An alarming number of sleep deprived families are turning to over-the-counter medications such as melatonin and Tylenol PM to help their children sleep. A recent study presented at a Canadian Paediatric Society conference surveyed the parents of 350 children brought into pediatric emergency for various reasons. The study concluded that 80% of children with underlying medical conditions reported sleep difficulties and 70% of children who were otherwise healthy also reported problems with sleep. The average age of the children whose parents completed the survey was 8 years old.
The Canadian Paediatric Society’s study found the sleep problems cited most often by parents were bedtime resistance/delayed sleep onset, frequent night wakings and difficulty falling asleep or returning to sleep. Of those children, 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.
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.
There is no clear picture of the long-term effects of OTC sleep-promoting medication on children but a great deal of research has been done on the adverse effects of melatonin on the cardiovascular, immune and metabolic systems. Adverse effects of melatonin use have also been found in the reproductive systems of animals.
The Canadian Paediatric Society’s paper states, “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 behavioural strategies and discouraging pharmacotherapy for managing pediatric insomnia.” The statement from the medical community is extremely clear on this issue, yet many parents continue to give their children OTC sleep-promoting medication without knowledge of the long-term effects.
How can parents encourage healthy sleep for their children without turning to OTC sleep-promoting medication? Parents need to understand that a true sleep disorder is extremely rare in children and requires a medical diagnosis. Most children who experience difficulty sleeping are dealing with disorderly sleep, not a sleep disorder. Because sleep is a learned behaviour the following behavioural interventions offer an effective solution.
- 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]