Counting sheep and melatonin gummies

NICK EICHER, HOST: Coming up next on The World and Everything in It: Getting children to sleep.

For many families, bedtime is a daily struggle to help kids unwind. And now, many parents are turning to melatonin. But some experts say there are underlying issues that need to be addressed first. World Reporter Juliana Chan Erikson has the story.

JULIANA CHAN ERIKSON: A new study published last month in JAMA Pediatrics reports that 1 in 5 children now take melatonin for sleep. In some cases, 1 year olds have been known to take the supplement. They’re often sold over the counter as flavored chewable gummies.

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And while doctors say it’s generally safe to give melatonin to children, there’s still a lot of questions about the hormone’s effects.

Humans naturally produce melatonin. It’s the hormone that regulates sleep and wake cycles. We typically produce more of it at night when it’s dark, and that sends signals to the rest of the body saying it’s time for bed. Some people don’t produce enough melatonin, and others work night shifts or travel a lot.

So back in the 90s, drug companies offered a solution—a synthetic form of melatonin you can buy over the counter.

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Researchers still don’t fully understand how safe it is for children. And since it’s considered a supplement and not a drug, melatonin isn’t tightly regulated by the Food and Drug Administration like other medications are.

Rosemary Stein, a pediatrician in North Carolina, says she occasionally prescribes melatonin to her young patients.

STEIN: If it's something that is temporary, melatonin will be helpful.

Stein has worked with thousands of young patients over the past 24 years and said that because of their developing brains, kids and teenagers will need more sleep than adults. But Stein says kids and teens these days aren’t getting enough shuteye.

STEIN: There is an ongoing problem with insomnia, with children, it has increased from what I had what I had, let's say 30 years ago, or even 10 years ago. And I think that a lot of this is environmental.

When Stein talks about the environment, she’s referring to busier schedules, less down time, more noise at night and more electronic screens in the home.

STEIN: Children have electronic devices all the time, so that distracts them. But that also stimulates your brain so that they have more difficulty reaching sleep, especially REM sleep.

Computer screens produce blue light, which some say can inhibit a person’s melatonin production. Karen Winter, a certified pediatric sleep specialist in Wisconsin, says this means screen time before bedtime isn’t a good idea.

WINTER: I think a lot of families are very reliant on screens, on TV, on iPads and use that in the late evening times, which affects the onset of sleep. Blue light highly affects the onset of sleep. So I think that's why we actually do see a lot more tired kiddos, kiddos not being able to fall asleep easily, because that blue light is affecting the so much of them.

She doesn’t recommend melatonin because she’s concerned there are too many unknowns.

A study published back in April found that 22 out of the 25 brands researchers examined did not list the accurate amount of melatonin. One brand had more than three times the amount of melatonin on the label. Another had none at all.

So what will help a child sleep? Stein and Winter both say what makes the most difference isn’t the actual bedtime routine, but what families do before.

Winter works with children between the ages of two and seven…and she says for the preschool set it may mean shedding midday naps and setting up sticker charts for those who stay in their beds longest. For older kids, it may mean less time on electronic devices and more time reading books.

And for some who find it impossible to sleep, it might mean melatonin. Stein will prescribe it for the kids who are struggling. But she doesn’t do it often because she says it’s a short term fix for a long term problem.

What ultimately helps, she says, is teaching kids how to rest.

STEIN: So at 8:30 you're in bed, you reading the book, you're telling a story, you saying a prayer, you're resting, you're saying thank you God for this great day. And then your day is done, then kid understands, okay, I can find rest.

Reporting for WORLD, I’m Juliana Chan Erikson.

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