Are melatonin supplements safe for kids?
Parents are buying melatonin products online without getting a prescription, doctors say. (Adobe Stock)
Lack of sleep can be devastating for children and their parents, especially if it becomes an ongoing problem.
When parents go looking for solutions, one that often comes up is melatonin supplements.
These supplements can be easily bought online, including in fruit-flavoured gummy formulations for children, and experts say they are being widely used by Australian parents.
While melatonin supplements for children require a prescription in Australia, it's easy — and often cheaper — for parents to buy them from overseas online retailers, which doctors say is a concern.
"They are very widely used and also people are using [melatonin supplements] without getting advice from a doctor, whether a GP or a paediatrician," says Dr James Best, chair of the Royal Australian College of General Practitioners' child and young person health network.
So, are these supposedly natural sleep supplements safe for kids? Here's what you need to know.
Loading...What to know about melatonin supplements for children
The Therapeutic Goods Administration (TGA) has classified melatonin as prescription-only medicine in Australia.
However, pharmacists are allowed to sell certain melatonin products to people over 18 with jet lag and people over 55 with insomnia without the need for a prescription.
Dr Best says while melatonin is a naturally occurring sleep hormone, we should still treat supplements like other medications.
"We haven't got a lot of data on how effective it is and if it's entirely safe. Though, I must say the safety concerns are limited," he says.
"Even though there's not a huge amount of data, we know it's been so widely used that if there were significant problems we would know about it."
Melatonin supplements are often sold in prolonged-release formulations, meaning the medication is slowly released during the sleep cycle.
Why melatonin supplements can be helpful for children with autism and ADHD
Dr Best says there is strong evidence to support the use of melatonin supplements for children with autism and ADHD.
"We do have better evidence within those paediatric populations of efficacy. It is quite commonly used in those populations, because sleep cycle issues are more common," he says.
Professor Sarah Blunden, head of paediatric sleep research at CQUniversity Australia, says there is less evidence available supporting the use of melatonin in children without these conditions.
"[We should be doing more studies] on typically developing children so that we can actually say to parents, doctors and health professionals, 'We haven't got a great deal of data, but we've got something,'" she says.
The potential problems that can arise buying melatonin online
One issue with buying melatonin online, Dr Best says, is that the formulations can be unreliable; you can't be confident how much melatonin is in the tablet or gummy and sometimes it might not be present at all.
"It's a bit of a gamble to be taking something that you're not even sure what it is and how much is in it safely," he says.
If your child takes too much melatonin, side effects could include prolonged drowsiness, daytime sleepiness, headaches and nausea.
"If they're prepared in gummy form, if the child happens to get their hand in the jar, they could be consuming an awful lot of melatonin," Dr Best says.
"That may well have some safety concerns."
If you are concerned your child has taken too much melatonin, contact a doctor immediately or call the Poisons Information Centre on 13 11 26.
Why some children have adverse reactions to melatonin supplements
Professor Blunden says it's important for parents to understand that "more does not mean better" when it comes to using melatonin supplements.
"There are some people who have adverse reactions to melatonin. I'd say in my experience about 5 per cent of kids [who take melatonin supplements] go hyperactive and aggressive," she says.
"Some families have said to me that [melatonin] has changed their personality; they stop melatonin and it goes back to normal.
"It's a hormone and it has a very strong relationship to serotonin, which is one of our mood hormones."
LoadingWhy parents might turn to melatonin supplements
Unlike some other medications used to aid sleep, Dr Best says people are unlikely to become dependent on melatonin supplements or experience withdrawals when they stop.
"Withdrawal shouldn't be a problem, assuming you are using normal doses," he says.
However, melatonin supplements do interact with other medications, including selective serotonin reuptake inhibitor (SSRI) drugs used to treat depression and anxiety.
Dr Best say these sorts of issues are why people considering using melatonin should speak to their doctors first.
He recommends parents try behavioural sleep strategies with their children before considering melatonin.
Professor Blunden says that when used correctly and supervised by a health professional melatonin supplements can be a "game-changer" for parents and children struggling with sleep.
"It can be absolutely the difference between a crisis and not a crisis," she says.
"Let's take autism … [some children] simply do not want to sleep, because their [natural levels of] melatonin can be completely dysfunctional.
"I have seen radical changes, and [parents say], 'It's like a whole new world to be able to rest at night and have our child go to sleep.'"