Kids may beg and plead to get five more minutes, one more story, or one last drink of water to delay their dreaded bedtime as long as possible. And once they've settled in, many children may toss and turn for hours before they're able to actually fall asleep. For parents, that's hours of anxiety spent waiting to hear their child sleep peacefully.
Sleep problems are common in children with developmental disorders, disabilities, and central nervous system disorders. These may include autism, attention deficit hyperactivity disorder (ADHD), cerebral palsy, and mental retardation. Studies have shown that children with ADHD were more likely to suffer from daytime sleepiness, experience sleep-disordered breathing, and were at a greater risk of restless legs syndrome and periodic leg movement syndrome during sleep. As many as 80 percent of children with autism spectrum disorders experience problems with sleep, and those sleep-deprived kids tend to experience more severe symptoms and behavioral problems than those without autism spectrum disorders. Children with developmental disorders like these tend to take much longer to fall asleep, wake earlier in the morning, and experience nighttime wakings.
So what's an exhausted parent to do? Sleep hygiene is important, but it's not always enough. Research is pointing to a possible solution in melatonin, a sleep supplement that is derived from the body's natural hormone that helps to regulate sleep and wake cycles.
How Melatonin Works
The pineal gland in the brain begins to release melatonin once the sun starts to go down. "Melatonin is a hormone that's naturally released in your brain. It essentially helps to prepare the entire body for sleep," said Charlene Gamaldo, MD, associate professor of neurology, pulmonary and critical medicine and director of the Neuro-Sleep Division at Johns Hopkins Hospital. "It's not a sleep inducer — you don't fall asleep right away. It's a sleep preparer," explained Dr. Gamaldo. "The way it's naturally released in your body, it starts to peak about four to six hours before your intended sleep time. It's really a hormone that sets the stage for getting ready to go to sleep."
What the Research Says
For kids who have a hard time "shutting off" and relaxing enough to go to sleep, melatonin can be very helpful in preparing the brain and body for sleep.
"There is a breadth of literature showing the benefits of melatonin for children with neurodevelopmental conditions with the greatest support for efficacy in ADHD and autism," said Gamaldo. "The literature pretty much uniformly shows benefits in sleep quality; more comprehensive ones demonstrated benefit with long-term use for mood, function, and sleep quality."
A 2012 study published in the British journal Health Technology Assessment reviewed the impact of melatonin given to 263 children (ages 3 to 15) with neurodevelopmental problems. Researchers found that using melatonin helped children fall sleep by a mean of 45 minutes faster; they also slept a total of 23 minutes longer.
Another study conducted at Vanderbilt University School of Medicine in 2011 examined the impact of melatonin given to children with autism spectrum disorders who struggled with sleep. After one week, children fell asleep more quickly and experienced overall improved sleep, as well as improvements in behaviors. Researchers also found that parents were less stressed, and the children tolerated the supplement well.
"In the pediatric population, melatonin has been used off-label in children with circadian rhythm disorders, and in adolescents who have very severe night-owl tendencies," said Gamaldo. Of course, "it's accompanied with other things like behavioral techniques and more regimented bedtime routines."
Sleep Hygiene for Kids
Supplements or medications are never a substitute for good sleep hygiene, so follow these tips and tricks to help kids get the best night of sleep possible:
- Create the right sleep environment, which is cool, dark, comfortable, and quiet.
- Stick to a consistent, calming, and relaxing bedtime routine each night.
- Set a regular bedtime and wake time, and follow it every day.
- Get plenty of regular exercise and spend time outdoors in the sunlight each day.
- Avoid stimulating activities — tablets and smart phones, television, computers, and video games — before bed.
Because melatonin is a supplement and is therefore not regulated by the U.S. Food and Drug Administration, Gamaldo noted that it's important to stick to a well-known brand name supplement purchased at a reputable store. It's also very important to consult your child's pediatrician before giving your child melatonin to help improve sleep.
"There is more data suggesting that when children have problems with sleep, it can affect their ability to learn and absorb information," said Gamaldo. Sleep is so important to kids' health and development that parents shouldn't hesitate to talk to their pediatrician about their concerns.
Last Updated: 7/9/2013