Assessment of Serum Melatonin Levels, Sleep Patterns, and Clinical Symptoms in Children With Autism Spectrum Disorder: A Case-Control Study.

Objective: This study aimed to investigate the relationship between serum melatonin levels, sleep habits, and clinical features in children with autism spectrum disorder (ASD) compared to healthy controls.

Methods: A total of 71 children, aged 2-8 years, including 38 with ASD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition criteria and 33 age- and sex-matched healthy controls, were evaluated. Serum melatonin, vitamin D, ferritin, serum iron, and iron-binding capacity were analyzed. Sleep habits were assessed using the Pediatric Sleep Habits Questionnaire, while the Autism Behavior Checklist and Modified Checklist for Autism in Toddlers were administered to the ASD group. Relationships between biochemical markers and questionnaire scores were analyzed.

Results: The mean age was 44.4±20.4 months in the ASD group and 51.2±20.0 months in the control group (p=0.104). The ASD group exhibited higher "bedwetting" scores, while the control group had higher "daytime sleepiness" scores (p=0.008, p=0.036, respectively). Serum melatonin levels were significantly elevated in the ASD group (823.2±237.9 U/L) compared to controls (677.4±254.7 U/L, p=0.027), with this difference significant in males (p=0.020) but not in females (p=0.608). No significant correlations were observed between melatonin levels and questionnaire scores.

Conclusion: Elevated daytime melatonin levels and altered sleep patterns in children with ASD suggest potential melatonin receptor desensitization. Sex-specific variations underline the importance of personalized melatonin-based interventions. These findings provide insights into developing tailored therapeutic strategies for managing sleep and behavioral challenges in ASD. However, future studies are needed to explore these findings further with larger and more diverse populations.