An advisory is issued for over-the-counter melatonin supplements.
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When it’s bedtime, what parents really want is for their children to go to sleep. Not only do parents want their children to get the rest they need, but parents want to rest themselves! So it’s understandable that when children have trouble sleeping, many parents look to melatonin. Recent warnings about melatonin call this into question.
What is melatonin?
Melatonin is a hormone that the body produces to regulate sleep. In the market, it is sold without a prescription as a sleep aid. If you give your body more of a hormone that helps you sleep, you’re more likely to fall asleep, right? This is not always true, of course; for many people, taking supplemental melatonin does little or nothing. But for some people it helps – including some children.
Over the past two decades, the use of melatonin supplements has increased significantly. It is the second most popular “natural” product that parents give their children after multivitamins.
A health tip on melatonin supplements for children
Whenever too many people do something, things can go wrong. And indeed, there have been many reports of melatonin overdoses in children. While overdoses can lead to excessive drowsiness, headaches, nausea or agitation, fortunately they are not dangerous most of the time. However, this does not mean that over-the-counter melatonin is completely safe. In fact, the American Academy of Sleep Medicine (AASM) recently issued a health advisory with warnings about its use.
Over-the-counter melatonin is classified as a dietary supplement. This means that it is not regulated by the FDA the way over-the-counter drugs like ibuprofen, acetaminophen, or diphenhydramine are regulated. There is no oversight over what companies put in the melatonin that parents buy.
And what they put in it is exactly the point. The AASM warns that the amount of actual melatonin in tablets or liquids can vary, from less than what the label says to much more. The biggest variation is found in chewable tablets, which unfortunately are the ones children are most likely to take. It’s also difficult—even impossible—to know what else might be in the supplement. The AASM reports that some melatonin products also contain serotonin, a hormone and neurotransmitter that requires a prescription.
Help children sleep well
The point is that while some children do benefit from melatonin, such as children with neurological or neurodevelopmental problems, most do not need it to get a good night’s sleep. Before buying a sleep aid — especially one that may not contain what you think it does — there are a few strategies parents should try first.
- Keep your child or teen on a regular sleep schedule. For teenagers, this sleep schedule preferably includes sleeping at night, not during the day. It’s okay if your child stays up a little later on a weekend or vacation, but try not to change too much. Our bodies are more likely to go to sleep when we are used to falling asleep at a certain time.
- Make sure your child gets exercise during the day; it helps them to be more tired before bed.
- Once your baby has given up on sleeping, don’t take naps. If they come home from school exhausted because they stayed up too late, don’t let them sleep in – it will just make it harder to sleep that night.
- Have a relaxing bedtime routine. This can be difficult for high school students who have sports practices and homework, but to the extent that you can limit stimulants right before bed, please do. Consider bathing, reading, and generally being more relaxed as bedtime approaches.
- Close the screens. The blue light emitted by screens can wake up the brain, and it’s easy to get absorbed in whatever you’re doing on that screen. Ideally, screens should be turned off two hours before bedtime. For teenagers, it’s best to charge phones somewhere other than the bedroom. If teenagers say they need their phone as a morning alarm, buy them an alarm clock.
- Create a favorable environment for sleep. Not having a TV or other device helps. For some children, room-darkening curtains are great; for others, a night light is important. A white noise machine can help if there is ambient noise. Make the space inviting and comfortable — for sleep. It is better if the children do not stay in bed during the day or do their homework there; the bed should be for sleeping.
If you’ve tried all of these and your child still has trouble sleeping, talk to your doctor before giving melatonin. There may be other issues in the game. By brainstorming together, you can come up with ideas.
If you decide to use melatonin:
- Choose a product with the USP Verified mark, as it is more likely to be of higher quality.
- Start with a low dose.
- Don’t give it every night. If you do this, your child’s body gets used to it and you have to increase the dose.
Bottom line: if your child is having trouble sleeping, there’s a lot to try before trying melatonin. Talk to your doctor before you buy – or try – it.
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