Melatonin and circadian rhythms in autism: Case report

Abstract

Among the most co-occurring conditions in autism spectrum disorders (ASD), there are sleep disorders which may exacerbate associated behavioral disorders and lead to intensification of existing autistic symptoms. Several studies investigating the use of melatonin in the treatment of sleep disorders in ASD have shown comparative efficiency in sleep with little or no side effects. Here we report a case of ASD with non-24-hour rhythm and the effect of melatonin in circadian parameters by actigraphy. Visual analysis of the first 10 days recorded and the periodogram suggest that this patient showed a non-24-hour rhythm. This ASD subject showed before melatonin administration an activity/rest rhythm lower than 24 hours. The results show that melatonin increased approximately 4.7 times the regularity of circadian activity rhythm and resting staying on average between 00:00 and 06:00 and showed positive effects in improving the quality of sleep and behavior. So, the actigraphy showed an ASD subject with a non-24-hour activity/rest rhythm which changed this rhythm to a 24-hour rhythm after melatonin administration. This result reinforces the prospect of therapy with melatonin for synchronization (increased regularity) of endogenous rhythms and improve sleep quality and hence behavior and indicates the actigraphy as a choice tool to characterize several parameters of the activity/rest rhythm of ASD individuals.

Non‐24‐hour sleep‐wake disorder successfully treated with the combination of ramelteon and suvorexant in a case of autism spectrum disorder

“…12,13 Among the etiological hypotheses, atypical production of melatonin may explain the high prevalence of sleep disorders in ASD. 9,10,14,15 Our case was a patient with ASD who displayed more severe symptoms after dropping out of college. When she was at school, she managed to maintain a standard sleep cycle but N24SWD became apparent once she stopped going outside.…”

“…ASD is a neurodevelopmental disorder characterized by impairments in communication skills and social interaction, as well as restricted, repetitive, and stereotyped patterns of behavior. 9,10 Among the most common comorbidities in ASD, sleep disorders 11 occur in 40% to 80% of cases, which exceeds the 20% to disorders in individuals with ASD may exacerbate associated behavioral disorders and lead to the intensification of existing autistic symptoms. 12,13 Among the etiological hypotheses, atypical production of melatonin may explain the high prevalence of sleep disorders in ASD.…”

“…ASD is a neurodevelopmental disorder characterized by impairments in communication skills and social interaction, as well as restricted, repetitive, and stereotyped patterns of behavior. 9,10 Among the most common comorbidities in ASD, sleep disorders 11 occur in 40% to 80% of cases, which exceeds the 20% to 40% in children with typical development. The presence of sleep F I G U R E 1 In September, we initiated behavioral education but, owing to a lack of improvement, we prescribed ramelteon 8 mg from the end of September.…”

“…The presence of sleep disorders in individuals with ASD may exacerbate associated behavioral disorders and lead to the intensification of existing autistic symptoms 12,13 . Among the etiological hypotheses, atypical production of melatonin may explain the high prevalence of sleep disorders in ASD 9,10,14,15 …”

Nonparametric time series summary statistics for high-frequency accelerometry data from individuals with advanced dementia

“…The simplest nonparametric estimator is the periodogram [ 27 ]. Some studies have preferred a modified version named the chi-squared periodogram [ 28 ] to characterise circadian rhythms [ 29 – 31 ]. For people who do not suffer from dementia or sleep disorders, both methods usually provide that the highest point in the spectrum generally occurs around the frequency of 1/24 hour -1 (known as the fundamental frequency), and further peaks occur at harmonic frequencies, which are positive integer multiples of the fundamental frequency.…”