Melatonin is a naturally occurring hormone secreted from the pineal gland. Production is stimulated by changes from light to dark, so in the evenings, we produce melatonin in greater quantity. It is also available to take as a supplement. It helps to shorten the time it takes to fall asleep and can be used to combat jet lag and other sleep disorders and disturbances.
We’ve seen an increase in melatonin usage for a variety of reasons. The COVID-19 pandemic is one factor. The pandemic caused a lot of stress, and changes in routine can certainly result in sleep disturbances in both adults and children.
Melatonin is also more accessible than other medications because it is a supplement, and it does not require a prescription from a doctor. This accessibility is helpful in some ways, but also introduces added risks related to reduced regulatory oversight of these products. Because of this, use for children especially should only occur under the guidance of a medical provider.
Sleep hygiene is important. Try to go to bed around the same time every night, avoid screens one hour before bedtime, and create a consistent, relaxing routine around bedtime. Getting appropriate amounts of exercise and outdoor activities during the day can also improve sleep at night, in addition to other benefits like improved daytime focus. There is a chance that other conditions may be contributing to poor sleep, so it’s important to discuss with your provider in this regard, too. In almost every scenario, a non-drug intervention for sleep would be preferred as the first step.
There is no known risk in taking it nightly, but we don’t have a lot of evidence to support long-term use. Clinical trials involving adults support safety for periods up to six months, and in children, we should try not to exceed three months of continuous use. Factors contributing to sleep disorders are often transient, so at around the three-month mark, see if you can wean yourself off of it and reassess sleep patterns for several weeks.
There isn’t a specific dose that should be used in all patients, as dosing is dependent on age, weight and other aspects of development. Studies have shown that there is no added benefit of doses exceeding 10 mg in any patient, and in children that threshold may be lower. You should always discuss dosing with your pediatrician or pharmacist, but a good rule of thumb is that doses should not typically exceed 3 mg for children less than 6 years old, or 6 mg for older children.
Melatonin does interact with some medications and supplements, so it’s always best to talk to your local pharmacist before taking any new product. They are always happy to help select a safe over-the-counter medication, can review for potential interactions and can discuss potentially common or serious medication side effects.
It is possible to take too much melatonin, but it isn’t likely that a single dose will cause harm if used as recommended. Be wary of leaving children alone in the vicinity of any medication or supplement. Kid-friendly dosage forms may present more risk, as children are more likely to take medicine when it looks tasty or attractive, such as when it comes in a fun package or is in the form of a gummy. Securing medications is important for anyone who may have children in their home, even if only on occasion. If you think your child or someone you know has taken too much melatonin, call Poison Control at (800) 222-1222.
March 18, 2024