If you or your child have been struggling to sleep during the pandemic, you’re not alone. And research shows an increasing number of people are turning to sleep aids, such as melatonin supplements, to help.
The Centers for Disease Control and Prevention says melatonin supplement use has become widespread among children and adults. Melatonin sales in the U.S. increased by nearly 200 percent between 2016 and 2020.
While the short-term use of melatonin supplements can help improve sleep for some people, there’s a lot to consider before giving them a try—especially if you’re planning to give them to your children.
UNC Health pediatrician Kori Flower, MD, sleep physician Adnan Pervez, MD, and pharmacist Amy Donnelly, PharmD, answer common questions.
What is melatonin?
Melatonin is a naturally occurring hormone released by the brain that helps regulate sleep cycles. Your body is triggered to release melatonin when it becomes dark outside, helping you fall asleep. Melatonin production can be suppressed by exposure to light (including light from electronic screens), physical activity and stress.
Synthetic melatonin is available over the counter as supplements for children and adults in various forms, including gummies, pills, chewable tablets and liquid. Many people take them before bed to fall asleep faster.
Is melatonin safe as a sleep aid for adults?
When used correctly, melatonin supplements are generally considered safe for adults as a short-term tool to help you sleep better, Dr. Pervez says. However, sleep experts caution against its long-term use for insomnia.
Melatonin can help adults with certain sleep disorders related to disruption of the body’s natural sleep rhythms or when a person’s sleep cycle (also called circadian rhythm) does not align with their schedule or environment (such as shift workers or someone experiencing jet lag). It may provide some relief for general insomnia and is also used for treatment of specific conditions for some people who exhibit abnormal behaviors during sleep, such as acting out physically while dreaming.
But there’s no clear evidence that melatonin supplements work to improve sleep long term in people without a sleep-cycle disruption disorder, Dr. Pervez says.
“It might help you fall asleep in the short term, but it’s better to adjust your lifestyle and routines to achieve better and more consistent sleep,” Dr. Pervez says.
The safety of long-term melatonin use has not been well-studied in adults or children.
Is melatonin safe as a sleep aid for children?
Sleep problems in children can be frustrating for the whole family. While it might be tempting to give a small dose of melatonin to your baby or toddler to help them fall asleep, it is not safe for children younger than age 3, as their body clocks are still developing.
If you’re considering giving melatonin to your child, it’s important to consult your child’s pediatrician first. They can help you get to the root cause of the sleep issues.
“There are a lot of sleep problems that warrant treatment from a healthcare provider, and we want to make sure we’re not missing those,” Dr. Flower says.
Difficulty sleeping can also tip off your pediatrician to larger underlying issues. A common reason for difficulty sleeping in children is anxiety, Dr. Flower says.
“Anxiety is incredibly common right now in children, and sleep problems can be the clue,” Dr. Flower says.
If the pediatrician determines there are no underlying conditions, they may give the greenlight to use melatonin supplements for a short period of time. However, just like in adults, it’s best to improve your child’s daily habits and sleep hygiene.
If you choose to use melatonin, how do you use it safely?
- Pick a good brand.
Supplements are not regulated by the U.S. Food and Drug Administration as closely as prescription medications, so not all melatonin supplements are created equal. The amount of melatonin present in each product can widely vary between brands.
Dr. Pervez recommends selecting a melatonin supplement that is certified by US Pharmacopeia. This will ensure that the potency of the product matches what is listed and it’s been made according to standardized manufacturing practices.
- Take it at the right time of day.
You want to take a melatonin supplement one to two hours before the time you usually fall asleep, which is when your body’s natural surge of melatonin occurs.
“Normally people take melatonin too late,” Dr. Pervez says. “Taking it at the wrong time like too close to bedtime or early morning can actually be counterproductive to your body’s sleep cycle.”
And if you don’t have a consistent bedtime, Dr. Pervez recommends establishing one before giving melatonin a try.
- Take the right amount.
When taking melatonin, less is more.
“If you take it at the right time, 0.5 to 1 milligram might be all you need,” Dr. Pervez says.
If you find you need to increase the dose, do so in small increments.
As a general rule, the dose should not exceed 3 mg for elementary school children, 5 mg for adolescents and 10 mg for adults. It’s best if the elderly don’t take more than 5 mg, as excessive drowsiness or dizziness can increase fall risk, Dr. Donnelly says.
- Know when it’s time to stop.
Melatonin supplements are not meant to be used long term. Dr. Donnelly says taking melatonin between two and four weeks is long enough to improve sleep or adjust your sleep cycle. She recommends against using melatonin for longer than a month at a time, so your body doesn’t start to rely on the supplement to produce melatonin.
- Store it safely.
As demand for melatonin has grown during the pandemic, so has the number of kids accidently ingesting it. New research shows melatonin poisonings in children are up 530 percent over the past decade. Taking too much melatonin can lead to severe drowsiness and difficulty waking up, and in some cases, it can be deadly.
Since melatonin comes in gummies, it’s easy for children to mistake them for candy.
To avoid any accidents, Dr. Donnelly recommends treating melatonin like you would a prescription medication.
“Don’t keep melatonin on your nightstand or in your nightstand, which is where you might think to store it because you take it before bed,” Dr. Donnelly says. “Instead, keep it in a high medicine closet or somewhere else that children can’t access.”
If your child does accidently ingest melatonin or any other substance that concerns you, reach out to your local poison control center. Programming this information into your phone or keeping it in an easily accessible location ahead of time is very important, she says.
Is melatonin habit-forming?
No. Since melatonin is not a medication, you can’t become addicted to it. However, it is possible that taking supplements could cause your brain to produce less melatonin naturally, Dr. Flower says. That’s why it’s only recommended as a short-term resource.
Can melatonin have side effects?
Yes, in high doses, melatonin can cause mood disruptions and nightmares. Other negative side effects can include headaches, excess drowsiness that carries into daytime, dizziness, nausea, stomach pain and agitation. Some parents report increased bed-wetting in children, Dr. Donnelly says.
If you’re noticing any negative side effects, consider scaling back the dose or discontinuing use. Either way, reach out to your provider.
Who should not take melatonin?
Melatonin supplements are not recommended for anyone taking medication for seizures or blood thinners.
It’s possible that medications containing estrogen can increase levels of melatonin, so if you’re taking birth control, discuss melatonin use with your provider first, Dr. Donnelly says.
Melatonin use has not been well-studied in pregnant or breastfeeding people, so it is not recommended for those groups.
How else can you improve your body’s sleep cycle?
You’ve probably heard this advice before: Don’t look at your phone right before bed. But really, don’t.
“The single most powerful thing you can do to improve your family’s routine is to avoid screens (phones, tablets, television and other electronics) at least an hour before bedtime,” Dr. Flower says. “This applies to children and adults. We know that melatonin is suppressed by blue light, so removing it before bedtime is key to helping the body fall asleep naturally.”
Other ways to improve your sleep, with or without using melatonin supplements, include:
- Don’t exercise too close to bedtime. Work out in the morning or during the day.
- Expose yourself to daylight early in the morning.
- Avoid naps during the day.
- Avoid drinks with caffeine and alcohol in the afternoon or evening hours.
- Reserve your bed for sleep and sex only.
- Maintain a consistent bedtime routine.
Looking for a sleep physician? Find one near you.