Melatonin decreases daytime challenging behaviour in persons with intellectual disability and chronic insomnia.
Study Goal
The researchers aimed to determine whether melatonin treatment reduces daytime challenging behavior in individuals with intellectual disability (ID) and chronic insomnia by improving sleep parameters or circadian melatonin rhythmicity.
Results Summary
Melatonin treatment significantly reduced daytime challenging behavior (measured by SGZ scores), improved sleep latency, reduced night wakes, increased total sleep time, and advanced dim light melatonin onset (DLMO). However, changes in challenging behavior did not significantly correlate with changes in sleep parameters or DLMO.
Population
49 individuals (25 men, 24 women; mean age 18.2 years) with intellectual disability and chronic insomnia.
Effective Dosage
5 mg (2.5 mg for those under 6 years old) daily.
Duration
4 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
melatonin | decrease | SGZ scores | persons with ID and chronic insomnia | - | significantly reduced | #1 |
melatonin | decrease | sleep latency | persons with ID and chronic insomnia | - | reduced | #2 |
melatonin | decrease | number of night wakes | persons with ID and chronic insomnia | - | reduced | #3 |
melatonin | decrease | duration of night wakes | persons with ID and chronic insomnia | - | reduced | #4 |
melatonin | increase | total sleep time | persons with ID and chronic insomnia | - | increased | #5 |
melatonin | increase | dim light melatonin onset (DLMO) | persons with ID and chronic insomnia | - | advanced | #6 |
melatonin | decrease | daytime challenging behaviour | persons with ID and chronic insomnia | - | decreases | #7 |
BACKGROUND: Persons with intellectual disability (ID) and sleep problems exhibit more daytime challenging behaviours than persons with ID without sleep problems. Several anecdotal reports suggest that melatonin is not only effective in the treatment of insomnia, but also decreases daytime challenging behaviour. However, the effect of melatonin treatment on daytime challenging behaviour in persons with ID has not been investigated in a randomised controlled trial. METHOD: We investigated the effects of melatonin on challenging behaviour using data from two randomised controlled trials on the efficacy of melatonin on sleep problems in 49 persons (25 men, 24 women; mean age 18.2 years, SD = 17.1) with ID and chronic insomnia. Participants received either melatonin 5 mg (<6 years 2.5 mg) or placebo during 4 weeks. Daytime challenging behaviour was measured by the Storend Gedragsschaal voor Zwakzinnigen - Maladaptive Behaviour Scale for the Mentally Retarded (SGZ; Kraijer & Kema, 1994) at baseline week and the end of the fourth treatment week. Salivary dim light melatonin onset (DLMO) was measured at baseline and the last day of the fourth treatment week. Sleep logs were used to gather information on sleep parameters. RESULTS: Melatonin treatment significantly reduced SGZ scores, sleep latency, and number and duration of night wakes, and treatment increased total sleep time and advanced DLMO. However, after 4 weeks of treatment, change in SGZ scores did not significantly correlate with change in sleep parameters, nor with change in DLMO. Relatively strong correlations were found between change in SGZ scores, change in DLMO and number of night wakes. CONCLUSIONS: Melatonin treatment in persons with ID and chronic insomnia decreases daytime challenging behaviour, probably by improving sleep maintenance or by improving circadian melatonin rhythmicity.