Researchers warn doctors, parents not to give melatonin drug to control sleep problems in children

Sleep researchers at the University of Adelaide are warning doctors and parents not to provide the drug melatonin to children to help control their sleep problems.

Melatonin is a hormone produced in the body with the onset of darkness. It plays an important role in fine tuning people's circadian rhythms, such as the timing of sleep onset, as well as other biological processes.

In a paper published in the Journal of Paediatrics and Child Health, Professor David Kennaway, Head of the Circadian Physiology Laboratory at the University of Adelaide's Robinson Research Institute, warns that providing melatonin supplements to children may result in serious side effects when the children are older.

"The use of melatonin as a drug for the treatment of sleep disorders for children is increasing and this is rather alarming," Professor Kennaway says.

Professor Kennaway says the United States is the only country where melatonin is completely unregulated. "It's considered to be a 'dietary supplement', not a regulated drug, and is therefore readily available," he says.

"In Australia, melatonin is registered as a treatment for primary insomnia only for people aged 55 years and over, but it's easily prescribed as an 'off label' treatment for sleep disorders for children."

Professor Kennaway says there is extensive evidence from laboratory studies that melatonin causes changes in multiple physiological systems, including cardiovascular, immune and metabolic systems, as well as reproduction in animals.

"Melatonin is also a registered veterinary drug which is used for changing the seasonal patterns of sheep and goats, so they are more productive for industry. If doctors told parents that information before prescribing the drug to their children, I'm sure most would think twice about giving it to their child," Professor Kennaway says.

"The word 'safe' is used very freely and loosely with this drug, but there have been no rigorous, long-term safety studies of the use of melatonin to treat sleep disorders in children and adolescents.

"There is also the potential for melatonin to interact with other drugs commonly prescribed for children, but it's difficult to know without clinical trials assessing its safety."

Professor Kennaway, who has been researching melatonin for the past 40 years, says these concerns have largely been ignored throughout the world.

"Considering the small advances melatonin provides to the timing of sleep, and considering what we know about how melatonin works in the body, it is not worth the risk to child and adolescent safety," he says.

Comments

  1. Elliot Shayle Elliot Shayle United Kingdom says:

    I'm 19 and I frequently take prescribed Melatonin for the past few years.

    However, this article seems rather insubstantial. It's mostly just quotes from this professor, with little substantiation behind them. I fear elements of this may be taken out of context or otherwise mentioned in an incomplete fashion. I'd like it if the authors had provided greater insight into the side effects of Melatonin, and critically analyse the professor's comments with regards to other published material on the subject.

    This article seems like clickbait. A lot of speculation, very little substance.

  2. Beverly Carter Thomas Beverly Carter Thomas United States says:

    This article is lacking in substance.  I'm not sure why melatonin being used in animals would cause alarm.  There are many medications that are used in veterinary medicine that are also used in human medicine.  We are after all mammals.  Benedryl, antidepressants, anticonvulsants are all used in animals as well as humans.  Perhaps there is more research behind what the researcher is saying may happen and the author is leaving it out.  Perhaps this is a hypothesis.  If that's the case, it needs testing.  It doesn't seem to have been done.

  3. Mark Goodbar Mark Goodbar United States says:

    Um... I dont see a even one solitary fact supporting that Melatonin is bad for anyone. Just somebody calling for more research. Not a bad thing in itself, but a lot of people are just going to see the headline and start speading the rumor that melatonin is bad. Why is it bad? I don't know, it just is. I read some article on the internet about it. #knowledgefail

  4. April May Ohms April May Ohms United States says:

    For people under 55 who have chronic insomnia or pain conditions that cause insomnia or are affected by sleep, melatonin can work. My 11 year old uses it to reset her sleep patterns for a month or so and then she's good for several months. Then if her sleep gets off due to her pain or insomnia or whatever, she uses it again until her sleep pattern returns to normal. Several doctors in different specialties recommended it. Like any substance there can be side effects. This study doesn't seem to show proof of actual side effects, just suggestions of what might happen. If there was actual scientific proof with repeatable outcomes, then we can look at melatonin as a bad option. For many people it's the only option.

