Why oh why do we mess with these critical system? It's a hormone. It's not safe to mess with hormones, especially with kids. The US does not regulate the use of melatonin and since it's considered to be a supplement, the FDA doesn't regulate it. In many countries, it's unavailable or requires a prescription.
Melatonin has been recommended, primarily, as a sleep inducing agent. This hormone is released by the pineal gland, a very small structure in the brain that responds to dark and light. It signals to the body that it's time to rest; the levels remain high during the night and fall during the daytime.
You should get natural sunlight into your room as soon as possible after rising. The light activates the pineal gland and you awaken much more vigorously if you throw open the shades instead of turning on lights! The same goes for kids. Maybe there's a reason for the old addage, "Rise and shine!"
When melatonin rises and falls, it regulates our internal clocks, circadian rhythm. That's a powerful system and it is very finely tuned.
As for infants, their melatonin levels become regular at about the third month after birth. Their highest levels come in between midnight and 8:00 a.m.
The melatonin release in teenagers is delayed, leading to later sleeping and waking times.
As we age, melatonin declines, resulting in sleep-related disorders.
Since nearly 2,000,000 American adults take it and about 500,00 kids take it, let's examine what melatonin is...
Pros
- It can be effective as an adjunct to treatment for people with nighttime hypertension.
- It can help people with sleep phase disorder (people with circadian rhythm problems).
- Known to aid effects of jet lag especially if you're traveling east. But, if you don't time it "just right", it can make jet lag worse.
- May reduce some types of headaches, including cluster headaches.
- May protect against gallstones.
- Protects against radiation damage.
- There's "tentative evidence" that it benefits tinnitus (ringing in the ears).
- Might improve sleep in those with autism. People with autism spectrum disorders (ASD) have lower levels of melatonin than the general population.
- Studies have proven that melatonin improves sleep for those with Attention-Deficit/Hyperactivity Disorder.
- Prolonged-release melatonin is safe to use for up to 12 months.
- Has an anti-inflammatory effect.
- Small amounts are in cherries, bananas, grapes, rice, cereals, herbs, plumbs, olive oil, wine and beer.
- Might play a role in reducing symptoms related to multiple sclerosis and may combat certain types of cancer cells, but more research is necessary.
- As an antioxidant, melatonin reduces inflammation in the brain, and protects it when it is injured or sick.
- Treats Seasonal Affective Disorder in the role as an antidepressant.
- May be as effective as Prozac, but without the side effects.
- Counteracts the effective of amyloid beta and tau proteins implicated in the development of Alzheimer's disease. In this role, melatonin slows cognitive impairment.
- No evidence it helps those with shift work although some makers of melatonin make claims although a 2007 study indicated that it may improve daytime sleep quality but not nighttime alertness.
- Nausea and headache.
- Next-day grogginess and irritability.
- In the elderly, can reduce blood flow and can cause hypothermia (lower core body temperature that can be dangerous) .
- Might increase or reduce symptoms in autoimmune disorders.
- Can lower hormone levels that impact human reproduction. In the 1990s, was used with some effectiveness as a contraceptive.
- Anticoagulants are known to interact with melatonin.
- Can make you fall asleep more quickly, but hasn't been proven to increase the total time or quality of sleep.
- May worsen mood in those with dementia.
- Timing of taking melatonin is critical to its effectiveness.
- "Natural" does not mean it's "safe".
- I'm not sure if this one is a "pro" or "con", but if you overdose, you won't die, but you'll be "pretty miserable".
- With children, it can affect puberty, disrupt menstrual cycles and normal hormonal development.
- Taking too much melatonin can lower body temperature resulting in reduced melatonin release which can then stimulate the production of prolactin which goes on to cause hormone problems, kidney and liver issues in men.
- Prolonged use can intensity insomnia.
- Difficult to have stable levels in the blood.
Melatonin is extremely powerful. The recommended dose ranges from .3 and 1 mg, yet if you walk into any pharmacy or grocery, dosages offered have a broad range up to 10 times that amount. Melatonin concentrations vary from product to product, lot to lot.
Don't take melatonin until you consult with your doctor about interactions with other medications you're taking, your specific health conditions which may be worsened by taking it and for heaven's sake, don't give it to your kids without a serious discussion with the pediatrician.
There's a qualitative difference between the melatonin that your body produces ("endogenous") and what ends up in the synthetic version ("exogenous") on the shelves at the drug store and market.
- Kids with ADHD, autism, other neurodevelopmental disorders and insomnia might benefit from melatonin. They are likely to fall asleep sooner, but will they stay asleep? They may not even if you give them the extended release form of melatonin.
- It won't help kids who use electronic devices right up until bedtime.
- There are mixed messages about the research, but we know for sure that melatonin is a hormone and hormones are powerful and can influence puberty.
- Never give to a child under the age of 3 years.
What should you do? Have your pediatrician conduct a comprehensive physical assessment to rule out anxiety, restless legs, situation stress, sleep apnea, bacterial or viral infection or any another condition that may impact their sleep.
Are you putting your child to sleep too soon? Are they getting enough physical exercise. Are they using their "screens" too close to bedtime? Observe healthy "sleep hygiene" practices to give them the best chance of falling asleep on their own.
Just do the best you can, Claudia
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