SLEEP DYSFUNCTION IN RETT-SYNDROME - A TRIAL OF EXOGENOUS MELATONIN TREATMENT

Nine girls with Rett syndrome (mean age, 10.1 years) were monitored 24 hours a day over a period of 10 weeks using wrist actigraphy, Baselin e sleep-wake patterns were assessed for 1 week, Subsequently, patients underwent a 4-week melatonin treatment period in a double-blind, plac ebo-controlled, crossover protocol that employed a 1-week washout betw een treatment trials. Melatonin doses ranged from 2.5 to 7.5 mg, based upon individual body weight. Baseline sleep quality was poor compared with healthy children, At baseline the group demonstrated a low sleep efficiency (mean [+/-SE], 68.0+/-3.9%), long sleep-onset latency (42. 1+/-12.0 minutes), and a short and fragmented total sleep time (7.5+/- 0.3 hours; 15+/-2 awakenings per night), Melatonin significantly decre ased sleep-onset latency to (mean +/- SE) 19.1+/-5.3 minutes (P<0.05) during the first 3 weeks of treatment. While the variability of indivi dual responsiveness was high, melatonin appeared to improve total slee p time and sleep efficiency in the patients with the worse baseline sl eep quality. Finally, a 4-week administration of melatonin appears to be a safe treatment as no adverse side effects were detected, yet long -term effects of chronic melatonin use in pediatric patients are unkno wn at this time.