What do you do when your child struggles to sleep? Often people talk to friends or family about parenting issues, or maybe they consult social media. One suggestion for sleep issues is melatonin. In the last few years, melatonin use in children has been on the rise in the United States But before using melatonin for your child, consider what we do and don’t know about it.
How does melatonin work?
Melatonin is a hormone in the brain that responds to darkness. Darkness triggers the production of melatonin which helps to induce sleep. When children have difficulty falling asleep, it may be tempting to use sleep aides like melatonin supplements, but is melatonin the right choice? There are few studies on the long-term effects of melatonin use in children.
Is melatonin right for your child?
We interviewed Dr. Suresh Kotagal, Chair of the International Pediatric Sleep Association’s melatonin task force, to get the facts about melatonin. Dr. Kotagal recommends avoiding melatonin for healthy children. If your child is sleeping, melatonin will not increase their quality of sleep. There may be a slight improvement in the time it takes to fall asleep, but the long-term effects are currently unknown.
If your child is having difficulty in falling asleep, Dr. Kotagal recommends establishing healthy sleep hygiene as a first line of treatment.
Healthy Sleep Hygiene
- Establish a consistent bedtime and waketime.
- Discontinue screen use at least one hour before bedtime.
- Provide a comfortable sleep environment including:
- A dark room
- Cool temperature
- Comfortable bed and sleepwear
Dr. Kotagal notes that children with autism and some with ADHD may benefit from melatonin use. This is because they are more likely to have reduced melatonin production or production that is out of sync with the light/dark cycle. Before melatonin is given to children in these populations, a doctor should be consulted. They can rule out other possible issues leading to sleep disruption. If it is determined that there are no other sleep disorders present, a low dose of melatonin for a limited time may be prescribed. If it proves beneficial, the prescription may be extended for longer use in children with autism or ADHD under a physician’s care.
Is there any harm in giving my child melatonin?
In many countries melatonin is only available as a prescription medication, However, in the United States melatonin is classified as a supplement, meaning it is not regulated by the Food and Drug Administration and you do not need a prescription to purchase it. A study done in 2023 found that melatonin levels in supplements range anywhere from 74%-347% of what is shown on the label. This means that you may be giving your child a lot more melatonin than you think. Also, some melatonin products have been tested and may include serotonin or CBT – supplements you may not realize your child is taking.
There may be adverse effects to melatonin. Young children under the age of five are particularly susceptible to melatonin poisoning. If too much is consumed, symptoms can include daytime sleepiness, vomiting, outbursts, agitation, and headache.
Conclusion
If your child is having difficulty sleeping, Dr. Kotagal suggests healthy sleep hygiene as a first line of treatment. If that doesn’t solve the sleep issue, consult a physician to see if there are other sleep disorders present. It is safest to only use melatonin as recommended by a doctor.
Suresh Kotagal MD is an Emeritus Professor in the Department of Neurology at Mayo Clinic, Rochester and has served as chair of the Division of Child Neurology at Mayo Clinic. He is Fellow of the American Academy of Neurology and the American Academy of Sleep Medicine. He was awarded the Lifetime Achievement Award by the Child Neurology Society.