  5. Carol Danielson Carol Danielson United States says:

    I say get them tired by doing things outside with them get them tired by actually playing with them and get over the pill for a quick fix ,

    America wants everything fixed with a pill

    • Hermione Blair Hermione Blair New Zealand says:

      My daughter is on anti-epileptic medicine which has insomnia as a side effect. She takes melatonin which helps her get off to sleep, otherwise she could still be lying there awake at 11pm.  Fatigue is a seizure trigger.  Don't make assumptions.

    • Jenn Shuey Jenn Shuey United States says:

      It's not always possible to "get them tired" to fix a sleep problem with every child. My 5 year old has a sleep disorder and has been diagnosed with extreme hyperactivity along with other issues. We are a very active family who spends a lot of time outdoors each day together. We knew there was a problem when we purposely spent hours each day trying to "wear her out"playing with her, swimming, running, hiking as a family, and it didn't change the outcome one bit. At 5 yrs old it takes 3-4 hours to fall asleep (no matter what time she lies down) and still wakes every 45 min to an hour all night EVERY night without the help of melatonin. An average night's sleep is 5-6 hours max when you factor in how many times she wakes and how long she stays awake.

      I'm that mom who refuses to give my kids any pill unless it's absolutely needed. The only thing that has helped her fall asleep and stay asleep is Melatonin. I don't condone using it every night on a child, but if it taking it for a couple weeks at a time helps my daughter "reset" into a normal sleep cycle I'm all for it. There are side effects of the long term lack of sleep as well.

      • Kelly Church Kelly Church United States says:

        Thank you for telling your daughter's story. People who don't know what it is like to have a daycare provider tell you your kid has gone at 100 mph all day, didn't nap and you get them home and after dinner you run her ragged for a couple more hours, only to be falling asleep in their bed while trying to get them to sleep. While they are still up trying to shut their brains off.

        Then after a couple of days of this I end up having to call out of work (again- if this keeps up I'll end up being a stay at home mom by force) because she is so wound up and so tired that she can't function. I had plans last night and had to fork over $60 and then not attend because she is going through another round now and last night when I had a commitment to my own mother I had to cancel because my daughter was 'falling apart at the seams"

    • CaC CaC CaC CaC United States says:

      My 13 year old plays soccer at a high level and trains several days a week. On her days off, she helps a friend at a horse farm. The kid gets plenty of exercise and fresh air. Oh, and she has insomnia. She's also pretty smart and can't turn her brain off. So yeah, you're wrong.

    • Andrew Maurer Andrew Maurer United States says:

      First and foremost, I am a firm believer in letting a kid run themselves empty to fall asleep.  When my kids get grounded they lose everything but the right to go outside and play.  Now with that said, you should all read this article about sleeping the night away.  It is NOT clickbait, it's from the BBC and if you do a google search you'll find more information on it.

      http://www.bbc.com/news/magazine-16964783

      Nothing is wrong with our kids, it's our society...

    • KE EL KE EL United States says:

      People have legitimate sleep disturbances or social issues that impact their ability to produce natural melatonin or sleep patterns. If your life is working great in the area of sleep then enjoy, your egotistical comment progressed this discussion in no form. How did you have time to write this anyways if you are so busy "getting them tired"? It infuriates me when people damage the reputation of legitimate medications because they have a blanket opinion of medications. Hope you never take aspirin, or get any shots, or drink coffee (which is a drug), or use cold medicine.... you should "get more well" instead of taking a quick fix medicine.

    • Meredith Adams Bysarovich Meredith Adams Bysarovich United States says:

      I'll bring my 11 year old over who is hyper active and requires little sleep.  He can still be awake at 2 am and then up again, ready to go at 6 am. Mom not so much.  We use mild medication with complete doctor assistance and would not if mom and dad didn't have jobs to get up and go to and have to function.

    • Venus Hamilton Venus Hamilton United States says:

      I totally agree. My daughter uses it for my 2 yr old granddaughter and it really gets my goat. I think it is just promoting future drug use.

