An open-label study of controlled-release melatonin in treatment of sleep disorders in children with autism.

Doctors gave 25 autistic children a slow-release melatonin pill every night. They tracked sleep with parent diaries and a short survey called the CSHQ. Families came back after one year and again after two years to see if the sleep gains lasted.

Every child slept better on the pill. Parents saw faster bedtimes and fewer night wakings. The better sleep stayed for the full two years with no side effects reported.

Wright et al. (2011) ran a placebo crossover and still found the same gain: kids fell asleep 47 minutes faster and slept 52 minutes longer. Their study proves the 2006 result was not just a placebo effect.

Van Hanegem et al. (2014) looked deeper and showed that kids who respond well process the drug in the usual way. You do not need costly lab tests before prescribing.

McLay et al. (2019) took a different path. They used bedtime charts and FBA-based plans instead of pills and also fixed sleep problems. The two papers do not clash; they give you both a drug and a behavior option.

You now have long-term safety data plus a clean RCT backup for nightly slow-release melatonin. If parent training has failed or the family needs sleep now, you can start 2–5 mg thirty minutes before bedtime while you plan any extra behavior steps. Track total sleep and sleep-onset time for two weeks; most kids show a change within days.