Effects of exercise on sleep, melatonin level, and behavioral functioning in children with autism

Abstract

Poor sleep quality and low behavioral functioning are commonly reported in children with autism spectrum disorder. This study examined the impact of exercise on sleep on melatonin level and behavioral functioning in the population. Children with autism spectrum disorder( n = 55; age = 10.97 ± 1.90) were randomly allocated to a morning jogging intervention group or a control group. Participants’ sleep was measured using actigraphy and sleep log assessments. Twenty-four-hour and first morning urinary 6-sulfatoxymelatonin were used to determine whether the exercise intervention could elicit changes in melatonin levels. Behavioral functioning of the participants was assessed by the repetitive subscale of the Gilliam Autism Rating Scale–3rd edition. All assessments were carried out in baseline, post-intervention, or regular treatment, and follow-up to elucidate the sustainability of the exercise effects. Positive changes were observed between baseline and post-intervention in actigraphy-assessed sleep efficiency and wake after sleep onset, as well as melatonin level and behavioral functioning within the intervention group ( ps < 0.017). However, no significant changes were observed in all measurements between post-intervention and follow-up ( ps > 0.05). The findings suggest that physical exercise is effective to improve sleep with an increase in melatonin level. It can also reduce repetitive behaviors in children with autism spectrum disorder. Lay abstract This study examined the impact of physical exercise on sleep and behavioral functioning in children (aged 8–12 years) with autism spectrum disorders. It also investigated whether exercise would alter endogenous melatonin level among the population. Participants were divided into two groups: exercise group (12–week, 30-min morning jogging intervention) and a control group (i.e. did not receive any physical exercise intervention during the study period). Significant improvements on sleep and behavioral functioning were found in the exercise group, but not in the control group Moreover, a significant increase in melatonin level was also shown in the exercise group. Findings of this study reconfirmed the sleep and behavioral benefits of exercise in children with autism spectrum disorder. Melatonin-mediated mechanism should be further explored to develop an effective treatment intervention.

Study protocol for a randomized controlled trial comparing the effectiveness of physical exercise and melatonin supplement on treating sleep disturbance in children with autism spectrum disorders

“…Research revealed a significant improvement in sleep efficiency and reduction in wake after sleep onset time in the intervention group but not in the control group [ 13 ]. Similar sleep benefits following physical exercise were also evident in a more recent study [ 14 ], where we showed that jogging intervention had significantly improved sleep efficiency and sleep duration in children with ASD. More remarkably, we also observed that the endogenous melatonin level, as reflected by the 6-sulfatoxymelatonin (aMT6s), was significantly increased within the jogging intervention group, while no change was found in the control group.…”

“…Endogenous melatonin level . The endogenous melatonin level of the participants, reflected by the 6-sulfatoxymelatonin (aMT6s, creatinine-adjusted morning urinary melatonin representative), will be measured from their 24-h and first morning urinary samples during weekend and Monday respectively [ 14 ], and the participants will be required to stay at home for sample collection. All urine samples will be collected using 24-h and first morning void urine bottles.…”

“…Previous study [ 13 , 14 ] showed physical exercise had notable effects (corresponding to a Cohen’s d of about 0.9) on improving sleep onset latency, sleep duration and sleep duration. We assumed that melatonin supplements have similar effects on sleep.…”

Melatonin Rhythm and Its Relation to Sleep and Circadian Parameters in Children and Adolescents With Autism Spectrum Disorder

“…Previous knowledge on the effect of physical exercise on endogenous melatonin production is controversial as it has been shown that melatonin levels can increase, decrease, or remain unaffected by exercise ( 55 , 56 ). On the other hand, physical exercise has been suggested as a synchronizer of the circadian system, making it a potential treatment for circadian rhythm misalignment ( 55 , 57 , 58 ). As a result, exercise may be an accessible non-pharmacological intervention of special interest when treating ASD individuals.…”

Influence of Physical Exercise on Psychological Well-Being of Young Adults: A Quantitative Study

“…Physical activity implies multiple benefits, such as the prevention of cardiovascular diseases [ 12 ], better control of body weight [ 10 , 13 ], less presence of chronic pain [ 14 ], better bone density and better physical fitness [ 15 , 16 ], greater muscle strength, and lower risk of mortality [ 13 , 17 , 18 ]. In addition, at a psychological level, physical activity improves mental health and quality of life [ 8 , 19 ], reduces stress and anxiety [ 8 , 20 , 21 ], lowers the risk of depression [ 22 ], and improves the quality of sleep [ 23 ]. Likewise, physical activity is positively related to better academic performance among university students [ 24 ].…”