Melatonin for the Treatment of DEE-SWAS

Inclusion Criteria: Clinic Dx of DEE-SWAS 1. Dx of DEE-SWAS by a board-certified pediatric neurology/epileptologist Clinical history of delayed milestones in at least 1 category, regression of milestones in at least 1 category, and/or failure to progress in milestones in at least 1 category 2. Abnormal baseline neuropsychiatric testing consistent with Dx Abnormal EEG 3. Epileptiform abnormalities (spike, polyspike, sharp) in at least 1 head region 4. Increase by 2-fold of epileptiform abnormalities during NREM sleep as compared to wakefulness 5. SWI of ≥50% in at least one head region on overnight EEG Exclusion Criteria: 1. Allergic to ingredients in study drug Melatonin * Hypoallergenic plant fiber (cellulose) * Active use of the medication viloxazine 2. History of known cardiac rhythm abnormalities, heart failure or decreased EF \<30% 3. History of known pulm requiring oxygen or invasive positive pressure ventilation. Patients with non-invasive PPV (e.g. CPAP) due OSA w/o 02 requirement, rate, or DX of CSA, on stable pressure settings for \>3 mnths will not be excluded. 4. History of liver dysf OR AST/ALT/AlkPhos \>2.5 ULN w/i year. If lab value meeting exclusion between 3-12 months, a repeat lab value \< 2.5 ULN will be considered for inclusion 5. Post-menarchal participants. of childbearing potential with a positive urine pregnancy test