Melatonin Not Recommended For Children Or Teens As Sleep Aid
Dear Mayo Clinic:
Is it okay to give my teenage daughter melatonin to help her sleep better? I have read that it’s a safe alternative to sleep medicines.
Answer:
Although melatonin has been shown to be useful for treating sleep problems in adults, it has not been carefully studied in children. Due to the lack of scientific evidence, and because of some potentially harmful side effects, melatonin is not recommended as a sleep aid for children and teens. Making lifestyle changes that can enhance healthy sleep is a better alternative for most people your daughter’s age.
Melatonin is a hormone produced by your brain’s pineal gland. Melatonin appears to be linked to the body’s sleep/wake cycle, or circadian rhythm. The release of melatonin is stimulated by darkness and suppressed by light. The levels of melatonin in your blood are highest just before you go to sleep.
Some research suggests that, in adults, melatonin supplements might be helpful in treating jet lag or reducing the time it takes to fall asleep. The most common side effects from taking melatonin are daytime sleepiness, dizziness and headaches. Less common side effects can include abdominal pain, mild anxiety, irritability, confusion and feelings of depression. It is not known how common or severe these side effects might be in children.
Brent Bauer, M.D., General Internal Medicine, Mayo Clinic, Rochester, Minn.
Is Melatonin Safe For Kids A Look At The Evidence
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Unfortunately, poor sleep can affect a childs mood and ability to pay attention and learn. It has also been linked to health issues such as childhood obesity .
This is why some parents consider giving their children melatonin, a hormone and popular sleep aid.
Though its considered safe for adults, you may wonder if your child can safely take melatonin.
This article explains whether kids can safely take melatonin supplements.
Melatonin is a hormone produced by your brains pineal gland.
Often referred to as the sleep hormone, it helps your body get ready for bed by setting your internal clock, also called the circadian rhythm .
Melatonin levels rise in the evening, which lets your body know its time to head to bed. Conversely, melatonin levels start to fall a few hours before its time to wake up.
Interestingly, this hormone plays a role in other functions besides sleep. It helps regulate your blood pressure, body temperature, cortisol levels and immune function (
In the US, melatonin is available over-the-counter at many drug and health food stores.
People take melatonin to cope with a variety of sleep-related issues, such as:
- Insomnia
- Sleep disorders related to mental health
- Delayed sleep phase syndrome
- Circadian rhythm disorders
However, in other parts of the world, including Australia, New Zealand and many European countries, melatonin is only available with a prescription.
Many parents wonder if melatonin supplements can help their child fall asleep.
Chronic Sleep Onset Insomnia And Melatonin:
Problems with falling asleep are common in children, just like in adults. In children with chronic difficulty falling asleep within 30 minutes of an age-appropriate bedtime. Use of melatonin results in less difficulty with falling asleep, earlier time of sleep onset, and more sleep at night. The initial studies used pretty high doses, but later studies comparing different doses showed that dose didnt matter, and that the lowest dose studied was as effective as the highest. This is likely due to the fact that ALL these doses were well above the amount produced naturally in the children. Timing between 67 PM was more effective than later doses. The authors point out that a midafternoon dose would have the best effect but that afternoon dosing would have the unpleasant side effective of making children sleepy in the afternoon. .
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Can You Overdose On Melatonin
While melatonin is generally considered safe, it is possible to take too much. There is no official recommended melatonin dosage, and people can have different sensitivities to melatonin, so finding an appropriate dose can be challenging. Moreover, because melatonin is not regulated in the U.S., the actual melatonin content of supplements can vary significantly. Studies have found that some melatonin products can have nearly five times as much melatonin as their label claims, or much less.
The first sign that youve taken too much melatonin is that youll continue feeling its soporific effects the following day. You may feel especially drowsy or groggy. Doses of 10 milligrams or higher can cause side effects like drowsiness and headache. Other symptoms of melatonin overdose include:
- Changes in blood pressure
- Vivid dreams or nightmares
How Often Are Children Using Melatonin
Its hard to know for sure. An article the New York Times, Parents Are Relying on Melatonin to Help Their Kids Sleep. Should They?, noted that melatonin sales overall had increased by 87% in the year prior to March 2020. The Times conducted a survey of 933 parents with children under age 18. One third had a history of sleep difficulties in the past year. Over half the parents reported giving melatonin to their children at one time.
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How Effective Is Melatonin For Sleep Problems In Children
The overall effects of melatonin for children include falling asleep more quickly and an increase in sleep time. Like all medicines used to help children fall asleep, there is fairly limited information available. This means that most studies have small groups followed for short periods of time. Furthermore, melatonin not regulated as a pharmaceutical in the U.S. Thus, there is no large pharmaceutical company bankrolling larger and long-term studies . Rather it is regulated as a food supplement by the FDA. For a terrific review, including dosing recommendations, I highly recommend this article by Bruni et al.
