1 in 5 School-Aged Children Take Melatonin, But Is It Safe? Benefits, Risks, and Long-term Effects

The trend of melatonin supplementation has soared, with parents increasingly turning to this natural sleep aid as part of their bedtime routine. Up to 25% of healthy children and adolescents, as well as up to 75% of children with neurodevelopmental conditions experience difficulty with sleep, making melatonin a welcomed ally. But the surge in usage begs an important question—how safe is melatonin for kids?

The role of melatonin in young patients' lives has become a point of both interest and contention, and there are a few crucial factors that parents and providers should consider. Let’s take a closer look at melatonin use among younger kids, its benefits, risks, and whether or not its increasing usage is a red flag for more serious underlying sleep problems.

Learn more about how integrative pediatrics helps your child thrive.

Melatonin for Children & Adolescents

Today, more than 1 in 5 school-aged children take melatonin to help them get a better night's sleep (1), so it's important that parents and caregivers understand the full spectrum of what this means for a child's developing body.

Melatonin is produced naturally in the pineal gland and its primary job is to regulate our sleep-wake cycle, or circadian rhythm, which runs on a 24-hour cycle. It’s used widely in adults, but research on its safety and efficacy in kids is still limited. 

Between 2017 and 2018, only about 1.3% of U.S. parents reported that their children used melatonin, but just a few years later in 2021, that percentage increased drastically (2).

In the previous 30 days, an increasing number of children surveyed had melatonin to sleep at night:

  • 18.5% of 5- to 9-year olds
  • 19.4% of preteens aged 10 to 13
  • 6% of preschoolers ages 1 to 4

Concerningly, in a recent test of 25 popular melatonin supplements, the actual melatonin amount ranged from 74% to 347% of the labeled content (3).

Despite the potential concerns about melatonin use, each child's sleep situation is different, so we'll be sharing a balanced view that can guide informed decision-making for parents and caregivers.

Related: Functional Medicine for Restful, Restorative Sleep

Benefits of Melatonin for Kids

There are several potential benefits of using melatonin for children and adolescents:

  • Promotes better sleep: Melatonin is often used to help children fall asleep faster and stay asleep longer, especially for those who have difficulty falling asleep due to ADHD, autism, or developmental disorders (4).
  • Regulates sleep patterns: Melatonin can help regulate circadian rhythms, making it easier for them to follow a normal sleep pattern (5).
  • Reduces anxiety: Melatonin has been shown to have anti-anxiety effects, which can be particularly helpful for children with ADHD or anxiety disorders that make it difficult for them to fall asleep (6).
  • Improves delayed sleep phase syndrome: Adolescents often grapple with delayed sleep phase syndrome, thanks to the natural dip in melatonin production that occurs later in the evening, compared to younger children and adults (7).

Shop: Calm & Sleep Solutions for Kids

Risks of Melatonin for Kids

While melatonin is generally considered safe, there are still some potential risks to be aware of when giving it to children and adolescents:

  • Side effects: While rare, side effects such as headache, dizziness, and nausea have been reported in children taking melatonin. Other side effects might include daytime sleepiness, grogginess upon waking, and increased agitation.
  • Hormonal changes: Melatonin is a hormone, and there are concerns that long-term use in children could disrupt their natural hormonal balance (8).
  • Interactions with other medications: Melatonin can interact with certain medications, such as certain antidepressant medications and birth control pills. It's important to consult with an experienced integrative pediatrician before giving melatonin to a child who is taking other medications.
  • Dependency is another factor under scrutiny. Given the ease of access to melatonin supplements and lack of clear guidelines for duration of use, questions arise about the potential for children to become reliant on these external sleep signals.

The youngest users, in particular, may be more susceptible to side effects. 

Read: 10 Mental Health Activities to Do With Your Children

When to Consult with a Healthcare Provider

Before giving your child melatonin, it's important to consult with a provider who is familiar with melatonin use in children, and the sleep problems that children and adolescents may experience.

This is especially crucial for children who have underlying medical conditions or are taking other medications.

Learn more about integrative pediatrics at CentreSpringMD

Underlying Sleep Problems

The conversation around melatonin doesn't end with short-term risks and benefits. In some cases, melatonin use may mask underlying sleep problems that require more comprehensive treatment. 

Common sleep disorders in children include sleep apnea and insomnia, as well as parasomnias, which are behaviors that disrupt sleep like sleepwalking and night terrors

Low levels of certain nutrients, like vitamin D and magnesium, may also play a role in a child’s sleep quality. 

It's important for parents and integrative pediatricians to identify and address other factors that may be contributing to their sleep issues, such as discomfort, environmental sensitivities, or neurological issues.

Read: Signs & Symptoms of Anxiety in Children

Impact on Overall Health and Development

Childhood and adolescence are vital windows for growth and development. Because melatonin is a hormone, effects could reach beyond sleep, influencing everything from bone density and linear growth to cardiovascular function (9). 

Given the lack of definitive studies on melatonin's role in young individuals' overall development, recommendations must tread cautiously, advocating for closely monitored use, and reassessment.

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Guidelines for Safe Melatonin Use

Dosage recommendations, timing considerations, and consulting healthcare professionals are important for safe supplementation.

Learn more: Vitamins for Kids, What’s Really Necessary?

Dosage Considerations for Children and Adolescents

While there’s no one-size-fits-all, experts suggest starting with the lowest effective dose—often at or below 0.5mg for younger children—to minimize the risk of overdose and reduce the possibility of downstream neurobiological effects (10). The concept of “less is more” holds true until resounding clinical data suggest otherwise.

Educational Tips for Parents and Educators

Melatonin use is not a standalone intervention, nor should it be the first-line choice for kids who struggle with sleep.

For sustainable improvement in a child’s sleep, consider the bigger picture of a child’s sleep needs. By fostering an environment that prioritizes sleep hygiene, parents can lay the groundwork for lifelong healthy sleep patterns.

Promote Healthy Sleep Habits in Children

Cementing the pillars of sleep hygiene—consistency, a calming pre-sleep routine, an environment conducive to sleep, and a balanced lifestyle—is the starting point.

Displacing screen time with relaxing activities, ensuring a comfortable sleep setting, and maintaining regular sleep and wake times can have a profound impact on a child’s ability to settle into sleep without the aid of melatonin.

More Alternatives to Melatonin Supplementation

While melatonin may provide the nudge toward sleep initiation, there are some safe alternatives to melatonin for your child:

  • Keep daytime naps short, especially for older kids.
  • Put them to bed while they are awake (versus carrying them to bed after falling asleep on the couch, your bed, etc.).
  • Avoid any caffeinated drinks for children under 12.
  • Cut off screen time at least 1 hour before bed, and research suggests that 2 hours is better for younger children (11).
  • Play outside or stay active during the day to make winding down at night easier. Many sleep issues are nighttime manifestations of factors that originate during the day.

The goal is to build resilience in your child’s ability to get themselves to sleep by addressing the root cause rather than just the symptom.

Read: 9 Popular Integrative Therapies for Children

The Takeaway

The allure of melatonin lies in its promise to solve an increasingly prevalent problem in our youngest patients—sleep disturbances. Yet, like any supplement, it’s best used responsibly and when it’s truly necessary.

For parents, healthcare providers, and caregivers, the path forward is neither to reject melatonin outright nor to rely upon it without asking questions. It’s about fostering an environment where informed choices, professional counsel, and a commitment to holistic well-being work in concert to nurture a generation that sleeps soundly.

The research on melatonin is ongoing, and as more information unfolds, so too will our understanding.


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