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Ask Dr. Matt: Is melatonin safe for kids having trouble sleeping?

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I started giving my 10-year-old son melatonin at bedtime. He previously became very active at around 8 pm and had difficulty getting to sleep. This has been completely resolved by using melatonin. Now I'm worried that melatonin might not be safe for him to use. Is it harmful?

Melatonin is a hormone made by the pineal gland that helps regulate our circadian rhythms. Melatonin production and release is affected by light and darkness. In general, it's best to have a circadian rhythm set by normal patterns of waking and sleeping.

In our culture, it can be a challenge for kids to maintain a regular sleep pattern, particularly if they're very busy with school, sports and homework. With all that work and activity, they may be fairly amped up right until they need to go to sleep. It takes our bodies time to settle down for sleep, so powering down a few hours before bedtime — that means dialing back physical and mental activity, and even exposure to light — is ideal. In particular, note that using electronic devices can expose kids to concentrated light that may suppress melatonin release.

Though it's best to use natural means to get the 9 to 10 hours of sleep most school-age kids need, I think it's better to get a small dose of melatonin than to be sleep-deprived. While we don't want to substitute melatonin for good sleep habits and our natural physiology, I think it's OK to use it for a while to get things on track. It has been well-studied, and found to be safe and effective for use in kids.

So try to work on good sleep habits, but use the low dose melatonin (0.2 and 0.3 mg) until those habits are well established. Then you can see how your child does with half a tab for a few nights, then a quarter tab, etc. Don't forget that other issues may lead to difficulty falling asleep, so check with your primary care provider if these tips don't help.

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