My son, age 12, has trouble falling asleep. He takes 500mcg of melatonin about an hour before going to bed. This helps, but I have heard that children should not take melatonin. What is your opinion?
Melatonin is a neurotransmitter secreted by the pineal gland in the brain at the onset of darkness, initiating the sleep cycle. I use synthetic melatonin as a remedy for jet lag, and it works well for adults as a treatment for occasional insomnia. To find out about the safety of using melatonin as a sleep aid for children, I consulted two experts: Rubin Naiman, Ph.D., a sleep and dream specialist and clinical assistant professor of medicine with the Program in Integrative Medicine at the University of Arizona, and George C. Brainard, a melatonin expert at Thomas Jefferson University in Philadelphia.
Dr. Naiman told me that children's brains produce significant amounts of melatonin. Because of this, and since the effects of extra melatonin on development are unknown, sleep specialists have cautioned against using it with kids. Dr. Naiman noted that some preliminary data suggests that melatonin may be effective in helping developmentally delayed children, especially autistic kids, with sleep problems, but he said the essential question to explore in your son's case is why he is having trouble sleeping. Addressing the underlying contributors is central to any long-term strategy.
Dr. Brainard said that taking melatonin supplements is safe when used for short periods of time, but for both adolescents and adults, the safety of taking them at higher doses for months or years is unclear. He also noted that when prescribed to children, melatonin has been effective and rarely associated with side effects (which can include seizures, more frequent seizures in kids with a history of them, hyperactivity, agitation, behavioral changes, worsening sleep patterns, nightmares and constipation).
My view is that a 12-year-old shouldn't be taking anything every night to go to sleep. Instead of relying on melatonin, consider the following approaches that can often help youngsters (regardless of age) overcome sleeping problems:
- Create a bedtime routine that includes least 15-30 minutes of calm, soothing activities.
- Discourage television, exercise, computer and telephone use before bedtime. (Forty-three percent of American school-age kids have television sets in their bedrooms; the more TV kids watch, the less they sleep. Some sleep experts advise keeping televisions and computers out of children's bedrooms.)
- Avoid beverages and foods containing caffeine.
If these measures don't help, talk to your son's pediatrician about his sleeping problems or consider taking your son to a sleep center where an expert can assess the problem. You can find one through the National Sleep Foundation. Go to www.sleepfoundation.org and click on the "Find a Sleep Professional."
Andrew Weil, M.D.
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