Like millions of parents, Lynne Bruton tried all the usual ways to get her three children to bed on time: turning the television off 30 minutes before bedtime, stopping them from eating and drinking well before going to sleep and sticking to a nightly routine that included sitting with her children in their rooms to help them "wind down."
But sometimes these methods didn't work — particularly with her oldest son, Clint. That meant he would get to sleep too late, which resulted in a tired and cranky boy in the morning.
Two years ago, Bruton discovered a new way to keep Clint, then 12, on a regular sleep schedule. At night she gave him melatonin — the nutritional supplement that is available at any pharmacy or health food store and is mainly promoted as an aid for travelers who have jet lag.
Almost immediately, the pill helped him fall asleep quickly and wake up fresh the next morning.
"It's been great," says Bruton, of Abilene, Texas. "With three kids, it has changed the dynamic of getting the kids ready in the morning."
Bruton has also at times given melatonin to her 10-year-old son, Dale, and it has worked.
Parents who have tried it say the pill has been nothing short of miraculous in getting their children to sleep. It's a trend that is occurring despite doctors' general reluctance to endorse melatonin as a sleeping aid for healthy children.
The Nutrition Business Journal says sales of melatonin supplements rose 11% in 2006 to $80 million. That followed a 7% jump in 2005. Sales were about $60 million in 2003, the Boulder, Colo.-based research publication estimates.
"We have seen tremendous growth of the use of melatonin by parents," says Susan Zafarlotfi, clinical director of the Institute for Sleep-Wake Disorders at Hackensack University Medical Center in New Jersey. "Melatonin is very useful for some teens who cannot get to sleep."
Zafarlotfi says occasional use of melatonin for children is fine as long as the dosage does not exceed 3 milligrams. She does not recommend giving it to kids younger than 10.
Melatonin, a hormone produced by the pineal gland in the brain, helps regulate the body's sleep-wake cycle, and its production is determined by light and dark. When darkness falls, the gland produces more melatonin, which promotes sleep.
Safe — with a few caveats
Melatonin supplements have proved safe and effective in numerous studies for helping adults with jet lag. More than two dozen studies have shown that melatonin also helps children who have insomnia, and it has few or no side effects.
After reviewing numerous studies, the U.S. Agency for Healthcare Research and Quality in 2005 concluded that melatonin supplements are safe if used for days or weeks.
The agency found evidence that melatonin is effective in treating people who have delayed sleep syndrome, who chronically tend to fall asleep well after midnight.
Nonetheless, medical groups have been cautious to endorse melatonin for children because nearly all the studies of melatonin on children were tested on those who had autism or other development disabilities or were blind. These children are given supplements because their bodies either don't produce melatonin or do so only erratically. The studies on children have been small, and there are no reports on the long-term effects of melatonin in children.
Doctors also worry that because melatonin is sold as a supplement, its manufacturing is not as stringently regulated by the Food and Drug Administration as if it were a prescription drug.
"This is not a treatment for the healthy child who just doesn't want to go to bed or the child with occasional trouble falling asleep," says Marcia Buck, clinical pharmacy specialist at the University of Virginia Children's Hospital in Charlottesville.
Melatonin is most beneficial for children who suffer brain injuries in which the brain no longer produces enough melatonin, she says.
Still, about 15% of pediatricians have recommended melatonin to help kids who have insomnia, according to a 2002 report in Pediatrics.
Factors to consider first
Parents who consider melatonin for a child should first discuss this with the child's pediatrician, who can rule out medical reasons for insomnia, such as breathing difficulties or behavioral conditions such as attention-deficit disorder, Buck says.
Also, before giving a child melatonin, parents should try changing the child's behavior, such as by limiting television before bedtime, she says.
Mike Dawson of North Kingstown, R.I., says melatonin has made a huge difference the past four years in getting his 10-year-old son, who has autism, to sleep. If the boy doesn't take it, he's awake until 11 p.m. or midnight.
"It made his life more peaceful both at night and during the day," Dawson says. "His demeanor and anxiety improved, and we all felt better because this giant stressor was alleviated."
