Nearly 1 in 5 elementary school-age children and preteens take melatonin, a recent Colorado study has found.
In addition, some parents regularly give melatonin to their preschool-age kids, according to the research, which was published in a letter in the journal JAMA Pediatrics on Monday (Nov. 13).
These findings raise concerns because there's a lack of long-term data on the safety and effectiveness of melatonin in children, the study authors wrote. The study also hints that the underlying causes of sleep problems in children taking melatonin are often going unaddressed.
Health care providers sometimes recommend melatonin as a short-term sleep aid in children with autism and severe sleep problems, because it's specifically been studied in that population, study co-author Julie Boergers, a psychologist and pediatric sleep specialist at Rhode Island Hospital and the Alpert Medical School of Brown University, said in a statement.
"But it is almost never a first-line treatment," she said. Families are typically advised to try addressing a child's sleep issues with behavioral strategies first. "Although [melatonin is] typically well-tolerated, whenever we're using any kind of medication or supplement in a young, developing body we want to exercise caution," she said.
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Melatonin gummies, capsules and liquids contain a synthetic version of a sleep-promoting hormone produced by the body. For the new research, the scientists asked parents of more than 990 children ages 1 to 13 about their kids' melatonin consumption. The survey was conducted between January and April 2023 and included parents in the area around Boulder and Denver, Colorado.
About 5.6% of the preschool-age kids had consumed melatonin in the preceding month, compared with 18.5% of elementary school-age kids and 19.4% of preteens. The typical melatonin doses increased with age, from about 0.5 milligrams in the youngest group to 2 mg in the oldest, per the parents' reports.
The number of days a week that kids took melatonin varied, but most took the supplement either one day a week or seven days a week. Many of the kids who had taken melatonin in the preceding month had been consistently taking the supplement for much longer. For preschoolers, the median duration of melatonin use was 12 months, compared with 18 months for elementary schoolers and 21 months for preteens.
The study included a relatively small sample of people who were all from one area, and it was conducted via surveys, so there's uncertainty about whether the findings apply elsewhere. However, it does still raise some red flags.
Because they're considered "dietary supplements," melatonin supplements are not as tightly regulated by the Food and Drug Administration as prescription and over-the-counter drugs are. And many melatonin gummies sold in the U.S. are inaccurately labeled, containing 74% to 347% the amount of melatonin listed, past research has found. Some products actually contain no melatonin at all, while some contain CBD, the non-psychoactive ingredient in cannabis.
And research has shown that, as melatonin supplements have grown in popularity, there's been an uptick in calls to poison control centers about children — particularly those age 5 and younger — ingesting large amounts of melatonin, with a small percentage of them experiencing severe toxic effects, such as respiratory failure or seizures.
In addition, there's little data on how or whether long-term melatonin use might negatively affect children at different stages of development, and scientists have raised questions about whether the practice could impact kids' puberty-related hormones.
"We are not saying that melatonin is necessarily harmful to children," lead study author Lauren Hartstein, a postdoctoral fellow in the Sleep and Development Lab at Colorado University Boulder, said in the statement. "But much more research needs to be done before we can state with confidence that it is safe for kids to be taking long-term."
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