Recent research from the University of Colorado Boulder has found that nearly one in five children and preteens use melatonin for sleep, with some parents administering it to preschoolers as well. Concerns have been raised due to limited safety data and the absence of regulation by the FDA. Experts emphasize caution, highlighting behavioral changes as more vital for addressing sleep issues in children.
Findings from studies indicate a notable increase in melatonin usage among children and preteens to aid sleep, prompting worries about safety, effectiveness, and potential long-term health consequences. Experts advise caution and suggest prioritizing behavioral solutions for children’s sleep problems.
New research from the University of Colorado Boulder, published in JAMA Pediatrics on November 13, reveals that approximately 20% of school-aged children and preteens now use melatonin for sleep, and some preschoolers are regularly given the hormone.
Warnings Highlighted by Researchers
Researchers express concerns, noting the scarcity of safety and effectiveness data for these products, as dietary supplements are not fully regulated by the Food and Drug Administration.
Lead author Lauren Hartstein, PhD, part of CU Boulder’s Sleep and Development Lab, voiced the hope that their findings will raise awareness among parents and clinicians and alert the scientific community about the need for more research before a definitive assertion about the safety of melatonin in children can be made. Ambiguity exists as to whether prolonged use is safe for children.
Researchers at the University of Colorado Boulder noticed a rise in melatonin use to help kids fall asleep. Postdoctoral fellow Lauren Hartstein describes what melatonin is and how the rise in use could be problematic.
Melatonin Trends and Data
Melatonin is a hormone naturally produced in the pineal gland to induce the body to sleep and regulate the circadian rhythm over a 24-hour period.
In many countries, it is classified as a drug available by prescription.
In the United States, chemically synthesized or animal-derived melatonin is sold over the counter as a dietary supplement, increasingly made available in gummy forms for children.
“In 2022, we started noticing an uptick in parents regularly giving melatonin to their healthy children,” explains Hartstein, who studies the impact of environmental cues, including nighttime light exposure, on children’s sleep patterns and melatonin production.
In 2017-18, about 1.3% of U.S. parents reported giving melatonin to their children.
To gauge the current prevalence, Hartstein and colleagues surveyed approximately 1,000 parents in the first half of 2023.
Among 5- to 9-year-olds, 18.5% had used melatonin in the previous 30 days. The usage increased to 19.4% for 10- to 13-year-olds. Nearly 6% of preschoolers aged 1 to 4 had taken melatonin over the previous month.
Preschoolers who used melatonin had been taking it for a median length of a year. Grade-schoolers and preteens had used it for median lengths of 18 and 21 months, respectively.
Older children were given greater doses, with preschoolers taking between 0.25 to 2 mg and preteens up to 10 mg.
Risks and Mislabeled Products
In an April study, researchers found that 22 out of 25 melatonin gummy products contained different melatonin amounts than indicated on the label. One product had over three times the labeled amount, and one had none at all. Some supplements were found to have other concerning substances such as serotonin.
“Parents might not be aware of what they are giving to their children when administering these supplements,” Hartstein remarks.
Scientists have also raised concerns that giving melatonin to young individuals whose brains and bodies are still developing could impact puberty onset timing.
Small-scale human studies on this matter have produced inconsistent results.
Additionally, gummies pose another risk as they resemble and taste like candy.
Reports indicate that from 2012 to 2021, cases of melatonin ingestion to poison control centers went up by 530%, predominantly among children under 5. Over 94% were unintentional, and 85% were asymptomatic.
Possible Hazards and Advice
Julie Boergers, PhD, a pediatric sleep specialist, emphasizes that melatonin can serve as a useful short-term aid under healthcare provider supervision, especially for youth with autism or severe sleep problems.
“However, it is almost never a first-line treatment,” Boergers underlines, encouraging families to focus on behavioral changes first and to use melatonin on a temporary basis. She highlights that while it is usually well-tolerated, using any medication or supplement in a young, developing body necessitates caution.
Boergers has observed that while melatonin may initially be effective, children may later need higher doses to achieve the same result.
Hartstein expresses concerns that introducing melatonin early on could wrongly convey the idea that taking a pill is the solution to sleep troubles.
Study Constraints and Wider Implications
The authors acknowledge the study’s relatively small scale and recognize that it may not be wholly representative of national usage. Nevertheless, the findings are telling.
“The significant number of children using melatonin suggests underlying sleep issues that need to be addressed,” Hartstein asserts. “Dealing with symptoms may not necessarily solve the underlying cause.”
Reference: “Characteristics of Melatonin Use Among US Children and Adolescents” by Lauren E. Hartstein, Michelle M. Garrison, Daniel Lewin, Julie Boergers and Monique K. LeBourgeois, 13 November 2023, JAMA Pediatrics.
DOI: 10.1001/jamapediatrics.2023.4749