First Off When Should You Use Melatonin With Your Toddler
This is where parents get a little confused. If your child can fall asleep on their own about 30 minutes after you put them to bed, melatonin may not be necessary! The natural sleep aid can be very helpful, however, if your child has a sleep dysfunction. For instance, if they cant fall asleep and lie awake for hours, or fall asleep and then wake several times during the night.
It can also be very helpful for kids on the autism spectrum, or those whove been diagnosed with ADHD. Kids with these disorders are well-known to have a lot of trouble falling asleep, and studies have shown melatonin to be effective in shortening the time it takes them to fall asleep.
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My Child Is Already On Melatonin Do I Need To Freak Out
I dont think so, as there is little concrete evidence of significant harm. However, if you started melatonin on your own I beg you to discuss it with your childs physician to see if it is really necessary. If your child has been using it long-term and sleeping well, you can consider slowly reducing the dose and seeing if it is still really necessary. Try to use it as needed as opposed to nightly. Also, I would take a hard look at sleep hygiene and ensure that you are ensuring good bedtime processes such as a high quality bedtime routine and avoidance of screen time for at least an hour prior to bedtime. I would try to reduce the dose, and potentially only use it as needed as opposed to nightly.
Should Melatonin Be Taken Every Night For Kids
The American Academy of Pediatrics and the National Institutes of Health both recommend that children avoid melatonin long-term, but neither organization defines what that means. It is natural for some children to fall asleep later than their parents would like, but melatonin is not required for them.
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What Is Melatonin What Does Melatonin Do
Melatonin is a hormone which is naturally produced by the pineal gland in your brain. It is both a chronobiotic agent, meaning that it regulates your circadian or body clock and a hypnotic, meaning that at higher doses it may induce sleep. Melatonin is usually used for its hypnotic effect, but it does not have this effect in everyone. Only the chronobiotic effect occurs in all individuals.The natural rise of melatonin levels in the body 1-3 hours before sleep onset is known as the dim light melatonin onset . This is the signal involved in body clock scheduling of sleep and corresponds to the end of the wakefulness signal produced by the circadian system. Children with insomnia may be given melatonin after their scheduled bedtime passes what this means is that their bodies are not yet ready for sleep. This is one reason why bedtime fading can be so effective for some children. The doses used clinically greatly exceed the amount secreted in the body.
There are a few things to be aware of:
Heres a short video I put together to explain how when you give the melatonin dose really matters. .
What Are Some Good Healthy Sleep Habits For My Child
Managing sleep problems needs to start with healthy sleep habits. This is sometimes called good ‘sleep hygiene’. Healthy sleep habits include:
- having a regular bedtime
- having the same relaxing bedtime routine each night
- having a cool, dark, calm bedroom environment
- avoiding screen activities in the bedroom, and for the hour or two before bedtime
- encouraging your child to fall asleep by themselves
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Parents Are Relying On Melatonin To Help Their Kids Sleep Should They
A survey suggests that nearly half of children with difficulty sleeping have taken melatonin.
For the Langstaff family, the bedtime routine had become more like a bedtime marathon.
My son has struggled with sleep from the moment he was born, Anna Langstaff, the head of a Montessori school in Portland, Ore., said of her 6-year-old son, Henry. We used to joke that he was like a little knight fighting a dragon called sleep.
When Henry was a toddler, dimming the lights and other bedtime cues simply sent him into battle mode she said. Hed start yelling, No bed! No bed!
After years of struggling with what had become a two-hour bedtime routine, the Langstaffs turned to their pediatrician, who recommended a chocolate containing melatonin, a hormone secreted by a pea-size organ in the brain called the pineal gland that helps regulate the bodys internal clock and induces sleepiness.
It was like magic, she said. Now Henry falls asleep at 7:30 p.m. and continues to wake up at the same time he always has, shortly before 6 a.m., Langstaff said.
Magic game changer these are words frequently used by parents describing how melatonin helps their children fall asleep.
An online survey of 933 parents with children under 18 conducted by YouGov for The New York Times in May found that only about a third had kids who were struggling with sleep issues in the past year. But among those parents, almost half had given melatonin to their children.
Is Melatonin Safe Forchildren
Its no wonder parents are uncertain about this. If you surfthe web, youre likely to get mixed messages:
- Australian experts called the increase in use among children alarming and warned in 2015 that parents shouldnt give it to their children. WebMD
- Melatonin, according to more than 24 studies, is safe for children and has been used with little to no side effects. NaturalSleep.org
- Currently, we dont have any evidence to say that taking melatonin on a daily basis in that sense is harmful, although there are no large-scale multicenter clinical trials to really test that.Medscape
This last quote is probably closest to where we actuallyare. However, it is clear there has been a dramatic increase in use ofmelatonin in children in the past five years or so. For example, in England, estimates have found a 25percent increase in melatonin prescriptions in children under 18 between2015-16 and 2017-18, and a 40 percent increase in the extended release formsduring the same period. There are no similar statistics in the U.S. forover-the-counter melatonin, but it is now rare in our experience that childrencoming to the Boston Childrens Sleep Clinic with insomnia are not already onmelatonin, usually recommended by their pediatrician.
