Melatonin is safe for long-term use in autistic children who have difficulty sleeping, according to a new study

The study tracked the sleep hormone’s effects in autistic children over a two-year period. Melatonin has previously been suggested as a sleep aid for children on the spectrum, but the new study is the first to systematically assess its long-term safety.

Up to 80 percent of autistic children struggle to fall or stay asleep. These difficulties can exacerbate problems with learning, behavior and overall quality of life, says lead investigator Beth Malow, professor of neurology and pediatrics at Vanderbilt University in Nashville, Tennessee. Helping children get more sleep, she says, may alleviate these issues.

“[Good sleep] can improve and mitigate a lot of problems, so that kids can focus better and do better in school and therapy, and also it can impact the family quality of life,” Malow says.

Improving sleep hygiene — by having a quiet bedtime routine and keeping devices out of the child’s room at night, for example — is the first step to better sleep, Malow says. But when that is not enough, many doctors and families also turn to melatonin, a hormone that is produced in the brain and promotes sleep. Melatonin is available as an over-the-counter supplement in the United States and by prescription in many other countries.

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