Melatonin is a natural hormone secreted by the pineal gland in the brain, for the purpose of helping sleep and regulating sleep hours. Therefore, melatonin levels rise at night with the onset of darkness, and then gradually decrease with sunrise, to hasten wakefulness.
But this natural cycle is disrupted in some people, especially children, and it is considered a disorder Children's sleep A nightmare for their parents, who endure this hardship, hoping that things will improve over time, or by introducing some nutritional and behavioral changes, before resorting to consulting a doctor.
Melatonin: nutritional supplement or medicine?
Melatonin has spread in the global market over the past five to ten years, and a special market has flourished on the Internet for products directed at children, in the form of gummies, sweetened syrups and flavours.
The licensing status of melatonin varies between countries. It is considered a nutritional supplement in most countries in the world, but it is only available by prescription in Japan, Australia, Britain, and the European Union, after the European Medicines Agency approved in 2018 its use to treat sleep disorders in children with neurological and psychological disorders. Just.
The American and East Asian market is the largest consumer of sleep treatments, according to the Statsta report for the year 2023, and the Arab market is still in the growth stage, and melatonin has spread in Arab pharmacies and electronic markets, without a prescription.
This free spread was accompanied by warnings from Arab Food and Drug Administrations and pediatricians against taking melatonin without a direct recommendation from a doctor, in addition to the spread of company sales representatives to special Arab groups on Facebook for mothers of children with autism and hyperactivity disorder, to promote the melatonin supplement without prescription.
There are still no Arab statistics on the prevalence of melatonin among children, but a comparison of the prevalence rates can be made between two models. The first includes “melatonin” under the heading of nutritional supplements, while the second restricts it to requiring a prescription.
American newspapers published the results of new research conducted by the University of Colorado, which was published in mid-November, which stated that approximately one in every 5 American children of school and teenage age takes melatonin for sleep, and some parents give the supplement routinely to pre-school children. .
Therefore, the American Academy of Sleep Medicine advises parents to talk to a doctor before giving melatonin or any nutritional supplement to children, especially given the lack of evidence that taking it as a supplement is effective in treating insomnia in healthy children.
On the other hand, a Dutch study estimated the prevalence of melatonin use in Eastern Europe at 6% among school-age children, indicating that 1 in 17 children is likely to take melatonin at least once a week.
Is melatonin safe for children?
No scientific study has yet confirmed the effectiveness of long-term use of melatonin, and its side effects. However, a Swedish study that extended between 2016 and 2019 confirmed the prevalence of continuing treatment with melatonin among children between the ages of 6 and 12 years, for more than 3 years, and even increased the dose of melatonin prescribed. them by 50% and 100% respectively.
There is another problem with the widespread use of melatonin supplements for children, sold online, due to the lack of control over its production in countries that classify it as a nutritional supplement. In 2017, Canadian researchers examined samples of a “melatonin” supplement produced by 31 different companies, equivalent to 71%. Of the trade names of melatonin supplements, they discovered that the percentage of the active ingredient melatonin ranged from 27% to 478% of the percentage stated on the label, and they observed the largest variation rates of the active ingredient in children’s gums.
A quarter of the samples also contained the neurotransmitter serotonin, which is used to treat neurological disorders and is supposed to be a drug-controlled ingredient.
The US Centers for Disease Control revealed that the rates of children taking melatonin supplements increased to 530%, in the period from 2012 to 2021.
Mothers need a solution
The sleep problem is complicated among children who suffer from neurological disorders, such as autism, attention deficit disorder, and hyperactivity, and these children continue to suffer from sleep until the teenage years, and perhaps beyond.
Asmaa was among the mothers of children on the autism spectrum who spoke to Al Jazeera.net. Asmaa’s child suffered from sleep difficulties since the age of 4 years, until a neurologist advised her to use melatonin at a reduced dose, so she consulted several doctors to be reassured. Because the medicine does not contain addictive ingredients, Asmaa confirmed to Al Jazeera.net that her child’s experience with “melatonin” was positive 3.5 years ago, with the doctor increasing the dose as its effectiveness decreased.
However, Sama, a mother of a child with autism spectrum disorder, did not have a long experience with the melatonin supplement, as a result of its short effect and the frequent need to increase the dose, which prompted the private doctor to replace it with another medication.
While “Sarah” confirmed to “Al Jazeera.net” that she had consulted her child’s doctor about the effectiveness of “melatonin” after reading the mothers’ comments and their experiences with the magic pill, but the doctor denied her child’s need, especially since she responded to strict rules applied by “Sarah” that included prohibiting her child from sleeping during the day. And practicing motor activities during the day, which ensured good results after 3 months of regularity.
However, the behavioral changes were not sufficient to improve the quality of sleep for Zahia, a child with impulsive movement disorder, and the child continued to suffer from insomnia, especially with Zahia’s extreme fear of her child taking any unnecessary medication, even if it was recommended by a doctor, until she underwent surgery. The child received a proper medical diagnosis, and her insomnia decreased, without the use of melatonin.
In this regard, Harvard Magazine published a set of tips for mothers before using melatonin, including:
- Prevent sleeping during the day, even if the child did not sleep well the night before.
- Ban screens two hours before bed.
- Prohibit sitting or playing on the bed during the day.
If you decide to use melatonin, choose a product labeled USP Verified to ensure its quality.