Melatonin & Medication
Understanding melatonin, how it's used for sleep in autistic children, and what to know about other medications.
What is Melatonin?
Melatonin is a hormone naturally produced by the body that helps regulate sleep-wake cycles. Synthetic melatonin supplements are sometimes prescribed to help with sleep difficulties, including for autistic children.
In the UK, melatonin is a prescription-only medication for children. It should only be used under the guidance and supervision of a qualified healthcare professional — typically a consultant paediatrician or child psychiatrist.
⚠️ Important Safety Information
- •Melatonin should only be used as prescribed by your doctor
- •Dosage and timing are important — follow your healthcare provider's instructions
- •Monitor for any side effects and report them to your doctor
- •Keep all medications 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.
Remember: Every child is different. Keep notes on what seems to help and discuss your observations with your healthcare provider.
Second-Line Medications
When behavioural strategies and melatonin are not sufficient, specialists may consider other medications. These are typically used only under the supervision of a consultant paediatrician or child psychiatrist.
⚠️ Expert Guidance Required: The use of these medications for sleep in children is often "off-license". This is common in paediatrics, but requires careful specialist monitoring and shared care agreements.
Clonidine
Alpha-2 adrenergic agonistMain 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.
Promethazine (Phenergan)
Sedating AntihistamineMain Use
Short-term sleep onset help
Side Effects
Morning drowsiness, blurred vision, dry mouth, constipation
Alimemazine (Vallergan)
Sedating AntihistamineMain Use
Severe sleep disturbances in children
Side Effects
Drowsiness, dry mouth, thickening of mucus, coordination issues
Chloral Hydrate
Sedative-hypnoticMain 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.
Professional Resources
⚠️ Critical Medical Disclaimer
Always consult with your GP or specialist paediatrician before starting, stopping, or changing any medication. Every child's medical history is unique. This website provides information only — not medical advice.