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Help for Children Having Trouble Sleeping

Children that have difficulties falling or staying asleep may benefit from taking melatonin before bedtime, according to a new study in Clinical Pediatrics (2003;42:51–8). The findings of this study suggest melatonin may help children fall asleep faster and prevent waking during the night.

In the new study, sleep habits from 32 children aged 2 to 18 years who attended a pediatric sleep center with chronic sleep initiation and maintenance problems were reviewed. Bedtime, rise time, awakenings in the night and resistance to sleeping were documented, as well as the frequency, duration and amount of melatonin taken. Melatonin was routinely given one hour before bedtime and the average amount given was about 2 mg per night. The average duration of melatonin treatment was approximately two months.

More than 90% of the children taking melatonin reported improvement in falling or staying asleep. Only three of the children reported no benefit with melatonin supplementation. However, the parents these three children were unwilling to increase the amount of melatonin, so it is unclear whether they would have improved by taking higher amounts. Parents reported that their children fell asleep faster soon after starting melatonin treatment, but it took 1 to 2 weeks until sleep patterns completely normalized. Sleep onset decreased from 90 minutes down to 25 minutes and awakenings in the night also dropped from 19 times per week to once per week. No adverse side effects with melatonin therapy were observed.

The authors also found that the effective amount of melatonin differed between age groups. Children between the ages of 2 to 6 required 1.4 mg per night of melatonin, compared with 2 mg per night in children between the ages of 7 to 11 and almost 3 mg per night in those in the 12 to 18 year-old group. Despite the increased amount of melatonin used with increased age, reductions in sleep onset and night awakenings were similar between all age groups.

Melatonin is a hormone produced by the pineal gland in the brain and plays a key role in regulating sleep patterns. Studies have shown that melatonin is effective in treating sleep disorders, jet-lag, some neurological diseases, migraine headaches and psychiatric disorders in adults. Poor quality of sleep and sleep loss has been associated with behavioral problems, hyperactivity, daytime sleepiness, fatigue and poor concentration in children. In the new study, parents reported their children were more attentive, less hyperactive, performed better in school and had better moods. This suggests melatonin may play a role in the development of ADHD in children and may be related to poor sleep habits. More research is necessary to clarify this issue. However, melatonin has been shown to be safe in children at the appropriate amounts and can help restore normal sleep patterns.

Darin Ingels, ND

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