For more kids, bedtime is med time

For many American parents, getting children to sleep isn’t as easy as reading them a bedtime story and turning off the light.

Stacey Wimberley and her husband tried bedtime routines with their six children, but some nights, she said, “they were too hyped up.” After enrolling in a sleep study and doing some research, the family found two things worked reliably to get their children sleeping: weighted blankets and melatonin.

She said the hormone supplement worked like a charm. Even so, Wimberley, a trained nurse who lives in Texas, said she cautiously limits them to one dose a week and only as needed.

New research shows that an increasing number of parents like Wimberley are turning to over-the-counter melatonin supplements to help their children sleep at night. The study, published last month in JAMA Pediatrics, notes that 1 in 5 children and pre-teens now take melatonin for sleep. Some parents give the hormone to children as young as 1.

Most agree that melatonin is generally safe to offer to children occasionally, but the research supporting its safety remains thin, and experts I spoke to are either hesitant or unwilling to recommend melatonin for anyone under 18.

Humans naturally produce melatonin, a hormone that regulates a body’s sleep and wake cycles. Typically, darkness increases melatonin production, causing a person to feel sleepy. Light inhibits it.

For decades, grocery stores have sold melatonin over the counter for adults struggling with insomnia, jetlag, or the occasional sleepless night. But it’s only recently that researchers have noted the sharp rise in children using it regularly. That’s not too surprising—melatonin is affordable and often sold as chewable gummies. Parents can buy a bottle of 120 strawberry-flavored melatonin gummies online for less than $8.

Dr. Rosemary Stein, a pediatrician in Burlington, N.C., said melatonin is a new solution but not a great one for an age-old problem. She will occasionally prescribe melatonin to children, but only for short-term use.

“Each child is different. You may not get any effect at all, or you want to give them three, four pills,” Stein said. She pointed out the medication is not completely benign, because “you can overdose a child on melatonin.”

The Centers for Disease Control and Prevention noted that melatonin ingestion calls to local poison control centers rose by 530 percent between 2012 and 2021, with 83 percent of those calls concerning a child 5 or younger. Most did not require hospitalization, but 1 percent ended up requiring intensive care.

The companies selling melatonin over the counter offer little consistency from brand to brand, which may further confuse parents. One brand offers 0.5 milligrams of melatonin and directs parents to give their child one gummy, while another recommends giving up to two of its 0.5 milligram gummies, and yet another advises giving one gummy that contains a 1 milligram dose.

Making matters worse, researchers in April found that 22 out of 25 examined brands of melatonin gummies contained different amounts of melatonin than what their labels indicated.

Wimberley said this lack of consistency matches her family’s experience. Her husband occasionally takes 10 milligrams of melatonin, but one time he took one or two children’s doses at a friend’s house. “It knocked him out,” she said. “It seems like it worked way stronger than what we have.”

The U.S. Food and Drug Administration considers melatonin a dietary supplement, so it does not regulate it as tightly as other prescriptions or over-the-counter medications.

Karen Winter, a certified pediatric sleep consultant in Wisconsin, does not recommend melatonin at all. She works with children between the ages of 2 and 7, and instead of medication, offers a combination of behavioral changes, careful planning, and accountability to help children develop good sleep habits.

“I think that melatonin is very much like a Band-Aid where it’s going to help that child feel tired,” Winter said, “but it’s not going to help their sleep overall.”

Instead, she recommends gently modifying a child’s bedtime routine. For many clients, the biggest modification is having children limit their time on electronic devices.

“I think kiddos aren’t having as much time to calm down … It’s very go-go-go-go-go,” she said. “Then parents see that if they turn on a show, or they give their kid an iPad, they’re quiet. But that doesn’t mean their body is calming in the right way.”

Stein, who’s also a member of the Christian Medical and Dental Associations, adds that with so many children doing organized activities or using electronics in the late hours, many have lost the skill of resting their bodies and shutting down in the evenings.

“Jesus went to sleep and He needed sleep so that He could keep on ministering to people,” she said. “Our children also need sleep so that they can learn and be active and play and be children. And I think we’ve gotten away from that.”