Kids and melatonin:
The days are getting shorter, leaves are changing, and it seems like it should be easier to fall asleep. Sleep is a hot topic and for some children it is just not easy. We have seen more children with difficulty falling and staying asleep since the pandemic and families are increasingly turning to melatonin, widely available as an over-the-counter sleep aid.
Melatonin use is up, but is it a good choice? Let’s talk about kids and melatonin and sleep.
First: Establish good sleep habits
Sleep difficulties are quite common. Approximately 15-25% of children and adolescents have difficulty falling and staying asleep.
The first step to helping your child with sleep is to establish good sleep habits that help your child relax and fall asleep naturally.
- Establish a sleep routine. Specific routines may vary depending on your child’s age and development but having a consistent sleep routine helps signal that it is time to wind down.
- Turn off the screens. The blue light from screens fools the brain into thinking it is daytime, making it hard to fall asleep. The American Academy of Pediatrics recommends putting screens away at least one hour before bedtime.
- Exercise. Children who exercise or play hard are usually better sleepers.
- Make the sleep space comfortable. Limit ambient light, noise, etc.
- Limit stress.
What if it’s still hard to sleep? How about melatonin?
Melatonin is a naturally occurring hormone produced in the pineal gland, which is located in the brain. Naturally occurring melatonin is released at night in response to changes in light as a trigger for sleep. While melatonin promotes falling asleep, it does not help people stay asleep.
Melatonin is also available as an over-the-counter dietary supplement. It has dramatically increased in popularity and is commonly used as a “sleep aid” for adults and children. It is available in several forms ― liquids, gummies, chewable, capsules and tablets ― all with varying dosages. There are no clear guidelines about appropriate dosages.
Risks and side effects of melatonin
Short-term melatonin use is associated with daytime drowsiness and increased nighttime urination. There is little data about the effects of long-term melatonin use. Pediatricians and sleep experts agree that more research is needed to understand the effects of melatonin use on growth and development.
Is melatonin safe?
Melatonin is regulated by the U.S. Food and Drug Administration as an over-the-counter dietary supplement. Because it is viewed as a dietary supplement there is little oversight. Unfortunately, the actual melatonin content in a supplement often varies significantly from what is stated on the label. A recent study found the amount of melatonin ranged from half to four times that stated on labels. The greatest variability in melatonin content was found in chewable tablets and gummies, which are often used for children.
Some melatonin is certified by third-party groups such as ConsumerLab.com, NSF International, UL and U.S. Pharmacopeia. There groups test the product to confirm it has the ingredients listed and is not contaminated. It is a good idea to check the label and confirm third-party certification.
Who benefits from melatonin?
Melatonin may be useful for short-term sleep corrections, such as jet lag or schedule changes. There is little evidence that melatonin is effective in treating insomnia in otherwise healthy children. Children with certain conditions such as attention deficit hyperactivity disorder or autism may benefit from melatonin use, but this is an important conversation to have with their medical provider.
Melatonin poisoning
Melatonin use has recently increased significantly, and this has led to an increase in melatonin overdoses. During 2012–2021 , there have been 260,000 reports of melatonin child poisoning, 4,000 hospital visits and 287 required intensive care, according to the CDC.
Always remember to manage melatonin as a medication and be sure to keep it out of reach.
What’s the proper kids’ melatonin dose?
There are no clear guidelines about melatonin dosage. Dosages between 0.5mg and 3mg are common.
- Always start with the lowest effective dose.
- It is most effective if taken 30 to 90 minutes before bedtime.
- If you are worried about your child’s ability to sleep, reach out to your medical provider. They can help you create a sleep plan and make sure there are no medical reasons for sleep problems.
Published Oct. 22, 2022
Have a question for Dr. Block? Send it to jhanson@seattleschild.com.
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