1 - Child and Adolescent Psychiatry, Hospital Dona Estefânia, Unidade Local de Saúde São José, Lisboa, Lisbon.
- 29th International Congress of the European Society for Child and Adolescent Psychiatry (ESCAP), 29 june – 1 july 2023, Copenhagen
- Poster Presentation (topic: treatment - psychopharmacology)
Background/Objective: It is well known that sleep disturbances affect many children with autism spectrum disorder (ASD), further impairing their development, functioning and family’s quality of life. Few non-pharmacologic therapeutic options are available, such as parental education and behavioral therapy, which are commonly found insufficient in these patients. Pediatric prolonged-release melatonin (Slenyto®) is currently the only approved pharmacologic therapy for this population. We report a case of severe sleep disturbance in a 15-year-old boy with ASD, treated with Slenyto®.
Method: A 15-year-old boy, diagnosed with ASD, was referred to our Child Psychiatric Outpatient Unit due to social communication and interaction impairment, hyperactivity and severe behavioral disorder. A genetic panel was performed, describing variants in CAMK2B and CSNK2A1 genes, which failed to retrieve clinical significance. We identified a major sleep disturbance with very reduced total sleep time (<5h), prolonged sleep latency (>1h), and prolonged awakenings (up to 3h). As he presented only a partial response to treatment with off-label geriatric prolonged-release melatonin, as well as to sleep hygiene measures, treatment with Slenyto® 2mg was started.
Results: After a few weeks of treatment, there was an overall improvement. Sleep latency was completely reduced, total sleep time increased to 10h, and sleep maintenance improved, with no awakenings reported. There was a significant improvement in his behavior and language development. It also had a very positive impact in parents’ sleep and daytime functioning.
Conclusion: Slenyto® allowed a substantial improvement in this patient’s overall condition, as well as in his parents’ quality of life.
Palavras Chave: autism spectrum disorder, melatonin, pediatric prolonged-release, sleep melatonin