Melatonin and medication
Understanding melatonin, how it is used for sleep in autistic children, and what to know about other medicines.
What is melatonin?
Melatonin is a hormone naturally produced by the body that helps regulate sleep–wake cycles. Synthetic melatonin is sometimes prescribed to help with sleep difficulties, including for autistic children.
In the UK, melatonin is a prescription-only medicine for children. It should only be used under the guidance of a qualified healthcare professional — typically a consultant paediatrician or child psychiatrist.
Safety
- Melatonin should only be used as prescribed by your doctor
- Dosage and timing matter — follow your healthcare provider’s instructions
- Monitor for any side effects and report them to your doctor
- Keep all medicines out of reach of children
- Do not adjust dosage without consulting your healthcare provider
- Behavioural and environmental strategies should be tried first, before medication
Tips to help melatonin work better
Melatonin is most effective when combined with good sleep habits and a supportive environment.
Regular daily exercise
Physical activity during the day helps promote better sleep at night. Aim for 30–60 minutes, but complete vigorous exercise at least 3–4 hours before bedtime.
Avoid heavy meals close to bedtime
Have the main evening meal at least 2–3 hours before bedtime. If a snack is needed, opt for something light like toast or a banana.
Consistent sleep hygiene routine
A predictable wind-down routine signals to the body that sleep is approaching — warm bath, brushing teeth, pyjamas, and quiet activities like reading.
Address sensory issues
Blackout curtains, white noise machines, comfortable bedding textures, cool room temperature (16–18°C), and seamless pyjamas can all help.
Limit screen time before bed
Blue light from screens interferes with natural melatonin production. Aim for 1–2 hours screen-free before bedtime.
Consistent timing
Give melatonin at the same time each night as recommended by your doctor (usually 30–60 minutes before desired sleep time). Keep wake times consistent too.
Natural light exposure
Exposure to daylight in the morning helps regulate the body’s internal clock. Spend time outdoors or near well-lit windows.
Calming activities before bed
Gentle music, audiobooks, massage, or deep breathing exercises. Some children respond well to proprioceptive input like gentle squeezes.
Every child is different. Keep notes on what seems to help and discuss your observations with your healthcare provider.
Second-line medicines
When behavioural strategies and melatonin are not sufficient, specialists may consider other medicines. These are typically used only under the supervision of a consultant paediatrician or child psychiatrist.
Use of these medicines for sleep in children is often “off-licence”. That is common in paediatrics, but it needs specialist monitoring and shared-care agreements.
Clonidine
Alpha-2 adrenergic agonist
Main use. Sleep onset and maintenance, often with ADHD
Side effects. Dry mouth, drowsiness, low blood pressure, headache. IMPORTANT: Never stop abruptly — risk of rebound hypertension.
BNFC informationPromethazine (Phenergan)
Sedating antihistamine
Main use. Short-term sleep onset help
Side effects. Morning drowsiness, blurred vision, dry mouth, constipation
BNFC informationAlimemazine (Vallergan)
Sedating antihistamine
Main use. Severe sleep disturbances in children
Side effects. Drowsiness, dry mouth, thickening of mucus, coordination issues
BNFC informationChloral hydrate
Sedative-hypnotic
Main use. Short-term treatment (max 2 weeks) for severe insomnia in neurodevelopmental disorders
Side effects. Drowsiness (can last 24h), stomach irritation, nausea, paradoxical excitement. Very strict monitoring required.
BNFC informationProfessional resources
Medical disclaimer
Always consult your GP or specialist paediatrician before starting, stopping, or changing any medicine. Every child’s medical history is unique. This website provides information only — not medical advice.