Desperate for Sleep: Exploring Parental Perceptions of Melatonin Use Among Adolescents With Neurodevelopmental Disorders.

PURPOSE: Sleep disturbances are common in adolescents diagnosed with neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD) and/or attention-deficit hyperactivity disorder (ADHD). Sleep-related impairment can include worsening of underlying symptoms such as stereotypic and repetitive behavior, inattention, hyperactivity, and impaired learning. Exogenous melatonin has shown promise in improving sleep onset latency and total sleep time in adolescents with NDDs. The purpose of this study was to describe parents' experiences with sleep disturbance, sleep-related impairment, and exogenous melatonin use in their adolescent child diagnosed with an NDD. DESIGN AND METHODS: We conducted semi-structured interviews with twenty-six parents of adolescents (11-18 years of age) diagnosed with ASD and/or ADHD. Data were analyzed using qualitative conventional content analysis. RESULTS: Before the initiation of melatonin, all parents stated their child had experienced difficulties falling asleep. Parents described sleep-related impairments in both child and family functioning, such as behavioral issues, cognitive difficulty, and parental lack of sleep. Most parents had attempted sleep hygiene-related interventions before initiating melatonin. Over half of the parents reported initiating melatonin at their healthcare provider's recommendation. All parents believed melatonin was natural, without major health or safety issues. All parents described subjective improvements in their child's sleep latency with the use of exogenous melatonin. Parents of adolescents diagnosed with ASD and/or ADHD reported that melatonin is a safe and effective intervention for the management of their child's sleep disturbances. Parents also reported switching melatonin brands, changing melatonin dosages, and discontinuing and restarting melatonin. PRACTICE IMPLICATIONS: Due to the known reported inconsistencies in purity and dosage between over-the-counter melatonin brands, frequent switching of brands and dosages should be a consideration for patient education and the potential impact of efficacy and safety. Practice would benefit from future studies targeting validation and standardization of age-appropriate adolescent sleep-related intervention, including the everyday usage and long-term safety of exogenous melatonin.