Will melatonin fix your child’s sleep problems?

Melatonin, is it the natural magical sleep pill it’s claimed to be? Will it really “fix” your child’s sleep problems overnight? If you have a toddler or an older child who doesn’t sleep well, you may have considered the use of melatonin. Indeed, if you’ve ever read a social media post from a parent asking how to help their child sleep better you’ll have noticed numerous comments suggesting melatonin. So it must work, right?

There are more and more parents turning to this substance, whether “officially” through their doctor or specialist’s recommendation, or finding their own way around the system. Every time I see melatonin suggested as a quick fix for childhood sleep it makes me cringe. But I also see the appeal.

These days life is busy, and if you’re a parent, anything you can do to make life easier with children can be a godsend. Especially if they’re not sleeping! If you have a child who isn’t sleeping well, chances are no-one in the family is getting the sleep they need. And when you’re sleep deprived, you can feel like ANYTHING that will help your child drift off to sleep more quickly is worth a try. You just want to help them sleep, for all the health benefits sleep brings, I know.  But not everything recommended on the internet is a good thing (you know this, even with a sleep addled brain). So should you give your child melatonin? Let’s dig a little deeper, then you can decide…

What is melatonin?
Simply put, melatonin is a hormone that is naturally produced in our bodies when it’s dark. It typically kicks in at night time and helps us regulate our circadian rhythm (our internal 24-hr sleep/wake clock) by making us feel tired when it’s time to sleep.

The truly natural form of melatonin comes from cow and pig brains (which as an aside I’d steer clear of). However, most forms of melatonin these days are synthetic.  And these synthetic versions have been available over the counter, at least in countries like the United States of America, since 1994. So it’s not a new “wonder drug”.  But let’s cut to the chase…

Does it work?

Yes, melatonin can help people sleep. It helps reset our internal clocks, making us feel sleepy when perhaps we wouldn’t normally.  Yes, there are studies that show that melatonin does decrease sleep latency (the time it takes you to get to sleep). Although the results on whether it helps you stay asleep are inconclusive. Results vary.

But when it comes to research surrounding melatonin, there is a complication. Melatonin is not regulated by the American Food and Drug Administration (the FDA).  It is considered a supplement in the United States, and it is readily obtainable over the counter there. This means two things: one, there are different strengths and formulations available, and two; melatonin hasn’t gone through the through testing that typical pharmaceuticals in the United States do. And, while it’s true that not all research comes from the States, it is a big contributor, and this has slowed research efforts. Significant information is missing; especially surrounding children.

Because there is no rigorous research available on the long-term safety effect of melatonin to treat sleep disorders in children and adolescents, even if it does work, we don’t actually know that it’s safe for children.

What is melatonin indicated for?

In New Zealand and Australia, melatonin has the green light to be used in the short term treatment of primary insomnia (trouble sleeping) in patients aged 55 years or more.  And that’s about it. Melatonin can also be used to treat jet lag and shift workers syndrome in adults, but it’s not indicated for this in New Zealand.

Indeed, melatonin (available on prescription in New Zealand under the brand name “Circadan”) is generally NOT recommended for use in children and adolescents below the age of 18 years due to the insufficient data on safety and efficacy, as mentioned above.

But it is prescribed for children!?

Yes, no doubt you know someone (who knows someone) who has a child taking melatonin. But when it is prescribed for children to help them sleep, it is done so “off label”. That means the doctor is using it for a purpose in which it was not initially intended. Furthermore those prescriptions should only be written for children diagnosed with a neurodevelopment disorder (those with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual developmental disorder or specific learning disorders for example).

And if you are considering using it without a prescription in New Zealand or Australia, it is really important to get the dosage and the timing right, or it still won’t work (that’s ignoring all the other potential factors, keep reading).

Are there side effects?

In the short term, melatonin is associated with few known side effects. That’s worth a sigh of relief right. The side effects are generally limited to drowsiness (duh), indigestion, stomach upsets, nausea and muscle, bone or joint pain (although there have been reports of hallucinations also).

However, the key words to note here are short term. Even when prescribed for adults, treatment should be limited. New Zealand’s medicine safety authority, Medsafe, warns that “prescribing for prolonged periods should be approached with caution, particularly in children and adolescents”. So even if it has been prescribed, it should be a short term measure, hopefully in association with a longer term fix like behavioural changes.

But remember we don’t really know the long-term effects of melatonin. Professor David Kennaway, Head of the Circadian Physiology Laboratory at the University of Adelaide’s Robinson Research Institute, warns that giving melatonin to children may result in serious side effects when the children are older.  And he has a very genuine reason to be concerned.

