Melatonin vs. Behavioural Strategies for Improving Kids’ Sleep
Melatonin can be appealing for sleep-deprived families. But the long-term effects of this hormonal drug are unclear. Learn proven-safe behavioral strategies for encouraging healthy sleep instead.
Sleep struggles can be all-too real for families with young children. And sleep-deprived families sometimes turn to over-the-counter medications such as melatonin and Tylenol PM to help their children sleep. But are these medicines safe for kids?
A recent study presented at a Canadian Paediatric Society conference found that sleep problems cited most often by parents included bedtime resistance/delayed sleep onset, frequent night wakings and difficulty falling asleep or returning to sleep.
Of the 350 children studied, over 20% had been given an OTC sleep-promoting medication by a parent at least once and less than 4% had been given a prescription for a sleep-promoting medication by a physician. The OTC sleep-promoting medications used were melatonin and Tylenol PM.
Do Sleep-Inducing Medicines Work?
There is a lack of research on the use of melatonin and Tylenol PM to encourage sleep in children who have no underlying medical issues.
The only research in this area reflects the benefits of melatonin for children with diagnosed sleep disorders, attention-deficit hyperactivity disorder, autism and other special populations. It should be noted that all of these studies involved a small population and only sought findings of short-term use.
Long-Term Effects are Unclear
There is no clear picture of the long-term effects of OTC sleep-promoting medication on children, and this is precisely why we don’t recommend relying on melatonin supplements or Tylenol PM to help kids sleep. Instead, any long-term strategy for improving sleep quality and quantity in kids should focus on behavioral interervention.
The Canadian Paediatric Society’s paper agrees, stating: “Canadian-wide data on the use of pharmacotherapy to treat, and guidelines for managing pediatric sleep disorders are urgently needed, along with pediatric data on sleep medication safety and dosing. Counseling for families should focus on emphasizing behavioral strategies and discouraging pharmacotherapy for managing pediatric insomnia.”
How can parents encourage healthy sleep for their children without turning to OTC sleep-promoting medication? Since sleep is a learned behavior, the following behavioural interventions can be an effective solution for many families.
Routine and Behavioral Interventions for Better Sleep
- Turn off screens well before bedtime. Screen time inhibits the body’s natural production of melatonin and causes difficulty with the onset of sleep.
- Help your child set her body clock naturally. We all have an internal clock which drives us to sleep at certain times of the day. Exposure to light sets this internal clock, so open the blinds in the morning and begin dimming the lights as bedtime nears.
- Take a look at your child’s sleep schedule and help her get more sleep. When a child becomes overtired, falling asleep and staying asleep becomes more difficult. Babies, toddlers and younger elementary school aged children need on average 11-12 hours of night time sleep. An early bedtime is a useful strategy to chip away at sleep debt that accumulates when a child is sleep deprived.
- Ensure your child’s sleep environment is conducive to healthy sleep. The room should be dark, cool, quiet and free of distractions.
- Make sleep a priority for your family. Discuss the importance of sleep at a family meeting and establish sleep rules for all the members of your family. Avoid using sleep as a punishment or threaten to send your kids to bed. Promote sleep as a positive, necessary component of a healthy lifestyle.
- Realize that there are various methods which are effective in teaching the skill of sleep and it’s never too late to make changes and start fresh. Consistency is the key to success in making any change towards a healthier lifestyle.
- Consider hiring a sleep professional. Sleep Consultants have specialized training in the science and behaviour of child sleep. They offer a fresh perspective and much needed encouragement in what feels like a hopeless situation. If a child’s sleep problems are caused by disorderly sleep, behavioural interventions will be effective. It is an extremely small population of children who require further support or medical intervention.
Alysa Dobson is a mom, wife and a Certified Child Sleep Consultant. As a mother to two former insomniacs, turned amazing sleepers, Alysa enjoys helping other families get the sleep they need. You can read more of Alysa’s writing at http://www.sleepwellbaby.ca/category/blog/ or contact her at [email protected].
