Melatonin
Have you or your children ever taken melatonin to help with sleeping problems? Many readers likely answer yes to this question, as melatonin supplements have become increasingly popular over the past few decades. Many people value melatonin as a natural sleep aid, while others may be skeptical of the product’s safety. In fact, a simple internet search on the topic provides a confusing array of positive and negative information. Below are basic facts about melatonin that can help you make an informed decision on the matter.
Melatonin is a hormone that regulates several bodily functions. The main role is regulating circadian rhythm, which is our internal clock that tells us when to be awake and when to sleep. Melatonin levels are correlated with lack of light. During daylight hours, very little melatonin is produced. As evening approaches and light from the sun decreases, melatonin levels gradually increase. The melatonin hormone readies the body for its primary nighttime activity of sleep. It does this by promoting calmness of body and mind, so that we feel tired and restful sleep can occur. Over-the-counter melatonin supplements are a synthetic version of the hormone made by the body.
In the United States, melatonin is considered a dietary supplement. Like all supplements, it is not FDA approved and has not gone through the same rigorous testing that prescription drugs must go through. Studies of melatonin’s safety and effectiveness do exist but are limited.
What kind of sleeping issues can be improved with a melatonin supplement? In general, the most common kinds of sleep issues involve difficulty falling asleep, staying asleep or poor quality of sleep. Typical causes of sleep problems are stress, anxiety, depression, blue light from screens, pain, medical diagnoses and numerous others. Pinpointing and addressing the cause of a sleep disturbance should always be the first step when trying to improve sleep. Nevertheless, sometimes more help is needed to get the quality sleep the body needs to stay healthy. Many people prefer melatonin over prescription sleep medications because it is considered to be more natural, has fewer side effects and is not habit forming.
Melatonin is most effective for sleep issues that require a reset of the circadian rhythm, such as jet lag or irregular sleep patterns from shift work. Melatonin in these cases can work to help restore the normal sleep-wake cycle. For children and adolescents with ADHD, autism or other related diagnoses, several studies have found melatonin to be beneficial for improving sleep issues. For most children experiencing a sleep disturbance, the first step should be to identify and address the cause of the sleep disturbance before turning to medications or supplements. Studies have found behavioral interventions most effective at treating sleep issues for children. This may include establishing a bedtime routine, decreasing screen time before bed, restricting fluids in the evening, doing relaxation exercises or even eliminating daytime naps. Most important is to evaluate whether underlying factors could be negatively impacting a child’s sleep. Sleep disturbances can be a symptom of a bigger issue like stress, major life changes, medical problems, anxiety or depression. Discussing these problems with a medical provider will allow for appropriate treatment of the issue and likely improved sleep.
We can find plenty of success stories from those who have had positive experiences using melatonin . But when it comes to scientific evidence, melatonin shows only small benefits. Several studies have found melatonin can aid in falling asleep faster by approximately seven minutes, and it may extend the time asleep by about eight minutes.
Although most people who use melatonin tolerate it with little to no trouble, there are potential side effects to consider before using it for the first time. The possible side effects include next-day drowsiness, abdominal pain, headaches, nightmares and dizziness. It is best to use the lowest dose of melatonin for the shortest amount of time.
Of concern is a recent increase in accidental melatonin overdoses. Following safe medication practices can prevent most of these accidents. Like all medications, melatonin should be kept out of reach of children. This is especially important since melatonin is often chewable with a pleasant taste, and many brands do not come in child-proof containers. Lastly, never refer to any medication or supplement as a treat or candy.
Overall, melatonin seems to be mostly safe with few mild side effects. A melatonin supplement for sleep should always be combined with healthy sleep practices for the best results. Remember, supplements may interact with other prescription or over-the-counter medications. Deciding whether a supplement or medication is right for your family is an individual choice. Consider the available data and, as always, discuss questions or concerns with your trusted health care provider.
Hailey Saunders. APRN, MSN, FNP-C, is a family nurse practitioner and Kansas City native who is passionate about evidence-based health education.
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