The widespread use of melatonin supplements among American children is raising concerns among medical professionals regarding potential impacts on sleep quality and cognitive development. Nearly half of parents report giving their children melatonin, a supplement second only to multivitamins in popularity for pediatric use. However, recent studies suggest that melatonin may interfere with rapid eye movement (REM) sleep, a vital phase for memory consolidation, learning, and emotional regulation.
Melatonin, a hormone naturally produced by the body to regulate sleep-wake cycles, has seen a significant surge in use over the past two decades. While often perceived as a benign, natural remedy for childhood sleep issues, its long-term effects and potential side effects, such as an increase in nightmares, are becoming subjects of greater scrutiny. A key concern is the lack of stringent FDA regulation for supplements. Studies have indicated that the actual dosage of melatonin in products can vary widely, ranging from significantly less to several times the amount stated on the label, making it difficult for parents and physicians to determine precise intake.
Dr. Daniel Bigman, a child adolescent psychiatry attending physician at Northwell’s Zucker Hillside Hospital and Cohen Children’s Medical Center, highlighted the potential for exogenous hormones to disrupt the body's natural systems. "Melatonin is a hormone that our body naturally produces," Bigman stated. "So, whenever there is anything that we give to children that can alter hormones, that can cause a kind of a domino effect with things in our body."
A study involving 684 children utilized polysomnography, a comprehensive sleep monitoring technique, to examine sleep stages. The research indicated that children who consumed melatonin experienced reduced amounts of REM sleep compared to their peers who did not use the supplement. REM sleep, often referred to as the dream stage, is considered crucial for cognitive functions including memory and learning. The study noted parallels with the observed effects of certain medications, like antidepressants and ADHD treatments, which also affect REM sleep and have raised concerns about their impact on developing brains.
"While it’s hard to understand exactly the reason why, or if the melatonin was even the primary cause, I think what’s more important is that there potentially is a relationship," Bigman commented on the findings.
Experts recommend a cautious approach to melatonin use in children. Before considering melatonin, underlying causes of sleep disturbances should be addressed. Factors such as iron deficiency, enlarged tonsils, or even persistent nightmares can disrupt a child's sleep and may not be resolved by melatonin. The importance of sleep hygiene—establishing consistent bedtime routines, limiting screen time before bed, and ensuring a dark, quiet sleep environment—is paramount. These practices, along with attention to diet and physical activity, should be prioritized to promote healthy sleep habits. Many experts suggest a target of eight to ten hours of sleep per night for children.
Dr. Bigman indicated he would only recommend melatonin for children diagnosed with a circadian rhythm disorder or a disrupted sleep-wake cycle. In such cases, he emphasized the importance of precise dosing and strategic timing, often using very small amounts administered several hours before the desired sleep time. The imprecise nature of over-the-counter melatonin dosages and the lack of comprehensive long-term safety data underscore the need for further research and careful consideration by parents and healthcare providers.