It is estimated that as many as 25% of children experience difficulty both falling and staying asleep -- and that's not looking at sleep issues related to coronavirus stress. Poor sleep can result in difficulty concentrating, mood disturbances, difficulty learning, and even obesity.
One remedy parents are turning to are melatonin supplements, The New York Times recently reported that sales of melatonin supplements for children increased by 87% compared to last year. But is it safe for kids?
Melatonin is a hormone that our bodies make naturally. Its purpose is to regulate our circadian rhythm, including when to go to sleep and wake up. Melatonin supplements marketed explicitly for use in kids are available in chewables, gummies, liquid, melting tablets, and chocolates.
The use of melatonin supplements as a sleep aid in adults has been studied extensively. It does help people fall asleep faster and sleep for longer. There are fewer studies on its use in children, but it appears to be effective on them as well.
“Studies performed in children have demonstrated some efficacy of melatonin. It has been shown effective for use in children with autism spectrum disorder or attention deficit hyperactivity disorder. Generally, it has been safe to use for three months or less to help regulate some falling asleep for children,” Maryanne Tranter, Ph.D., APN, founder of The Healthy Child Concierge tells Parentology
Melatonin is classified as a supplement, so it is not regulated by the FDA for either safety or effectiveness. Some practitioners have expressed concern regarding its use in children.
“The long-term effects of giving children melatonin to help them sleep are still being studied, and melatonin supplements have not yet been approved for use in children by the FDA. Although giving children melatonin may prove to be safe, we don’t know enough yet to recommend this practice,” Dr. Rob Darzynkiewicz, Chief Medical Officer at Hazel Health, tells Parentology.
“The biggest risk is of accidental overdose,” Tranter points out. She adds that there are potential short and long-term effects, such as interruption of sleep patterns, daytime drowsiness, potential hormonal changes that can lead to early puberty, and there is some research saying it can affect metabolism.
"Sleep problems also can recur after ending treatment, or symptoms can worsen after stopping melatonin," she adds. "Long term use research is scant. Using melatonin may replace safer or more effective behavioral interventions. Families may use melatonin instead of working to manage sleep issues. It can also contribute to the idea that a child needs medication to sleep.”
Darzynkiewicz advises visiting a doctor, who can help get to the root of the problem before any sort of supplement is needed. Tranter agrees, adding “Children should be evaluated for sleep disorders including obstructive sleep apnea, among others. Psychosocial evaluations on sleep disturbance, including family and child stress. The impact of sleep problems on the child should also be considered.”
Both Tranter and Darzynkiewicz recommend that 30-60 minutes before bedtime be free of any electronic screens.
“The light emitted from these devices disrupts melatonin production and will make it more difficult to get to sleep. You can also make sure that you have a set bedtime routine in place for younger children. Taking a shower or bath before bed can also help children settle down for the night. These are all ways to make sure children are relaxed before going to bed, and that they can produce melatonin as normal,” recommends Dr.Darzynkiewicz.
Tranter also suggest:
Finally, when melatonin is used, look for products that have logos from Underwriters Laboratories (UL), United States Pharmacopeia (USP), or ConsumerLab.com. This will ensure the melatonin supplement that parents are purchasing has undergone testing to evaluate it for purity standards.
Maryanne Tranter, PhD, AP - The Healthy Child Concierge
Dr. Rob Darzynkiewicz -Hazel Health
New York Times - Parents Are Relying on Melatonin to Help Their Kids Sleep. Should They?
WebMD – What is Melatonin?
Frontiers in Neuroendocrinology - Exogenous melatonin as a treatment for secondary sleep disorders: A systematic review and meta-analysis