is indicated when behavioral strategies, such as sleep hygiene, are insufficient. For these patients, the immediate release formulation is less effective, since its therapeutic benefit is centered on sleep induction, not being as efficient in reducing nocturnal awakenings. Long-release melatonin, besides reducing latency, contributes to the increase of total duration and improved sleep maintenance. This composition, whose peak is reached in 3 hours after the intake of 2 mg, does not cause unwanted phase advance in the sleep-wake cycle. Another important point is the positive impact on externalizing behaviors, especially in hyperactivity and inattention, as well as on improving academic performance. This drug has a favorable profile regarding tolerance and acceptability. Its adverse effects are considered mild (headache, drowsiness, fatigue and dizziness) and manifest in the initial weeks.

Conclusões

Melatonin with prolonged release is considered the first line pharmacological treatment for insomnia in patients with ASD, due to its efficacy in effects that are not restricted to sleep induction, besides safety with long-term use. Its therapeutic contribution can also improve the quality of life of caregivers, since the well-being of patients shows significant improvement, especially in the daytime. However, the preferential treatment for insomnia in autistic people is based on behavioral and environmental interventions.

Palavras -chave

Autism; Sleep; Melatonin.