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Will My Child Become Dependent
Unlike other sleep medications, melatonin hasnt been shown to cause withdrawal or other symptoms of dependency.
Any time we take a form of what our body already produces, our body will decrease the production, Dr. Kuhn said. When you abruptly stop, your body needs time to reproduce levels, but that doesnt seem to be the case with melatonin. One doesnt have to taper off.
How Is The Over
In the mid-90s, melatonin became available as an over-the-counter dietary supplement for people experiencing difficulty falling asleep, and its use has steadily increased over the years especially for kids. In March 2020, the technology firm SPINS found that sales of childrens melatonin supplements grew 87% over the prior year in retail stores. Its now sold for children as gummies, chewables, capsules, liquids, tablets and even chocolate pieces.
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Melatonin Pills For Kids: A Safe Sleep Solution
Between 24/7 access to technology, after-school activities and hours of homework, more and more kids are having trouble falling asleep at night.
In fact, the National Sleep Foundations 2014 Sleep in America poll, which is being released on Monday, reveals that kids are falling short on the amount of time they should be sleeping each night.
And for some parents who are desperate for a natural way to get their kids to go to sleep, popping one melatonin pill each night has been the answer, but it is safe?
What is melatonin? Known as the hormone of darkness, melatonin is produced in the brain as the sun goes down, signaling that bedtime is coming within a few hours, according to Dr. Shelby Harris, a sleep psychologist and director of the Behavioral Sleep Medicine program at Montefiore Medical Center in New York City.
Many parents, however, falsely believe that the pills will work in the same way the brain does.
They think of melatonin like an over-the-counter, natural remedy that does the same thing as Ambien and it doesnt, Harris said.
Plus, many parents are using melatonin incorrectlyeither by giving their kids too much or by using it too close to bedtime.
Harris knows of a lot of pediatricians who are prescribing the over-the-counter medicine when parents ask for a natural and safe solution.
It can be good for some kids, but it shouldnt be the first-line effort that youre doing, she said.
Parents have given up on committing time to sleep, he said.
How Does Melatonin Work
Natural melatonin is predominantly made in your pineal gland, which is located in your brain. Light exposure inhibits the production of melatonin, but darkness stimulates it.
Melatonin levels in your brain begin to increase at dusk as the sun goes down and darkness falls. They reach their peak levels in the middle of the night and start decreasing as dawn gets closer.
The action of melatonin inhibits signals in your brain that promote wakefulness. This helps encourage sleep by making you feel tired or drowsy as you get closer to bedtime.
Because of melatonins sleep-promoting effects, melatonin supplements are used to treat a variety of sleep problems. These can include:
Melatonin typically takes 1 to 2 hours to work, so its often taken up to 2 hours before bedtime.
If youre looking to try melatonin for the first time, it may be best to begin with a lower dose. Your doctor can help recommend a safe dose for you to start with.
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Melatonin Helps Autistic Kids Sleep
Study Shows No Side Effects From Low-Dose Supplements of Melatonin
Eleven youngsters with autism ages 4 to 10 fell asleep more quickly and slept longer when given low-dose supplements of melatonin, says Beth Malow, MD, director of the Sleep Disorders Center at Vanderbilt University in Nashville, Tenn.
The supplements didn’t appear to cause any side effects, suggesting parents can continue to give them to their kids as long as needed, she tells WebMD.
Studies have shown that as many as 70% of children with autism suffer from sleep problems, according to Andrew Zimmerman, MD, of the Kennedy Krieger Institute in Baltimore, who specializes in treating autism.
Other research points to a deficiency of melatonin — the body’s natural sleep hormone — as the culprit, Malow says. Secreted at night by the pineal gland in the brain, melatonin is thought to control sleep cycles, which are frequently disturbed in the elderly — and kids with autism, she says.
Delayed Sleep Phase Syndrome And Melatonin
Delayed sleep phase syndrome is a common disorder in teens, where their natural sleep period is shifted significantly later than the schedule which their commitments mandates. Thus, teens with this disorder an unable to fall asleep by 12 AM in the morning or even later. I have seen kids who are routinely falling asleep between 45 AM. Melatonin has a clear role in this disorder, as small doses 34 hours earlier than sleep onset can be effective in managing this disorder. The reason for the delay is a marked delay in the DLMO, so melatonin dosing can move sleep periods earlier. For children with DSPS, giving a dose 46 hours prior to the current time of sleep onset, then moving it earlier every 45 days, is recommended, with low dose preparations. Of all the conditions mentioned here, this has the clearest benefit from melatonin. Here is a terrific review article.
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