Regular use of melatonin as a sleep aid for kids has become what researchers are calling “exceedingly common,” a trend that pediatricians consider to be worrisome.

In its natural form, melatonin is a hormone produced in the brain that regulates the body’s sleep-wake cycles. It’s also an over-the-counter supplement that is being given to 1 in 5 adolescents, 18% of elementary school-aged kids and 6% of preschoolers as a sleep aid, according to new research.

Pediatrician Dr. Pilar Bradshaw says long-term use of melatonin in kids is not advised, in part because the supplement is not closely regulated and the dosage can vary. “Because it’s an over-the-counter supplement, the FDA does not regulate melatonin as closely as it does prescription drugs and we know from having studied how much melatonin is in all of those supplements that it varies quite widely.”

While studies have shown that short-term use of melatonin is relatively safe, the American Academy of Pediatrics advises that less is known about longer uses of melatonin. There are concerns about how it might affect a child’s growth and development. More immediate side effects are also a concern and may include morning sleepiness and potential interactions with medications.

Improving sleep hygiene
A better answer is to avoid supplements for sleep issues, Dr. Bradshaw says.

“Pediatricians really want you to come talk to us about your child’s sleep problems before you start giving an over-the-counter supplement,” she says. “Sleep experts for kids and adults point out that the vast majority of sleep problems can be handled without taking any kind of supplement or remedy, and one of the best ways to avoid needing a chemical to put you to sleep is to work on your sleep hygiene.”

Good sleep hygiene includes:

  • Being busy and active during the day so that your brain and body are ready for sleep.
  • Adhering to regular bedtimes and wake up times.
  • Avoiding exercise, caffeine or eating a large snack or meal too close to sleep.
  • Turning off all screens two hours before bedtime.

“Screen light and images really wake up our brain even if we think that’s a relaxing activity,” Dr. Bradshaw says. “Doing the things that help us have good sleep hygiene are not always favorable or popular with kids or adults but they’re so important because we need our brain to learn how to wind down and fall asleep naturally.”

That includes being careful about what we eat or drink late in the evening. “People think having a bedtime snack will help them fall asleep, but it would actually be better for our body if we had a break from eating and drinking between dinner and the time we go to bed,” Dr. Bradshaw says. “Caffeine is incredibly disruptive to sleep patterns, so it’s ideal if we can have no caffeine intake after about 2 or 3 pm.”

If your child is having difficulty falling asleep or waking up, be sure to talk with your doctor.