I'm a registered dietitian, mom of 4, avid lover of food and strong promoter of healthy habits. Here you will find lots of delicious recipes full of fruits and veggies, tips for getting your kids to eat better and become intuitive eaters and lots of resources for feeding your family.Learn More about Natalie
Avoid cane sugar or too many sugars as in per example the ones in sugary fruits such as grapes and bananas. Avoid chocolate as also over stymulates the nervous system. Eat whole grains and whole meal (soaked brown rice and barley), millet, spelt, wholewheat past, bulgur wheat, etc instead of processed ones like white rice an white pasta and white bread. Whole grains give the slow sugars to get people the sleep thru the night. Fast sugars over excite and run out fast leaving the body over tired who stays awake to compensate.
I agree in regards of the sugars shortly before bedtime, however that does not include bananas – bananas contain potassium and magnesium, both muscle relaxants and even if the amounts are not huge, they still count; most importantly though bananas contain amino acid tryptophan – a important precursor for both serotonin and melatonin. So, eating a banana before sleep can actually be good.
My 10 year old has never been a good sleeper since day 1. He was also stubborn since day 1. When he was an infant he would wake up a few times a night and cry and cry. We would go and pat his butt until he was asleep. As a toddler he would just stay away in his bed and go to sleep hours after his bedtime. Now he stays awake in his bed or bothering his little brother. He get up earlier than anyone else in the house and it is usually before 7:30 for no reason. He has to get up earlier for school now though. I never once thought about giving him anything OTC of otherwise to help him sleep. As a child I didn’t go to bed until later. As an adult I wake up often because I am a very light sleeper. My dad is also. He is a smart active boy. I just think over medicating is a big problems anymore. I also don’t give medicines for colds unless they are really bad. Everyone is different and I know everyone has different needs, but I think we just need to stop relying on so many quick fixes that we don’t even know the long term effects of.
Great read. I am definitely pro behavioral strategies for treating sleep difficulties in children. I was wondering if you can share references regarding the “great deal of research has been done on the adverse effects of melatonin on the cardiovascular, immune and metabolic systems.” What I found and continue to find in the literature is the opposite…. The benefits of melatonin use on the above systems. The only time I hear about negarives is really in mom blogs (also without cited references). I would very much like to educate myself on the downsides of melatonin, so please share some references!
My son just turned 9 years old and for the last 6 months he has been sleeping with us. He was a great sleeper before, but now he’s terrified of everything. We’ve tried routine, encouragement, discussion. We’re at a total loss and definitely do not want to give him anything. How do we get him over his fears (literally everything scares him). Help. 🙂
Ash, I’m sorry about your son’s change of behaviour, that must be quite hard on you too.. it sounds like there must’ve been a sudden trigger, something that caused him to become fearful – have you considered a consultation with his GP or/and a paediatric specialist? Could your son have been exposed to bullying at school for example? Or have witnessed something he perceived as disturbing maybe? I’m sure you’ve tried to ask him that already and I certainly hope it’s not the case and hopefully your son is just going through some temporary difficult stage and will soon settle back to normal again.
But if you are very worried, I’d for sure ask for help – I’d make an appointment at his school and ask whether they noticed anything and also ask them to keep an eye on him and his behaviour while interacting with other pupils, and I’d go have a chat with his GP/paediatrician too (without your son first to make the doctor aware and allow him to prepare for talking with him next).
Good luck, I hope you’ll get all the help and advice necessary and that with your support and love your boy will get through this very quickly and be a happy himself again soon!
you say “adverse effects of melatonin on …..” do you have any references to support that ?
Hi there, thanks for reaching out and for being a good critical reader. 🙂 We did some digging and did not find compelling references to support that particular claim, so we removed that statement from the article. Our overall recommendation remains the same: parents should work with their child’s doctors to address sleeping challenges using behavioral strategies and interventions, rather than hormonal supplements or pharmaceutical products.
This is such an inspiring article about sleep. It really helped