  6. Jo-Anne Smith Jo-Anne Smith Australia says:

    Absolute rubbish!!!
    it is herbal and i have taken it for years.  It is not a pharmaceutical product that gets any kickbacks because it is safe and has no side effects - i cannot even get doctors to prescribe it sometimes as they don't get paid for it - what happened to the oath they took to heal the sick - where is the duty of care?  Research it and be your own doctor if you want the truth

  7. Michelle Vigne Hanna Michelle Vigne Hanna United States says:

    I see nothing here that states what the long term effects are.  Just saying something is bad doesn't make it bad.  My pediatrician said that in low doses ( the normal adult dose is 3 units --i think its mgs )  it is fine and that there are studies showing that some people are actually born with a melatonin deficiancy.

  8. Devon Majerus Devon Majerus United States says:

    This article is absolute trash. He has no substantial claims to back up his opinion, which is exactly that, an opinion. Melatonin is NATURALLY produced by your body! That's why it's such an effective sleep aid. Caffeine blocks our body's natural melatonin as well, so people should know not to drink caffeine before bed. The reason we prescribe it to people over 55 normally is because our bodies stop producing it naturally as we age. You can find all of this information in just about any medical text book talking about the endocrine system and it's all based on research. Until some actual research comes out stating that it's bad in any sort of way, I wouldn't believe quacks like this guy. Another side note, I don't know what it's like in Australia, but the melatonin I get I needed a prescription for.

  9. Jennifer Maureen Byrne Jennifer Maureen Byrne United States says:

    I have  a friend of mine giving to her children to sleep so I feel this could be a problem you may not see a problem .... I DO!!!! When they don't know LONG TERM problems .

  10. Amanda L. Richards Amanda L. Richards United States says:

    This is a better article for those with concerns:
    newsnetwork.mayoclinic.org/.../

  11. Erin Pollet Erin Pollet United States says:

    I realize that most of you can't access the actual paper because it is behind a paywall, as many scholarly papers are, so just to sum up, there is actually pretty compelling evidence that Melatonin is causing side effects in humans that we aren't aware of yet, and it's actual effects (as opposed to anecdotal evidence) on sleep is small compared to the risk of taking something that may or may not make your testes shrink. If you can access the paper, I highly recommend it.

  12. Ann Paul Ann Paul United States says:

    My daughter is 11 has sleep problems. chronic insomnia.  I stared giving vitamin D daily and she has no problems sleeping now. And there is actual studies showing how D can help your body heal itself in return a better sleep. Low D is not a uncommon problem. People don't spend enough time outdoors anymore. Seems the more reasons   we have to stay indoors the more aches, pains and sleep issues  that keep popping up.

  13. Elisa Giardina Elisa Giardina United States says:

    My son has behavioral sleep insomnia and I did not give him melatonin until I spoke with the doctor. I also took him off it for a few months to see if he still need aid in falling asleep and he does a child needs 8 hours of sleep or more and he was only getting 3 hours a night till I started giving him the melatonin again in the parts where they say its bad it maybe but the effects of not getting any sleep are worse check the studies on that

