Many parents have questions about the use of melatonin supplements for children who have difficulty sleeping. It is very easy to get wrong information off of the internet, and even many doctors are ill-informed about the use of dietary supplements, and they themselves sometimes fall prey to the idea of, “well, it’s natural, so it must be safe.”
In the case of melatonin, this is not necessarily the case. I advocate the use of caution and restraint with regard to the use of melatonin for children. Let’s take a look at the facts.
Melatonin is a chemical secreted from an area in our brains known as the pineal gland. Once released, it enters our bloodstream where it can often behave as a hormone, acting on different parts of the body. Although melatonin is now understood to have a wide variety of effects on our bodies, it is perhaps best known outside the medical community for its influence on our so-called circadian rhythms and sleep cycles.
When melatonin begins to circulate in increased amounts in our bodies, it can help regulate the sleep-wake cycle by triggering drowsiness, decreasing appetite, lowering body temperature, and acting to trigger other physiologic changes associated with sleep. Daylight helps regulate this cycle: photoreceptors in our eyes, in response to daylight (or more specifically, in response to a particular type of blue light that’s found within daylight) signal the brain to decrease release of melatonin. At nighttime, without the influence of daylight to keep melatonin levels at bay, larger amounts of this substance can be secreted, carrying the potential to lead to increasing drowsiness. It should be noted, however, that recent research has begun to suggest that melatonin actually has a much smaller effect on our sleep/wake cycle than previously predicted.
Despite the general pop culture belief that taking melatonin supplements (often used in doses of 2-3mg) will help cure insomnia and sleep-related disorders, the actual data is far less conclusive. A 2006 study for instance, failed to show a benefit for using melatonin to treat secondary sleep disorders – i.e. sleep issues triggered by jet lag, shiftwork, etc. Furthermore, the FDA has not approved the use of melatonin as a drug, instead categorizing it as a dietary supplement. This means that that the bottle of melatonin on sale behind the counter in a convenience store lacks the rigorous safety testing or regulation as, for instance, the bottle of aspirin sitting next to it.
Not only is the safety of long-term use of melatonin uncertain, there are also some definite (and significant) side effects that are already known about this supplement. For instance, melatonin can disrupt with our sexual functions, by interfering with the portion of the brain that secretes luteinizing hormone and follicle-stimulating hormone. These hormones are critical in both men and women for regulation of sperm production, ovulation, libido, and other sexual functions. Other known side effects of melatonin use can include nausea, irritation, and potentially dangerous drops in blood pressure.
Of great concern to me is the phenomenon of hormonal down regulation. Simply stated, when you supplement the body’s hormones either long term or in excessive amounts, your body becomes desensitized to that hormone, and possibly begins to stop producing it on it’s own. This is what is happening when I hear parents say “We started Johnny on 2mg of melatonin and now we’re up to 6mg! It works great! He’s been on it for years now, he can’t sleep without it. It’s totally natural, so it’s fine!” This is an example of how long term, over supplementation of melatonin can have an adverse effect on the body’s natural chemistry.
Should you decide to use melatonin as a sleep aid for your child, use the lowest dose possible, and for the shortest period of time possible. I would consider this the last resort before pharmacological intervention. As a well informed parent with all the facts in front of you, you will make the the best choice for your family.
Allison Blaisdell, MSTOM, Lic.Ac. is a licensed acupuncturist and herbalist in private practice at Maverick Square Acupuncture in Boston, and also at Massachusetts General Hospital. She offers private and community acupuncture treatments, as well as online holistic health coaching and consultation. Her mission is to educate and empower her patients to achieve their best possible health.