Melatonin, a hormone that helps regulate the sleep-wake cycle, is widely used by parents as a sleep aid for their children. However, experts warn that over-the-counter melatonin supplements are not regulated by the FDA and may contain harmful ingredients or inaccurate doses. Moreover, most children do not need melatonin to get a good night’s sleep, and there are other natural ways to improve their sleep quality.
According to a recent study, almost half of parents give melatonin to their children to help them fall asleep. The American Academy of Sleep Medicine (AASM) found that 46% of parents report giving melatonin to their children under 13, and 30% give it to their teens. Melatonin is the second most popular “natural” product parents give to their children after multivitamins.
However, the AASM recently issued a health advisory with warnings about its use. Over-the-counter melatonin is classified as a dietary supplement, meaning it’s not regulated by the FDA the way over-the-counter medicines like ibuprofen, acetaminophen, or diphenhydramine are regulated. There is no oversight on what companies put in the melatonin that parents buy. The AASM warns that the amount of actual melatonin in tablets or liquid can vary, from less than what the label says to much more. The greatest variation is found in the chewable tablets, which are unfortunately the ones children are most likely to take.
Moreover, it’s also hard — impossible, even — 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. While overdoses can lead to excessive sleepiness, headaches, nausea, or agitation, luckily they aren’t dangerous most of the time. That doesn’t mean that over-the-counter melatonin is completely safe, however.
Dr. Judith Owens, director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital and a professor of neurology at Harvard Medical School, said that melatonin is not a benign substance. She said that it can have side effects such as nightmares, morning grogginess, and changes in puberty timing. She also said that there is not enough research on the long-term effects of melatonin use in children.
While some children really do benefit from melatonin, such as children with neurologic or neurodevelopmental problems, most don’t 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 some strategies parents should try first. For instance, keeping your child or teen on a regular sleep schedule.
Dr. Owens said that the most important thing parents can do is to set a consistent bedtime and wake-up time for their children, even on weekends and holidays. She said that this helps to synchronize the body’s internal clock and make it easier to fall asleep and stay asleep. She also recommended limiting screen time before bed, as the blue light emitted by devices can suppress the natural production of melatonin and interfere with sleep quality. She said that the bedroom should be dark, quiet, and comfortable, and that children should avoid caffeine, nicotine, and alcohol in the evening.
Additionally, there are other natural alternatives to melatonin that parents might consider. These include magnesium, GABA, valerian root, and tart cherry. These substances are also sold as dietary supplements, so they are not regulated by the FDA either, but they may have fewer side effects than melatonin. Magnesium is a mineral that helps relax the muscles and nerves, and may also reduce anxiety and stress. GABA is a neurotransmitter that inhibits brain activity and promotes relaxation. Valerian root is an herb that has sedative and anti-anxiety properties. Tart cherry is a fruit that contains natural melatonin and antioxidants.
As always, it’s recommended to consult with a healthcare provider before starting any new medication or supplement regimen for your child. Dr. Owens said that parents should not assume that melatonin is safe or effective for their child, and that they should always seek medical advice before using it. She said that melatonin is not a magic bullet, and that it should only be used as a last resort after trying other behavioral and environmental interventions. She said that the best way to help your child sleep better is to teach them good sleep habits and routines that they can follow throughout their life.