Pharmacological treatment of sleep disturbance in developmental disabilities: a review of the literature.

Hattier et al. (2011) read every sleep-medication paper they could find on kids with developmental disabilities. They hunted for controlled trials, case reports, anything that gave a pill for bedtime problems.

They wanted one clear answer: which drug is safest and actually works?

Melatonin won. The review says it has the strongest evidence and the cleanest safety record.

Other sleep drugs showed up in too few good studies, so the team called for more trials before anyone counts on them.

Taylor et al. (2017) adds the behavioral half of the story. Their meta-analysis of 169 participants shows large, quick gains when you use bedtime routines or response-reduction without any pills. The two reviews sit side-by-side: try behavior first, reach for melatonin if that fails.

Egan et al. (2020) looks only at Angelman syndrome and finds the same drug—melatonin—gives mixed results. The clash sounds scary, but their pool is smaller and lumped together studies with very different doses. A et al.’s wider lens still holds.

Smit et al. (2019) moves the question to adults and finds almost no solid drug evidence. The 2011 kid-focused conclusion therefore stays the best guide for pediatric practice, while grown-ups still wait for good trials.

If a family has tried bedtime fading, stimulus control, and chopped screen time yet the child still lies awake for hours, you now have one medication with real data behind it. Start with low-dose melatonin, track sleep with a simple log, and you are following the strongest evidence base available. Keep other sleep drugs on the “needs more research” shelf until clearer studies arrive.