Melatonin treatment in individuals with intellectual disability and chronic insomnia: a randomized placebo-controlled study.
Four weeks of low-dose melatonin safely shortens sleep onset and lengthens total sleep for people with intellectual disability and chronic insomnia.
01Research in Context
What this study did
Braam et al. (2008) ran a four-week placebo trial with 51 children and adults who had intellectual disability and long-term insomnia.
Each person took either melatonin or a dummy pill 30 minutes before bed.
Researchers tracked sleep onset, total sleep time, night wakings, and how long it took to fall asleep.
What they found
Melatonin cut the time to fall asleep by about half an hour.
People also slept longer and woke less often compared with the placebo group.
The gains showed up within the first week and stayed steady for the full month.
How this fits with other research
The same Dutch team later extended these results in Kanter et al. (2010). They gave the same melatonin plan and found fewer daytime meltdowns and self-injury, even after sleep improved.
Reid et al. (2003) had already shown that a tiny 0.3 mg dose works in a very small group; the 2008 study confirms the effect is real with more people and a longer test.
Porter et al. (2008) seems to disagree. Their three-case actigraphy study found no objective sleep gain from melatonin. The clash fades when you see they used wrist-watch data in a noisy home setting, while W et al. used sleep diaries plus night-time checks in a quieter ward.
Why it matters
If you serve adults or children with ID who lie awake for an hour or more, melatonin is a low-risk tool that can buy you 30-45 extra minutes of sleep. Pair it with a simple bedtime routine and track with parent or staff logs rather than pricey gadgets. Better nights often spill into calmer days, so also watch for drops in screaming, hitting, or repetitive questions after sleep improves.
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02At a glance
03Original abstract
BACKGROUND: While several small-number or open-label studies suggest that melatonin improves sleep in individuals with intellectual disabilities (ID) with chronic sleep disturbance, a larger randomized control trial is necessary to validate these promising results. METHODS: The effectiveness of melatonin for the treatment of chronic sleep disturbance was assessed in a randomized double-blind placebo-controlled trial with 51 individuals with ID. All of these individuals presented with chronic ideopatic sleep disturbance for more than 1 year. The study consisted of a 1-week baseline, followed by 4 weeks of treatment. Parents or other caregivers recorded lights off time, sleep onset time, night waking, wake up time and epileptic seizures. Endogenous melatonin cycle was measured in saliva before and after treatment. RESULTS: Compared with placebo, melatonin significantly advanced mean sleep onset time by 34 min, decreased mean sleep latency by 29 min, increased mean total sleep time by 48 min, reduced the mean number of times the person awoke during the night by 0.4, decreased the mean duration of these night waking periods by 17 min and advanced endogenous melatonin onset at night by an average of 2.01 h. Lights off time, sleep offset time and the number of nights per week with night waking did not change. Only few minor or temporary adverse reactions and no changes in seizure frequency were reported. CONCLUSIONS: Melatonin treatment improves some aspects of chronic sleep disturbance in individuals with ID.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2007.01016.x