It is well known that improving sleep patterns leads to a general improvement in health, behaviour and wellbeing. Any child being considered for a trial of melatonin must have:
1. significant sleep onset difficulties.
2. at least one of the following:
- ocular visual impairment
- severe to profound learning disabilities
- neurological disorder, eg cerebral palsy
- neurodevelopmental disorder, eg attention deficit hyperactivity disorder (ADHD) and autism.
Sleep disorders in children with neurological and neurodevelopmental disorders are very common. Causes include:
- delayed brain maturation
- altered function of sensory organs, especially vision
- abnormalities of the sleep centres.
The particular types of sleep difficulties seen include:
- delayed sleep onset
- frequent wakening
- early morning wakening
- day-night reversal patterns.
- Melatonin may be prescribed to assist development of improved sleep patterns and behaviours, when and only once, appropriate behavioural sleep interventions fail.
- It may also be viewed as an alternative to sedatives and hypnotics, which have adverse side-effects.