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9 Petrie K, Dawson A G, Thomson L, Brook R. A double- blind trial of melatonin as a treatment for jet lag in international cabin crew. Biol Psychiatry 1993; 33: ) Tomoda A, Miike T, Uezono K, Kawasaki T. A school refusal case with biological rhythm disturbance and melatonin therapy. Brain Dev (Tokyo) 1994; 16: ) Regestein Q R, Pavlova M. Treatment of delayed sleep phase syndrome. Gen Hosp Psychiatry 1995; 17: ) Haimov I, Lavia P, Laudon M, Herer P, Vigder C. Melatonin replacement therapy of elderly insomniacs. Sleep 1995; 18: ) Garfinkel D, Laudon M, Nof D, Zisapel N. Im- of sleep quality in elderly people by provement controlled- release melatonin. Lancet 1995; 346: ) Skene D J, Deacon S, Arendt J. Use of melatonin in circadian rhythm disorders and following phase shifts. Acta Neurobiol Exp (Warsz) 1996; 56: ) Jan J E, Espezel H, Appleton R E. The treatment of sleep disorders with melatonin. Dev Med Child Neurol 1994; 36:

10 1990; 50: ) Waldhauser F, Waldhauser M, Lieberman H R, Deng M H, Lynch H J, Wurtman R J. Bioavailability of oral melatonin in humans. Neuro- 11) Jan J E, O'Donnell M E. Use of melatonin in the endocrinology 1984; 39: treatment of paediatric sleep disorders. J Pineal Res 1996; 21: ) Canfield P, Gordon K, Dooley J, Canfield C. Melatonin appears ineffective in children with intellectual deficits and fragmented sleep: six "N of 1" trials. J Child Neurol 1996; 11: ) Waldhauser F, Ehrhart B, Forster E. Clinical aspects of the melatonin action: impact of development, aging, and puberty, involvement of melatonin in psychiatric disease and importance of neuroimmunoendocrine interactions. Experientia 1993; 49: ) Sandyk R. Pineal melatonin function: possible relevance to Parkinson's disease. Int J Neurosci 21) Saitoh S, Hoshi Y, Kohsaka S, et al. Melatonin rhythm in Angelman syndrome patients. Psychiatry Clin Neurosci 1997; 51: S ) McArthur A J, Budden S S. Sleep dysfunction in Rett syndrome : a trial of exogenous melatonin treatment. Dev Med Child Neurol 1998; 40: ) Chase J E, Gidal B E. Melatonin : therapeutic use in sleep disorders. Ann Pharmacother 1997; 31: Usefulness of Melatonin for Developmental Sleep and Emotional/Behavior Disorders-Studies of Melatonin Trial on 50 Patients with Developmental Disorders Asayo Ishizaki, M D, Michiko Sugama, M D and Noriko Takeuchi, M D Oji Clinic Division of Medicine, Association of Remedial Teaching for Mentally Developmental Disorder's INC, Tokyo We studied the usefulness of melatonin for sleep disorders and emotional/ behavior disturbances of patients with developmental disorders. The efficacy and side effects of melatonin at bedtime were evaluated in 50 children and young adults with sleep disorders (3-28 years old, 41 males and 9 females, autism [AU] in 27 patients, mentally retardation [MR] in 20 patients, and severe motor and intellectual disability [SMID] in 3 patients). The sleep diorders consisted of various types of insomnia in 44 patients and of circadian rhythm sleep disorders in 6 patients. Thirty nine of the insomnia patients and 3 of the circadian rhythmsleep disorder patients experienced improvement in response to melatonin. In some cases, the efficacies were diminished after the daily medication of melatonin. With the emotional/behavior disturbances, excitabilities were often improved in cases whose sleep disorders were also improved. There was almost no change in contrariness, stereotyped behavior and in school/ workshop refusal. Melatonin at bedtime was efficacious in 42 of the 50 patients with sleep disorders. In 17 patients, there were side effects (residual drowsiness on the next morning, awakening in the middle of sleep, excitement after awakening and before going to sleep, etc.). But these side effects were not serious. The effects of melatonin were influenced by the type of sleep disturbances, the factors of the environment and the mental conditions. Taking side effects into account, we judged melatonin to be useful in 34 patients. No To Hattatsu 1999; 31:

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