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Psychiatry Investig > Volume 22(4); 2025 > Article
Psychiatry Investigation 2025;22(4):397-404.
DOI: https://doi.org/10.30773/pi.2024.0355    Published online April 11, 2025.
Assessment of Serum Melatonin Levels, Sleep Patterns, and Clinical Symptoms in Children With Autism Spectrum Disorder: A Case-Control Study
Çağlar Charles Daniel Jaicks1  , Perihan Çam Ray2  , Özlem Görüroğlu Öztürk3  , Gonca Gül Çelik2  , Ayşegül Yolga Tahiroğlu2  , Zeliha Haytoğlu4  , Yusuf Döğüş3 
1Child and Adolescent Psychiatry Department, Istanbul Aydın University Hospital, Istanbul Aydın University, Istanbul, Türkiye
2Child and Adolescent Psychiatry Department, Çukurova University Faculty of Medicine Hospital, Çukurova University, Sarıçam, Adana, Türkiye
3Biochemistry Department, Çukurova University Faculty of Medicine Hospital, Çukurova University, Sarıçam, Adana, Türkiye
4Pediatrics Department, Çukurova University Faculty of Medicine Hospital, Çukurova University, Sarıçam, Adana, Türkiye
Correspondence: Çağlar Charles Daniel Jaicks ,Tel: +90 532 313 81 54, Email: caglarjaicks@yahoo.com
Received: November 22, 2024   Revised: January 5, 2025   Accepted: January 23, 2025   Published online: April 11, 2025
Abstract
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.
Key words   Circadian rhythm; Melatonin; Autism spectrum disorder; Sleep disorders


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