There are two times of the day many parents dread:
1 | The morning rush and,
2 | Bedtime.
Bedtime can be particularly challenging when your child struggles with insomnia. How can you help them? For some parents, the answer is melatonin.
Between 2007 and 2012, melatonin use among children aged 4 to 17 rose significantly, according to the National Institutes of Health, from 0.1 percent to 0.7 percent in that age group. Since this study was conducted, experts suspect the number of children on melatonin has risen even more.
Although there are no definitive statistics, Mohammed Jalloh, a pharmacist and spokesperson for the American Pharmacists Association, says, “I can definitely tell you that it is growing in usage, because people believe melatonin, like other dietary supplements, is all natural and something our body produces. More people have been asking about it.”
Melatonin is a hormone produced in the brain’s pineal gland, and in other tissues in the body, which helps regulate the natural circadian (sleep and wake) cycle. Peak levels occur at night. Trivial amounts of melatonin are also found in foods such as meats, grains, fruits, and vegetables.
Up to 25 percent of healthy children, as well as up to 75 percent of children with neurodevelopmental or psychiatric conditions, experience difficulty with sleep. According to Dr. Judith Owens, director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital.
The gold standard used to be sedating children with antihistamines, like diphenhydramine or Benadryl. Today, more pediatricians and parents are choosing melatonin. “I think we have a little bit better evidence bases for the use of melatonin, particularly in the ADHD and autism spectrum populations,” says Owens.
What is causing the rise in usage? More children are experiencing sleep problems for a variety of reasons. Owens says oftentimes there is a mismatch between a child’s bedtime and their natural fall-asleep time. For others, typically older kids with ADHD, anxiety causes difficulties sleeping.
Some children also struggle with restless leg syndrome, acid reflux, and other ailments and illnesses. Screen time, however, seems to be the largest growing problem, second only to the lack of a regular bedtime routine, according to Owens. The blue light from TVs, iPads, and other electronics disrupts a child’s natural sleep rhythm.
Yet more children are staring at these sources of entertainment and education right up until bedtime. According to a recent study, 72 percent of all children and 89 percent of adolescents have at least one device in their sleep environment. A study in the journal “Pediatrics” found that children had trouble sleeping if they had screen time after 7 p.m.
Blue light suppresses the production of melatonin more than any other type of light. Stressors that affect a child’s circadian clock, such as blue-light exposure, can have serious consequences. According to the Centers for Disease Control (CDC), insufficient sleep is a public health epidemic, linked to cognitive impairment and risk for injury.
According to Dr. Jodi Mindell, Associate Director at the Sleep Center at the Children’s Hospital of Philadelphia and author of “Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night’s Sleep,” not getting enough sleep really affects every aspect of a child’s well-being and functioning. “Children who don’t get sufficient sleep at night, are more likely to be overactive and noncompliant, as well as being more withdrawn and anxious,” she said in an earlier interview.
If your child is experiencing insomnia, Owen says behavioral therapy should be used first or in conjunction with a sleep aid like melatonin, because a supplement alone will not address the underlying problem. “The vast majority of parents don’t want their kids on medication, but that is a quick solution to this problem where the behavior intervention is clearly more challenging,” says Owens.
Two critical questions for parents to ask before reaching for a sleep aid are:
1 | Did the pediatrician ask the right questions to get to the root cause or causes of the insomnia?
2 | What other kinds of behavioral strategies can I use in conjunction with melatonin to address the problem?
To encourage good sleep hygiene in children, the National Sleep Foundation recommends the following:
- Napping during the day should be avoided
- Appropriate dinnertime should be at least two hours before bedtime
- Screen time (i.e., watching television, reading on an iPad or tablet, playing computer or video games) should be discontinued at least an hour before bedtime
- Regular bedtime routine including routine sleep and wake-up times should be maintained
- Children should sleep in their own beds
- Sleep environment should be dark and quiet; room should not be too hot
- Caffeine should be avoided
Have you used or are you currently using melatonin to help your child sleep? Share your experiences in the comments!