Data supports what many parents already know – improving sleep habits and making behavioral changes are the most effective and long lasting way to ensure good sleep for children.  And though many parents want a “quick fix” for their child’s sleep problem, there is very little data on the safety and efficacy of sleep medications in children.

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WHERE TO START

Patients and parents should meet with their pediatrician to discuss good sleep habits and to make sure there are no medical issues like obstructive sleep apnea (often presents with snoring), medications that disrupt sleep, or other concerns.

FIRST, FOCUS ON GOOD SLEEP HABITS!!

• A consistent (and relatively early) bedtime
• A consistent bedtime routine (books, bath, meditation, calming activities)
• Limited screen time (not within 2 hours of bedtime)
• A safe, calm and quiet sleep space
• A short goodnight

IF THAT DOESN’T WORK

Improving sleep habits can be a labor intensive job. And for some children, even with many behavioral modifications, sleep issues may persist.  THERE ARE NO FDA APPROVED MEDICATIONS FOR INSOMNIA IN CHILDREN UNDER 16.  Many exhausted parents look to over-the-counter options, and of those, Melatonin is a common medication parents consider.

ALWAYS SPEAK with your pediatrician before trying any medications for sleep issues.

WHAT IS MELATONIN?

Melatonin is a hormone secreted by the pineal gland in the brain in response to decreased light.  It causes the body to feel sleepy at night and helps with setting a person’s “circadian rhythm.”  Giving over-the-counter Melatonin increases the amount of Melatonin in a child’s body.

WHAT IT WORKS FOR

• Melatonin can be helpful for children who have difficulty falling asleep because of a circadian rhythm delay.
• Some data has also shown that Melatonin can help children who have “sleep onset insomnia,” and “sleep latency insomnia.” This means the child has problems falling asleep when they are put to bed.
• Children with ADHD or autistic spectrum disorders who have long term sleep issues, seem to have significant benefits from Melatonin.
• Melatonin can also be helpful in treating occasional jet-lag.

CAUTIONS ABOUT USING MELATONIN

• Consult YOUR pediatrician before trying Melatonin with your child and discuss potential side effects. These can include: headaches, nausea and drowsiness
• Melatonin should not be used in healthy children to promote good sleep behavior. Behavioral strategies should always be utilized first, as they have the most success for long-term sleep health.
• Melatonin is available as an over-the-counter medication. However, because it is not regulated by the FDA, the actual amount of Melatonin can vary from what is reported on the bottle.  For children whose “circadian rhythm” seems off, giving 0.2-0.5 mg of Melatonin 3-4 hours before bedtime can help.  This dose may need to be increased up to a maximum of 3mg for children and 5mg for adolescents.

To read more about the debate over Melatonin, check out this article from the New York Times.

For more on the importance of sleep for both children and adults, click here.

To learn more about establishing bedtime routines, click here.

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