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Sleep and behavior in Specific Learning Disorder: case report


Among the factors that may negatively interfere in the learning process are the specific learning disorders and difficulties, and the quality of sleep, essential for learning predictive skills such as attention and memory. Sleep, in turn, is modulated by factors such as melatonin rhythm and, when diagnosed, sleep disorders can be treated, leading to behavioral and abilities improvement in several conditions.


To investigate characteristics of school performance, language, sleep-wake cycle, and melatonin rhythm of a child with specific learning disorders pre and post-intervention for sleep improvement.


A female patient (10 years old) diagnosed with specific learning disorders were followed for 12 months by a multidisciplinary team that evaluated her with the Test of School Performance (TDE) and the Test of Narrative Language (TNL-2) at the beginning and after 6 and 12 months, and evaluated her sleep-wake cycle using a questionnaire and actigraphy at the beginning and after treatment with melatonin (3mg-30 days, 5 mg-60 days) and dosage of salivary melatonin by ELISA.


In the initial analysis, the TDE showed lower performance than expected for age in writing, reading, and arithmetic skills. The TNL-2 showed alterations in action sequence, with chronologically disorganized descriptions, and incomplete oral storytelling. There was an indication of sleep disturbances with sleep latency above acceptable, nights with three to five hours of sleep, and excessive daytime sleepiness. The nocturnal melatonin content was about 50% lower than expected for age. After administration of melatonin 3mg- 30 days, most of the parameters analyzed did not change. After melatonin 5mg- 60 days there was an improvement in sleep quality parameters, sleep latency, and actogram more synchronized to the light-dark cycle. The analysis after 12 months of follow-up showed improvement regarding school performance on the TDE, with results within the expected range for age in writing and reading skills. There was an improvement in the performance of receptive and expressive language skills in its different aspects with oral storytelling higher than expected for age.


The learning and language alterations initially presented were minimized after improvement in sleep quality.


Sleep, Specific Learning Disorder, Speech Language Pathology


Relato de Caso


Universidade Estadual Paulista Júlio de Mesquita Filho - São Paulo - Brasil


Nathani Cristina da Silva, Kriscia Gobi Rosa, Ana Luiza Decanini Miranda de Souza, Celia Maria Giacheti, Luciana Pinato