Q: Is it OK for my teen to take melatonin to help him sleep?
A: Trouble falling and staying asleep affects 15% to 25% of children and adolescents. Not getting enough sleep can lead to some pretty difficult behaviors and health problems: crankiness, trouble paying attention, high blood pressure, weight problems and obesity, headaches and depression.
Not surprisingly, many parents are searching for solutions to their child's sleep troubles, and some are considering dietary supplements like melatonin.
Melatonin is sold as a sleep aid. It can be found over the counter as a dietary supplement. Its use is not regulated by the Food and Drug Administration or approved for that purpose.
Melatonin is a hormone-like substance produced by an area in the brain called the pineal gland. It is released naturally at night and tells the body it's time to sleep.
While melatonin plays a role in sleep, it is not a sleeping pill. It should only be used after a discussion with your pediatrician and pre-established healthy sleep habits that do not include medication. There has been a sharp increase in the number of reported melatonin poisonings in the past few years, so always be sure to store any medicine, vitamins, and supplements in a safe place, where children can’t get them.
Often, a child's sleep issues can be solved with good bedtime routines. What the actual routines are can be specific to your child and his or her age, but they should occur each night around the same time. This will help your child understand that it's time to settle down and get ready to sleep.
The key to successful sleep routines is consistency. When starting a new sleep routine, it may take a while to get established. But don't give up! Routines are great for kids and well worth the time it takes to get them going.
Blue lights (as from tablets, e-readers or smartphones) have a short wavelength that affects levels of melatonin more than any other wavelength does. The blue light fools the brain into thinking that it is daytime, making us feel more alert when we should be feeling sleepy. Over time, this wreaks havoc on our body's natural production of melatonin. The American Academy of Pediatrics recommends avoiding exposure to screens for at least one hour before going to bed.
If, no matter how hard you try, you are unable to establish a good bedtime routine for your child, talk with your pediatrician to see if there are any other issues that might be causing your child's sleep difficulties.
Melatonin may be a short-term way to help some kids get rest while you keep trying to establish good bedtime routines. It may also help some older children and teens reset sleep schedules, such as after vacations, summer breaks or other interruptions. Getting enough sleep each night can be hard for teens whose natural sleep cycles make it difficult for them to fall asleep before 11 p.m. and who face a first-period class at 7:30 a.m. or earlier; this is where melatonin may help.
Melatonin may also help children with neurodevelopmental disorders, such as autism or ADHD. Its use in these circumstances should be carefully monitored by a child's pediatrician.
Melatonin comes in several forms ― liquids, gummies, chewable, capsules and tablets ― all with varying dosages. And because there are no specific guidelines on melatonin dosing for children, it can be confusing.
The quality may not be the same for all melatonin products. It is not possible to tell how much melatonin you are getting. Also, there may be other ingredients in the products that can interact with other medicines or supplements you are taking. Look for supplements with "USP Verified" on the label. This mark indicates that the product contains the ingredients that are listed on the label, in that potency and amount.
The melatonin dosage and timing depend on why and how you plan to use it. Many children will respond to a low dose (0.5 mg or 1 mg) when taken 30 to 90 minutes before bedtime. Most children who do benefit from melatonin, even those with ADHD, don't need more than 3 to 6 mg of melatonin.
While studies have shown that short-term use is relatively safe, less is known about longer uses of melatonin. For example, there are concerns about how it might affect a child's growth and development, particularly during puberty. Studies have also found that morning sleepiness, drowsiness and possible increased urination at night are the most common side effects that occur while taking melatonin. Melatonin also may interact with other medicines a child takes.
Always talk with your pediatrician about the proper dose and timing of melatonin. And remember, melatonin should not be a substitute for a good bedtime routine.
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ABOUT THE WRITER
Dr. Anna Esparham is a triple-board certified physician in pediatrics, medical acupuncture, and integrative medicine. She is the founder of the Health Is PowHer podcast and a headache pain specialist at a pediatric academic medical center. For more information, go to HealthyChildren.org, the website for parents from the AAP.
