March 21, 2024 – For Courtney Stinson, ensuring her daughter’s comfort is a constant battle with the challenges of congenital myopathy. The 9-year-old relies on a ventilator to breathe, receives multiple respiratory treatments daily and receives constant care from a rotating cast of skilled caregivers. Last year alone, she endured 36 doctor's visits.
To alleviate her daughter's sleep problems, Stinson consulted her pediatrician and turned to melatonin, a hormone that the body naturally produces to manage sleep. She gave her daughter a low dose of melatonin and found that her ability to calm down, especially when her heart raced, improved significantly.
„With everything going through her head, she would have a hard time sleeping,“ said Stinson, a mother of two who lives in Milan, Michigan. She said, „This was really helpful when her brain was going 160 miles an hour.“
Melatonin is sold over the counter as a sleep aid in supplement form. Melatonin can be a valuable resource for some parents, especially those with children with complex needs, but pediatric sleep experts say increases in melatonin across healthy populations are also having an impact. .
Recent data from the CDC illustrates one of these shortcomings. Over the past 20 years, there has been a significant increase in melatonin accidental ingestion among young children.
The report found that from 2012 to 2021, poison center calls related to pediatric melatonin exposure jumped 530%, and that emergency department visits due to unsupervised melatonin ingestion by infants and young children increased from 2009 to 2020. It jumped 420%. CDC report.
Between 2019 and 2022, an estimated 10,930 emergency room visits were associated with 295 cases in which children under 6 years of age ingested melatonin. According to the report, these incidents accounted for 7.1% of all emergency department visits due to drug exposure in this age group.
% of US adults using melatonin It increased from 0.4% in 1999-2000 to 2.1% in 2017-2018.
Doctors say the increase in melatonin-related incidents highlights the need for increased awareness and safety measures to protect young children from unintentional overdose, which can cause nausea, vomiting, diarrhea, dizziness and confusion. It states that
„I think there are ways to use it safely in certain children, but it should only be used under medical supervision,“ said Dr. Laura Sterni, director of the Johns Hopkins Pediatric Sleep Center. She added, „It's dangerous to use without that guidance.“
largely 1 in 5 children uses melatonin
Nearly one in five school-aged children and pre-teens take melatonin to help them sleep, according to a study published last year. JAMA Pediatricsalso found that 18% of children between the ages of 5 and 9 take supplements.
American Academy of Sleep Medicine issued a warning In 2022, parents are advised to be cautious when using sleep aids.
„While melatonin may be helpful in treating certain sleep-wake disorders such as jet lag, there is much less evidence that melatonin helps healthy children and adults fall asleep faster,“ says the Academy of Sleep Medicine. said M. Adeel Rishi, MD, Vice Chairman. The Public Safety Commission issued a warning on the school's website. „Rather than relying on melatonin, parents can help their children develop good sleep habits, such as setting regular bedtimes and wake-up times, establishing bedtime routines, and limiting screen time as bedtime approaches. We should try to make it happen.”
What is the best way to give melatonin to children?
Melatonin has been found to be effective for children Attention Deficit Hyperactivity Disorder (ADHD), with autism spectrum disorderor other conditions such as blindness that can interfere with the development of normal circadian rhythms.
But in addition to consulting with a pediatrician, caregivers with healthy children should first consider trying other approaches to sleep disturbances, such as proper sleep hygiene and anxiety, which should be addressed first. Sterni said.
„Most sleep problems in children should be addressed with behavioral therapy alone,“ she says. „I think it's the wrong approach to take medicine first for treatment.“
Dr. Sterni also recommends starting with the lowest possible dose, 0.5 milligrams, with the help of your pediatrician. She said it should be taken one to two hours before bedtime and two hours after the last meal.
However, she points out that because melatonin is sold as a supplement and is not regulated by the FDA, it is impossible to know the exact amount in each dose.
according to Japan Automobile Manufacturers AssociationOf the 25 melatonin supplements, most contained up to 50% more melatonin than the stated amount.
Dangerous to keep within reach
Dr. Jenna Wheeler, a pediatric critical care physician at Orlando Health Arnold Palmer Children's Hospital, said one of the biggest risks to children is that melatonin is sold in gummy or chewable tablets that are appealing to children. He says that this happens often.
Since it is sold as a supplement, there are no child-safe packaging requirements.
„From a critical care standpoint, remember to store it in an elevated location and not in a nightstand or drawer,” Wheeler said. „Children may think, 'It's just a fruit snack,' and eat the whole jar.“
He said the amount people need is often less than what you would buy over the counter, and that it is not intended as a long-term supplement for adults or children, regardless of whether it is used in the right amount. It pointed out.
„Like anything in the world, it's all about how it's used,“ Wheeler says. „The problem is when kids use it incorrectly or when it's not used properly.“