The American Academy of Sleep Medicine advises not to use in case of chronic insomnia in both adults and children

Melatonin for children.

Melatonin for children.

For three difficult years, Lauren Lockwood tried to put her son Rex to sleep through the night. As a child, he could not sleep without a blanket that completely covered him to cover the outside world. As a 2-year-old, he sometimes needed hours to sleep, and so did his mother, and then woke up at first with terrified nightmares that made him scream in panic.

For years, Lockwood, a nursing midwife who works with a group of new mothers at her home in Auckland, California, has experimented with different approaches to bedtime.

As a child, I allowed her to cry so she could learn to sleep on her own. As he grew up, he lay beside her for hours every night. Eventually, he hired a sleep counselor who developed another program that did not solve the problem. When Rex was 3 years old, Lockwood was exhausted and desperate on the road with one child.

Then you read about melatonin, a hormone released by the pineal gland that helps regulate the sleep cycle. Melatonin is sold in pharmacies as a dietary supplement, in the form of chewable tablets, aromatic liquids, chewing gum for children. “I thought maybe he just needed a little help,” Lockwood said.

Lockwood said that from the first night his son “became a completely different boy.” He gave her a melatonin pill, read a story, and she fell asleep almost immediately. “Our plan was to use melatonin for two weeks and then stop.”

Six years later, he still takes it every night.

Throughout history, parents have sought out the secret to calming down bedtime. Sleeping together, sleeping separately, Ferber’s method of willpower, stuffed animals, pacifiers, hot milk, even spending $ 1,600 on a “smart” basket that responds. baby crying with white noise (quiet) և movement.

In recent years, melatonin supplements have become increasingly popular as a non-prescription, only light, prescription drug regulated in the United States by the Food and Drug Administration (FDA).

In 2021, Americans spent $ 1.09 billion on melatonin supplements, up almost 150% from 2018 sales, according to data provided by NielsenIQ. At the same time, according to the American Association of Poison Control Centers, the number of reports of melatonin poisoning in young children, which means that they took excessive doses, more than doubled from 2017 to 2021.

In 2021, 46,300 cases of poisoning were registered among children under 5 years of age, compared to almost 19,400 in 2017. Possible symptoms of overdose include headache, dizziness, and irritability. Only a few of the reported cases led to serious medical problems.

“This speaks volumes about the widespread use of melatonin. It has spread to more and more children, ”said Dr. Judith Owens, co-director of the Sleep Center at Boston Children’s Hospital and a professor of neurology at Harvard Medical School. “I am especially alarmed that pediatricians recommend it as a quick fix. It sends parents and then older children that if you can not sleep, you should take a pill.

The American Academy of Sleep Medicine advises not to use melatonin in chronic insomnia in both adults and children. Adel Rishi, Co-Chair of the Academy’s Public Safety Committee, Sleep Specialist, Indiana University.

“Children’s insomnia is often a behavioral problem, related to their bedtime routine, access to electronic devices at bedtime, and other activities in which they are involved. “Focus instead of on sleep,” Rishi said. “It can often be treated without medication, behavioral interventions.

Risch attributes the recent increase in melatonin use in children, in part, to the marketing efforts of supplement manufacturers, including products such as baby chewing gum. But he also believes that the epidemic has caused a “growing epidemic of insomnia.”

“As a society, we live in very stressful times. And this is available on the shelf so it is easy to access. Parents usually accept it. And it’s supposed to be safe, “said Rishi. “It’s kind of a perfect storm.”

But despite its concerns about melatonin, it still has loyal supporters among sleep professionals and pediatricians, creating a mixed message for parents looking for a sleep-at-home solution.

Dr. Rafael Pelayo, a professor of sleep medicine at Stanford Medicine, said he believed that melatonin was a useful tool in treating many young people with sleep disorders. “It just tells the brain that night is coming,” he said. “I think the real problem is not that it is overused, but the large number of sleep problems that children have.”

“A small improvement in a baby’s sleep,” he added, “can have a dramatic effect on the family.”

Pelayo said he sometimes recommends melatonin to babies, while the family makes behavioral changes to address the underlying problem. Many children get by without it when they learn to sleep on their own, he says, but some end up accepting it for a long time. He said it works better for children who have difficulty sleeping than those who often wake up at night.

Melatonin is a hot topic on Facebook, such as The Mamahood-SF Bay Area, of which Jill Kunishima is a member. Kunishima first tried melatonin for her son at the suggestion of a pediatrician. He slept well until he started preschool at the age of three. His sleep schedule at school disrupted his sleep patterns, and he stayed awake until 10 p.m.

“The next day was a disaster. “In the morning we went into his room and he was all upset,” said Kunishima, who lives in Auckland.

The pediatrician offered one milligram of melatonin pill for a week or two, and his son was at 8:30 p.m. “It made his body relax,” he said. “That was exactly what I needed.” But when he took the pill, the problem started again.

When Kunisima returned to the doctor with her son, the pediatrician told her not to worry. “If it helps you in your life, go on,” he recalled the doctor. “But now he is 6 years old, he is in the first grade, he is still taking pills.”

Studies show that melatonin appears to be safe for short-term use in children, but little is known about its long-term effects, according to the National Institutes of Health. Because melatonin is a hormone, some experts are concerned that its use may delay puberty, although there is little evidence. Other possible side effects include drowsiness, bedwetting, and restlessness.

Because melatonin is considered a supplement in the United States, և not a medicine, the quality և dosage levels can vary greatly. A 2017 study of 31 melatonin supplements found that actual melatonin levels ranged from one-fifth to almost five times the dosage on their labels.

The fourth product tested also contains serotonin, a hormone that can have serious side effects, even in small doses.

Owens said he was concerned about teens, young people who have been taking melatonin for a decade or more, the effects of which are still unknown. “When sleeping pills are prescribed or prescribed, you need to have an exit strategy. What is your reference point for deciding if we are going to stop taking this medicine?

“I have patients who ask for their sleeping pills every night, it creeps on me.”

He is also concerned that the American Academy of Pediatrics has not published official guidelines for the use of melatonin in children, given that melatonin is often recommended by pediatricians as a sleep aid for younger patients, sometimes up to 6 months old.

Lockwood said his son, now 9, continues to take a quarter milligram of melatonin every night before bed. It is such a small dose that, he wonders, he may feel a placebo effect, but efforts to remove it again inflame his insomnia.

Sleeping in a group of Lockwood new mothers in Auckland is often the talk of the town. “It’s something that consumes us as mothers,” she said. “What happened to me was that no one helped me, no one gave me a solution.”

“Sometimes I wonder if he will have to keep doing it for the rest of his life,” he added. “But I do not torment myself anymore!” It works, he’s happy. “

KHN (Kaiser Health News) is a national newsroom that provides in-depth journalism on health issues. It is one of the three main programs of KFF (Kaiser Family Foundation). KFF is a non-profit, endowed organization that provides health information to the nation.

This story was originally published April 7, 2022, 5:00 p.m.

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