"We have seen tremendous growth of the use of melatonin by parents," says Susan Zafarlotfi, clinical director of the Institute for Sleep-Wake Disorders at Hackensack University Medical Center in New Jersey. "Melatonin is very useful for some teens who cannot get to sleep."
Zafarlotfi says occasional use of melatonin for children is fine as long as the dosage does not exceed 3 milligrams. She does not recommend giving it to kids younger than 10.
Melatonin, a hormone produced by the pineal gland in the brain, helps regulate the body's sleep-wake cycle, and its production is determined by light and dark. When darkness falls, the gland produces more melatonin, which promotes sleep.
Safe — with a few caveats
Melatonin supplements have proved safe and effective in numerous studies for helping adults with jet lag. More than two dozen studies have shown that melatonin also helps children who have insomnia, and it has few or no side effects.
After reviewing numerous studies, the U.S. Agency for Healthcare Research and Quality in 2005 concluded that melatonin supplements are safe if used for days or weeks.
The agency found evidence that melatonin is effective in treating people who have delayed sleep syndrome, who chronically tend to fall asleep well after midnight.
Nonetheless, medical groups have been cautious to endorse melatonin for children because nearly all the studies of melatonin on children were tested on those who had autism or other development disabilities or were blind. These children are given supplements because their bodies either don't produce melatonin or do so only erratically. The studies on children have been small, and there are no reports on the long-term effects of melatonin in children.
Doctors also worry that because melatonin is sold as a supplement, its manufacturing is not as stringently regulated by the Food and Drug Administration as if it were a prescription drug.
"This is not a treatment for the healthy child who just doesn't want to go to bed or the child with occasional trouble falling asleep," says Marcia Buck, clinical pharmacy specialist at the University of Virginia Children's Hospital in Charlottesville.
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