Melatonin does more than help you sleep.

I think it’s important to point out that melatonin affects other parts of your body, not just the sleep/wake system. Laboratory studies show that melatonin causes changes in multiple physiological systems, including cardiovascular (heart), immune (health) and metabolic (growth/energy) systems.  Studies have looked at its use in the treatment of a wide range of medical conditions including melanoma, migraines, asthma, tinnitus and hypertension, with varying results.

Melatonin also works on the reproductive system and has been implicated in the control of the onset of puberty and the timing of ovulation. Indeed, melatonin is also a veterinary drug given to sheep and goats to change their seasonal reproductive patterns, and make them more valuable for industry. This is not a widely publicised fact for obvious reasons.

But my child is wired differently, so he needs it

Remember how melatonin was indicated (off label) for children with neurodevelopment disorders? These children are wired differently, and yes, sleep disturbances in this population are even more common. If your child has ASD, ADHD or other complex neurodevelopment disorders, sleep can be tricky.

And you know what, I hear you! Children with neurodevelopmental disorders have numerous difficulties outside the range of normal and it can be a lifesaver to receive a prescription that helps with sleep. It’s one less thing to worry about (at least until you read this blog, sorry).

I too have a child with ADHD (and he has dyslexia and ODD too). And yes, he has struggled with sleep in the past, and sometimes still does. But he is also proof that behavioural methods work, and I do not need to give him something his body is quite capable of making when the conditions are right. As a parent you CAN help sleep come easier for your atypical child. But it takes a little bit of work.

In saying that, it is also true that some autistic children secrete lower levels of melatonin compared with neurotypical children. And, just like any hormone therapy, there is a time and a place for it. Melatonin can really help these children, and if you are in this bracket you do not need to be alarmed; you will know who you are. This blog is not about these specific children. And if this isn’t you, you need to know that these children are much rarer than the number of prescriptions being handed out would imply.

Get to the root of the issue

If low levels of melatonin are not the problem with sleep, taking it as a pill still won’t help your child. And even if it does help for a while, it is really just a band aid solution; assuming your child is not in that small subgroup mentioned above. You need to consider why your child may have low levels of melatonin and work to help them correct this naturally. Chances are their body can produce enough of it without a pill.

If your child was having ongoing headaches, would you be happy receiving a prescription for pain killers, and then being sent away with no further explanation? If this was me, I’d want to get to the cause of the problem and address it, not just mask the symptom.  And just like headaches can occur for numerous reasons (eye trouble, dehydration, illness…. the list goes on), the cause for sleep difficulties can be numerous too. Sleep is complex after all.

What you can do instead of giving melatonin

When your child doesn’t sleep well, it’s a really hard place to be. And there are some very valid reasons to hire a sleep consultant (make sure they normally work with clients your child’s age). But small changes to sleep hygiene can also make a big difference. These changes can also promote melatonin release in the body naturally (without ingesting it):

• Make lighting dim before bedtime and dark when asleep
• Make sure the temperature is conducive to sleep (around 18-20 degrees Celsius)
• Have a good daily schedule that helps your child get up and go to bed around the same time each day (yes, that means weekends too)
• Avoid vigorous exercise and limit screen time for 1-2 hours before bed
• Minimise stress (which can also suppress melatonin)
• Ensure your child gets outside into natural sunlight during the day
• Put good routines and expectations in place around bedtime
• Eat foods rich in tryptophan (milk and dairy products plus sweet corn, rice and oats) and those that contain melatonin (e.g. cherries, ginger, grapes, tomatoes, bananas).

In summary

If you need help with sleep, please seek that help from someone who knows about sleep. This is generally not your social online network. The right person will be able to evaluate the problem and can support you through behavioural changes. Yes it takes effort, but it really is a life changer!

I’m not saying that melatonin is always bad. I agree it can be a really helpful tool for short term use along with behavioural techniques in some children. But you need to know that taking melatonin is a form of hormone therapy, and weigh up the risks appropriately. So if you are still interested in it as an option for your child, please ensure it is being prescribed under the guidance of a paediatrician, so you can ensure it is effective, and all safety avenues are covered.

So what are your thoughts now? I’d love to hear them.

If you don’t think that melatonin is the way forward for you, but you still need some help with a sleep issue that is affecting your family; I have sleep packages that work and I’d love to help. I’ve been somewhere similar to where you are now, so I get it. If you’re interested, you can book in a free initial phone call HERE.

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