Melatonin

Melatonin is a naturally occurring hormone that is produced by the brain and it plays an important role in supporting the body’s circadian rhythm and promoting restful sleep. 

Levels of melatonin rise at night time making you feel sleepy and drop at dawn causing you to wake, which is why it is sometimes called ‘the hormone of darkness’.

The best way of ensuring optimal melatonin production is for your child to sleep in as dark an environment as possible. Use heavy lined curtains and/or blackout blinds to block out external light.

In the run up to bedtime, dim the lights and avoid screen time. Melatonin production is interfered with by screen activities for example watching television or playing on a computer. The light from the screens will stop the melatonin being produced as effectively therefore it is best to avoid these activities in the hour leading up to bedtime.

Melatonin prescriptions

Melatonin can be prescribed and is sometimes used in the management of sleep issues in children.  Children with Special Educational Needs and Disabilities are more at risk of having sleep issues and more commonly prescribed the drug.

Before a prescription is given it is important to try non-pharmacological sleep intervention methods.  This involves assessment of the sleep issues by a practitioner who will then work with a family to develop a programme of intervention.  This may include making changes to the bedtime routine, sleep/wake times and the bedroom environment amongst other things.  If a behavioural sleep intervention programme is not successful the use of melatonin may be discussed.  If a prescription of melatonin is required good sleep hygiene should still be followed as the aim is to stop the drug once a good routine is achieved. 

Side effects of melatonin

Melatonin is usually well tolerated by youngsters, the most common side effects reported are headaches, drowsiness, nausea and dizziness. More rarely it can increase heart rate and may possibly increase seizures in children with epilepsy.  If you are concerned about side effects you should raise this with a medical professional.  Children’s temperature commonly falls after taking the melatonin, this is a typical reaction.

Melatonin in the UK

Until recently only one licensed preparation was available in the UK (Circadin), the license however does not cover use in patients under 55 years of age. Slenyto is a relatively new drug that is licensed for the treatment of insomnia in children and adolescents age 2-18 with Autism Spectrum Disorder and/or Smith-Magenis Syndrome. 

The prescriber will work out the correct dose that a child needs and the time that it should be administered.  It will probably be recommended that they begin on a low dose which may be increased if necessary. Your child should begin to feel sleepy 30 minutes to an hour after taking their medication.