March 21, 2024 – For Courtney Stinson, ensuring her daughter's well-being is a continuing battle against the challenges of congenital myopathy. At the age of 9, she relies on a ventilator to breathe, undergoes several ventilation treatments each day and is consistently cared for by changing, qualified carers. Last 12 months alone she needed to endure 36 doctor's appointments.
To ease her daughter's sleep problems, Stinson, after consulting with a pediatrician, turned to melatonin, a hormone the body naturally produces to control sleep. She gave her daughter a low dose of melatonin and saw a major improvement in her ability to calm down, especially when her thoughts were racing.
“She would have such a hard time sleeping with everything going through her head,” said Stinson, a mother of two who lives in Milan, Michigan. “It was really helpful to have their brain moving at 100 miles per hour.”
Melatonin is sold over-the-counter as a sleep aid in the shape of a dietary complement. For some parents, especially those whose children have complex needs, melatonin could be a precious resource — but the rise in melatonin in otherwise healthy populations also has consequences, in keeping with pediatric sleep experts.
Recent data from the CDC highlights one among these drawbacks: a major increase in accidental ingestion of melatonin in young children over the past twenty years.
Between 2012 and 2021, calls to poison control centers related to pediatric melatonin exposures increased 530%, while emergency room visits for unsupervised melatonin ingestion by infants and young children increased 420% from 2009 to 2020, the study said CDC report.
Between 2019 and 2022, an estimated 10,930 emergency room visits were related to 295 cases of melatonin use in children under 6 years old. These incidents accounted for 7.1% of all emergency room visits for drug exposure on this age group, in keeping with the report.
The proportion of US adults who use the next Melatonin increased from 0.4% in 1999-2000 to 2.1% in 2017-2018.
Doctors say the increasing variety of melatonin-related incidents underscores the necessity for greater awareness and safety measures to guard young children from accidental overdose, which may cause nausea, vomiting, diarrhea, dizziness and confusion.
“While I believe there is a safe way to use it in certain children, it should only be used under the guidance of a doctor,” said Laura Sterni, MD, director of the Johns Hopkins Pediatric Sleep Center. “There are dangers in using it without these instructions.”
Nearly One in five children uses melatonin
According to a study published last 12 months, almost one in five school-age children and adolescents take melatonin to sleep JAMA PediatricsIt was also found that 18% of kids between 5 and 9 years old take the dietary complement.
The American Academy of Sleep Medicine issued a warning in 2022 advises parents to watch out with the sleeping pill.
“While melatonin may be useful in treating certain sleep-wake disorders such as jet lag, there is much less evidence that it can help healthy children or adults fall asleep faster,” M. Adeel Rishi, MD, vice chairman of the Academy of Sleep Medicine Public Safety Committee warned on the academy's website. “Instead of resorting to melatonin, parents should work to encourage their children to develop good sleep habits, such as setting a regular bedtime and wake-up time, having a bedtime routine, and limiting screen time as bedtime approaches.”
What is the perfect technique to give melatonin to children?
Melatonin has been found to work well in children with attention deficit hyperactivity disorder (ADHD), autism spectrum disorderor other medical conditions, akin to blindness, that will hinder the event of a standard circadian rhythm.
But beyond consulting a pediatrician, caregivers whose children are otherwise healthy should first consider other approaches to treating sleep problems, Sterni said, and things like proper sleep hygiene and anxiety must be addressed first.
“Most sleep problems in children should really only be treated with behavioral therapy,” she said. “Pulling out a drug first to treat it, I think is the wrong approach.”
Sterni also recommends starting with the bottom possible dose, 0.5 milligrams, with the assistance of a pediatrician. It must be taken 1 to 2 hours before bedtime and a couple of hours after the last meal, she said.
However, she cautions that because melatonin is sold as a dietary complement and shouldn't be regulated by the FDA, it's unimaginable to know the precise amount in each dose.
Accordingly JAMAOf the 25 melatonin supplements, most products contained as much as 50% more melatonin than listed.
Dangerous if kept within sight
One of the largest dangers to children is that melatonin is usually sold in the shape of gummies or chewable tablets – things that appeal to children, Dr. Jenna Wheeler, a pediatric critical care physician at Orlando Health Arnold Palmer Hospital for Children.
Because it's sold as a dietary complement, there aren't any requirements for child-resistant packaging.
“From a critical care perspective, think about keeping it high up, not on the bedside table or in a drawer,” Wheeler said. “A child might eat the whole bottle and think, 'It's like a fruit snack.'”
She noted that the quantity people need is usually lower than what they buy in the shop, and that no matter whether it's utilized in the suitable amount, it shouldn't be intended as a long-term dietary complement — for adults either for youngsters.
“As with anything out there, it depends on how it’s used,” Wheeler said. “The problem is when children accidentally get into it or when it’s not used properly.”