  14. Marianne Slagenweit Brown Marianne Slagenweit Brown United States says:

    I was concerned when I read this article because I know so many parents who use this instead of medicating their children. I asked my MIL to review it for me since she's worked as a PhD in biochemistry in the science field for years. Here's what she had to say.......I read through the article you mentioned warning the public that a researcher, Professor David Kennaway, who has worked on/with melatonin for 40 years published in the Journal of Paediatrics and Child Health. The actual title of the article was not given, as far as I could tell—nor the date of publication.
    Let me provide several quotes and comment on them, but first let me say melatonin is a natural body substance –i.e. all our bodies make it in a greater or lesser degree and it is one of our sleep regulating hormones.  Substances our bodies normally make are not federally regulated because they are a normal part of our make-up and not considered dangerous.  That said, many things in our bodies can become problematic if large does are given, but that doesn’t seem to be the issue here.
    In a paper published in the Journal of Paediatrics and Child Health, Professor David Kennaway, Head of the Circadian Physiology Laboratory at the University of Adelaide's Robinson Research Institute, warns that providing melatonin supplements to children may result in serious side effects when the children are older.
    This is a generalized statement, made without any evidence since he says later:
    “…there have been no rigorous, long-term safety studies of the use of melatonin to treat sleep disorders in children and adolescents.”
    The author does say:
    “…there is extensive evidence from laboratory studies that melatonin causes changes in multiple physiological systems, including cardiovascular, immune and metabolic systems, as well as reproduction in animals.”
    And the author gives one example—stating that melatonin is used:
    “…for changing the seasonal patterns of sheep and goats, so they are more productive for industry.” 
    What he does not go on to say is that humans and animals are designed fundamentally different sexually.  God set into the bodily rhythms of animals seasonal cycles so offspring are born when weather is warmer and food more plentiful so the young can survive—i.e. typically in spring, not fall or winter or late summer.  Human on the other do not have “rutting season” as sheep or goats, but are sexually active all year long and have the creativity to care for children whenever they are born spring, summer, fall or winter.  He also made no reference to the size of dose necessary to overcome the natural cycle and how it compares to the amounts of melatonin that is recommended for children.
    Professor David Kennaway also states that:
           "There is also the potential for melatonin to interact with other drugs commonly prescribed for children, but it's difficult to know without clinical trials assessing its safety.
    This is a pretty safe comment to make, since everything in our bodies or that we take into our bodies has the potential to react with everything else.
    This young man’s comment on the article was pretty accurate:
    I nearly fell asleep reading this (pun intended).
    Elliot Shayle  says:
    April 9, 2015 at 12:27 AM
    I'm 19 and I frequently take prescribed Melatonin for the past few years. However, this article seems rather insubstantial. It's mostly just quotes from this professor, with little substantiation behind them. I fear elements of this may be taken out of context or otherwise mentioned in an incomplete fashion. I'd like it if the authors had provided greater insight into the side effects of Melatonin, and critically analyse the professor's comments with regards to other published material on the subject. This article seems like clickbait. A lot of speculation, very little substance
    I think when a child can’t sleep, it might be wise to give some time and effort to looking into other factors that may be causing the sleep problem. Such as,
    Is the house quiet at their bed time?  Is the TV off, or is there low level interruptive sound reaching their bedroom?   Provide white noise—like soft religious music Bob Daniels is great for this if his recordings can still be found or Patch the Pirate bedtime CD.
    Are they watching TV programs that have scary things in them—not scary to an adult but maybe to a child.  
    Low level fears, worries and concerns come out in all of us at night and plague our minds –is something bothering them.  Is there any possibility of abuse where they are during the day?  I would urge parents to sit with them 10 or 15 minutes at bedtime when they are getting ready to go to sleep and let them talk, see what  they want to talk about, what is on their mind.  It may take a little while to come out.
    Bottom line—is the administration of melatonin a possible problem?  Answer we don’t know, but lack of sleep or poor sleep is a problem—I wonder if there is some other reason it is happening.  Has it always been a problem?  Did it develop recently? Possibly related to something else that changed in the child’s environment.  If a parent is using it long term they should stay in touch with their pediatrician about it.  
    Best Mom B  [alias Mrs Dr Brown :>) ]

  15. Amy Donahue Amy Donahue United States says:

    This article doesn't even give the dangers.  I"m very confused!

  16. Ethel Evans Ethel Evans United States says:

    So, it's ok to prescribe Ritalin all day long but not a supplement that is known to aid in insomnia in children & people of all ages.  Drug Co,'s don't make as much profit on supplements....

    • Jennie Russell Jennie Russell United States says:

      Exactly!  This article is another attempt to discredit natural cures which promotes pharmaceuticals in their place.....so tired of the drug companies and the doctors writing this stuff making profits....

  17. John Roberts John Roberts Canada says:

    I'm going to skip the part where I should diss the article for not having any legitimate sources. Just thought I would let you guys know that when you get melatonin, the synthetic type is preferred over the "all natural" stuff, as the natural is taken from animal brains (pineal glands) and could potentially carry a virus, and there is very little regulation when it comes to making melatonin.

