• J Intellect Disabil Res · Jan 2010

    Randomized Controlled Trial

    Melatonin decreases daytime challenging behaviour in persons with intellectual disability and chronic insomnia.

    • W Braam, R Didden, A P H M Maas, H Korzilius, M G Smits, and L M G Curfs.
    • 's Heeren Loo Zuid-Veluwe, Wekerom, The Netherlands. wiebe.braam@sheerenloo.nl
    • J Intellect Disabil Res. 2010 Jan 1; 54 (1): 52-9.

    BackgroundPersons 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.MethodWe 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.ResultsMelatonin 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.ConclusionsMelatonin treatment in persons with ID and chronic insomnia decreases daytime challenging behaviour, probably by improving sleep maintenance or by improving circadian melatonin rhythmicity.

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