What is melatonin?

Many children have difficulty sleeping at night. Melatonin is useful for resetting kids' sleep-wake cycles, but it is not the best approach to healthy and restful sleep.
Many children have difficulty sleeping at night. Melatonin is useful for resetting kids' sleep-wake cycles, but it is not the best approach to healthy and restful sleep.

Many children have difficulty sleeping at night. Poor nighttime sleep makes them sleepy and irritable during the day and affects their school performance. Melatonin helps children sleep better, but you may not be comfortable using it. It's safe to use, so why shouldn't you give your child melatonin? Can adopting good sleep hygiene measures be better for your kid?

The pineal gland lies inside the skull and produces melatonin. The gland releases melatonin in the evening, and blood levels peak between 2 and 4 a.m. Rising levels of melatonin help in falling asleep and staying asleep.

Melatonin is not a chemical sleep-inducing drug. It's a natural body product, now manufactured in laboratories. In the U.S. and Canada, it is not approved for use as a medicine but is sold as a dietary supplement.

Insomnia is a difficulty in initiating and maintaining sleep. A reduction of daytime function resulting from unsatisfactory sleep is also part of insomnia. Melatonin is approved as a medicine for this condition in the U.K. and several other countries.

Why you shouldn't give your child melatonin

Melatonin is quite safe to use for short periods. However, it is not a strong sleep-inducing drug like the benzodiazepines and barbiturates. Melatonin works best when your child helps the medicine to induce sleep. 

Melatonin won't work as a sleep inducer if the child wants to stay awake. If they're determined to watch television or use social media, giving this substance won't be effective. The American Academy of Pediatrics advises that melatonin should not be the first step. You should only use it if healthy sleep habits have been put in place and are not giving the desired results.

The most frequent cause of poor sleep in childhood is behavioral insomnia of childhood. These children have poor sleep because of their habits. The usual culprits are screen use, social media, caffeine, alcohol, inactive lifestyle, and irregular bedtime. Changing these habits will give your kid better sleep than melatonin use.

When should you give your kid melatonin?

Melatonin is useful for specific purposes. In these situations, it fulfills a need and is safe and effective.

After international travel. If you've just returned from a family trip to faraway lands, your child may find it difficult to get back to their normal sleep-wake cycle. Giving them melatonin in the late evening and reducing their activity and stimuli will help.

Back to school. Older kids and teens get into the late-sleeping late-rising habit during the summer holidays. When early morning classes restart, they can't sleep early and are sleepy in the morning. Using melatonin in the evening for a few days will help the transition to school reopening.

Attention deficit hyperactivity disorder (ADHD). Most children with this disorder have difficulty falling asleep. The stimulant drugs used in ADHD treatment may increase sleep problems. Melatonin is very effective in these children.

Neurodevelopmental and psychiatric disorders. A high proportion of children with autism have sleep difficulty. Melatonin secretion is low in major depressive disorder, bipolar disorder, and schizophrenia. Melatonin helps these children and their families.

Sleep hygiene

This should always be the first step in improving your kid's sleep. Sleep hygiene needs consistency and patience. Results are not immediate and can be difficult to achieve with a rebellious child. But if both you and your child desire to improve sleep, good sleep habits can give long-lasting results in the form of restful nighttime sleep. 

These routines are important:

  • A regular bedtime. Sleeping and waking at approximately the same time every day is crucial. Sleeping and waking late on weekends don't allow the development of a healthy sleep-wake cycle.
  • Daytime naps avoidance. Children who don't sleep well at night should cut out daytime naps.
  • A quiet, dark room. Children should get used to sleeping without a light in the room at night.
  • Relaxation before bed. Have quiet and relaxing activities with your child before bed. Storytelling, listening to music, reading, or quiet conversation promote falling asleep. 
  • Screen avoidance. Exciting television programs or video games stimulate children and drive away sleep. The blue light from screens reduces melatonin secretion from the pineal gland. 
  • Caffeine and alcohol avoidance. Coffee is the obvious culprit, but energy drinks, sports drinks, and carbonated drinks also contain caffeine. Your kid shouldn't have any of these in the evening.

Good sleep habits are the best medicine for daily use. 

QUESTION

Why do we sleep? See Answer

Melatonin safety

Melatonin is considered safe and effective for short-term use in children. The usual doses are 2.5 to 3 milligrams in children and 5 to 10 milligrams in adolescents. 

It has mild side effects like a rash, itchiness, nervousness, or stomach pain. Some children complain of daytime sleepiness, headaches, or a dry mouth. Severe allergies or effects on the heart can happen but are rare.

Melatonin interacts with some drugs. Always let your pediatrician know all the drugs your child is taking. Children with epilepsy, diabetes, high blood pressure, or an autoimmune disorder should not take melatonin.

Melatonin long-term safety

How safe is melatonin for prolonged use? There is relatively little research on this in children. One study on children with ADHD followed them for almost 4 years and found no serious adverse events. The treatment was effective in more than 90% of children with difficulty sleeping. Behavior and mood also improved. Melatonin is not a cure, though. Almost all children had difficulty sleeping when melatonin was stopped.

There is little research on children without long-term disorders. Melatonin possibly has effects on growth and development, especially during puberty. Melatonin appears safe when used for a few days to reset the sleep cycle after travel or holidays. Using it every day for a long time is an unexplored area. You should wait till more research on the safety of daily use is available.

Conclusion

Almost a quarter of children and teens have difficulty falling asleep and sleeping through the night. This causes several problems like overweight and obesity, high blood pressure, depression, headaches, and reduced school performance. Melatonin is useful for resetting kids' sleep-wake cycles. But for long-term good sleep, establishing good sleep routines is the better approach. Taking melatonin every night is not the best approach to healthy and restful sleep.

Health Solutions From Our Sponsors

Medically Reviewed on 5/13/2022
References
SOURCES:

American Academy of Pediatrics: "Melatonin and Children's Sleep."

Canadian Pediatric Society: "Melatonin for the management of sleep disorders in children and adolescents."

Current Neuropharmacology: "Melatonin: Pharmacology, Functions and Therapeutic Benefits."

John Hopkins Medicine: "Melatonin for Sleep: Does It Work?"

Journal of Pineal Research: "Long-term follow-up of melatonin treatment in children with ADHD and chronic sleep onset insomnia."

Journal of Translational Medicine: "Pediatric sleep disturbances and treatment with melatonin."

Medicines for Children: "Melatonin for sleep disorders."