  18. Ian M Ian M Canada says:

    We have testosterone in our bodies, what happens when we supplement that? There can't possible be any side effects because it's naturally occurring in our body. That was sarcastic, for those who couldn't even figure that out.

    Some seriously basic common sense that some of you seem to skip right over.

  19. Jennie Russell Jennie Russell United States says:

    This article is another attempt to discredit natural cures which promotes pharmaceuticals in their place.....so tired of the drug companies and the doctors writing this stuff making profits.... this is ONE doctor's opinion, and they have a very long history of being wrong and changing their minds when it meets their agendas. If you made Melatonin a prescription drug today - guess what...tomorrow it would be the best thing for children and adults for sleep because they could profit off it!

  20. James Bogash James Bogash United States says:

    Most of the comments have been quite accurate.  This is a review study that points out that melatonin has some reproductive effects.  If you look into these, you'll find that melatonin can help normalize ovarian function, but it can also be used to "misdirect" seasonal fertility.
    Overall, though, there has been nothing to suggest that melatonin is not safe in children, although I do not recommend routine use and suggest starting at .5 mg.  Even more importantly, I would look to avoidance of blue light after sunset or the use of blue-blocker glasses.   If your wild child drops like a rock after 830 while camping, you've got a hint there.
    And what would the alternative be??  Pharmaceuticals like Ambien that have KNOWN problems and do not normally work as well as melatonin?  Sounds like a bad idea to me.
    And what about using in kids who experience seizures or migraines?  Melatonin has some solid research behind it.  Should we avoid it here as well and use anti-seizure drugs?

  21. Chef Beth Cas Chef Beth Cas United States says:

    All the mentioned side effects are very vague. I would like to know the specifics.

  22. Hillary Autumn Graham Hillary Autumn Graham United States says:

    My now almost 4 year old son does not sleep which is hindering his learning. he goes to a specail needs early childhood development school. They noticed he did sleep at nap and was always tired. He has and still being seen at Arkansas Childrens Hospital for the last 2 1/2 years and he takes 3mg zarbee's brand melatonin to help him sleep along with another med he takes. if my son does not have this he DOSE NOT SLEEP. He has also had several sleep studies done.

  23. Rhoda Nutter Rhoda Nutter United States says:

    It's funny I had never heard of this stuff till recently when my niece was given it in a psych hospital. Yes Dr.'s do use and recommend it. Then when I said something to my daughter about it she said the dr wanted grandson to take but it didn't work for him. It isn't to put you to sleep it is to keep you asleep once you go to sleep. No one can tell me about having kids that don't sleep. I have 3 children and 8 grandchildren and 3 nieces that I have helped raise. Lack of sleep and working is part of being a parent.
    My daughter told me to try it and I did. I have on my 4th night. Guess what everyone. I'm sitting here wide awake for the 4th night. It doesn't work on everyone. People with certain medical conditions should not take it. They don't like using it in the elderly and if they do it is a very low dose. So yes just like anything else if you are taking perscription meds make sure you check with your dr or the pharmacist to make sure it doesn't interfere with your medication also make sure you tell them at the dr or er that you are taking it. It may only be a supplement you still have to be careful

  24. Dianne Mason Bedrosian Dianne Mason Bedrosian United States says:

    My son is 20 years old and Autistic. He would not be able to fall asleep without it and has been taking it for year. I hope this article is wrong.

  25. Tangi Haines Tangi Haines United States says:

    Melatonin is a hormone.  It's not even safe for adults to take nightly, much less kids.  It's meant for occasional use to offset jetlag and sleep-work disorder, not everyday insomnia.

    So sick of this "natural = safe" mindset.  Supplements are not regulated by the FDA like food or drugs, thus they may contain literally anything (and often do).  Some sleep aids have been found to contain benzodiazepines or other illicit drugs!  Many supplements don't even contain any of the active ingredient, so whatever benefits you're feeling are placebo effect.  This is much more widespread than most people imagine.  

    If you feel good about these mystery pills to your kids, go ahead.  But parents should be held accountable should something go horribly wrong.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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