Record numbers of children and tweens now take melatonin for sleep, potentially doing harm to their development, a new study warns.
Nearly one in five school-aged kids are popping melatonin to help them rest, often with the help of their parents, researchers reported in the Nov. 13 issue of the journal JAMA Pediatrics.
But safety and effectiveness data for melatonin is slim, and the U.S. Food and Drug Administration doesn’t heavily regulate such supplements, researchers say.
“We hope this paper raises awareness for parents and clinicians, and sounds the alarm for the scientific community,” said lead study author Lauren Hartstein, a postdoctoral fellow in the Sleep and Development Lab at University of Colorado Boulder.
“We are not saying that melatonin is necessarily harmful to children,” Hartstein added in a university news release. “But much more research needs to be done before we can state with confidence that it is safe for kids to be taking long-term.”
The human pineal gland naturally produces melatonin, to signal to the body that it is time to sleep and to regulate the 24-hour circadian sleep cycle.
Many countries classify melatonin as a drug that’s available by prescription only, researchers said in background notes.
But in the United States, melatonin is available over the counter as a dietary supplement — increasingly available in child-friendly gummies.
Only a little more than 1% of U.S. parents reported in 2018 that their children used melatonin, but Hartstein and her colleagues noticed that in 2022 more parents said their healthy child was regularly taking melatonin.
To get a sense of how many kids now take the supplement, researchers surveyed about 1,000 parents in the first half of 2023.
What they found was startling:
Nearly 19% of children ages 5 to 9 had taken melatonin in the previous 30 days, and more than 19% of tweens 10 to 13 did
Nearly 6% of preschoolers ages 1 to 4 had used melatonin in the previous month.
Preschoolers using melatonin had been taking it for an average of a year, while grade schoolers and tweens had been using on average for 18 and 21 months, respectively.
The older the child, the greater the dosage, with preschoolers taking between 0.25 milligrams (mg) to 2 mg and preteens taking up to 10 mg.
The problem is that melatonin gummies contain varying amounts of the hormone, researchers said.
About 22 of 25 melatonin gummies analyzed in an April study contained different amounts of the hormone than the label indicated. One had more than three times the amount on the label, while another had none at all.
In addition, some melatonin supplements contained other substances, such as serotonin.
“Parents may not actually know what they are giving to their children when administering these supplements,” Hartstein said.
Scientists have raised concerns that melatonin given to developing children could influence the timing of the onset of puberty.
Gummies also look and taste like candy, increasing the risk of a child overdosing on melatonin.
Reports of melatonin ingestion to poison control centers increased 530% from 2012 to 2021, the authors noted, largely occurring among children under age 5.
More than 94% were unintentional overdoses, and luckily 85% were asymptomatic, researchers added.
When used under the supervision of a health expert, melatonin can be a useful short-term aid, particularly in children with autism or a severe sleep problem, said co-researcher Julie Boergers, a psychologist and pediatric sleep specialist at Rhode Island Hospital and the Alpert Medical School of Brown University.
“But it is almost never a first-line treatment,” Boergers said, noting that she often recommends that families use melatonin only temporarily. “Although it’s typically well-tolerated, whenever we’re using any kind of medication or supplement in a young, developing body we want to exercise caution.”
Boergers said she’s heard from parents that melatonin often works well in the beginning, but over time children might need higher doses to achieve the same effect.
Giving children melatonin also sends a message that If you’re having trouble sleeping, a pill is the answer, the researchers noted.
“If this many kids are taking melatonin, that suggests there are a lot of underlying sleep issues out there that need to be addressed,” Hartstein said. “Addressing the symptom doesn’t necessarily address the cause.”
Harvard Medical School has more about melatonin and children.
SOURCE: University of Colorado Boulder, news release, Nov. 13, 2023
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