Sleep problems are common in children, especially those children with neurodevelopmental disorders (such as ADHD, autism spectrum disorder and blindness). A range of things can cause difficulty falling asleep or staying asleep. It is important to find out the reasons for your child's sleep problems. Knowing the reason means you can use the right tools to manage the sleep problem.
Find out about the different problems getting to sleep [1]
Pain, reflux, sleep-disordered breathing and worrying can all have an effect on your child's sleep. Make sure your child receives a diagnosis and treatment for these before thinking about using other strategies such as a trial of melatonin.
Medicines can also affect your child's sleep. If your child is taking a medicine that you think is affecting their sleep, talk to your doctor.
See more information about helping your child sleep soundly [2]
Managing sleep problems needs to start with healthy sleep habits. This is sometimes called good 'sleep hygiene'. Healthy sleep habits include:
Melatonin can be helpful for some but not all sleep problems. Talk to your family doctor before using melatonin.
In most children, healthy sleep habits will sort out their sleep problems. If your child does need more help, using a medicine such as melatonin will work better if healthy sleep habits are in place.
Melatonin is a hormone produced by the pineal gland in the brain. It helps control your body's day-night cycle. Melatonin levels are lower during the day and higher at night.
Melatonin as a medicine can be helpful for some children, especially children with autism spectrum disorder. But, in New Zealand, all use in children is 'off-label'. That means using the medicine in a different way from the approved use.
Melatonin can be helpful for some but not all sleep problems. It's safest to talk to your family doctor before using it.
You give your child a small dose 30 to 60 minutes before bedtime. It's a small dose but is still much higher than your child's body can produce. The dose makes your child feel sleepy. People use doses from 0.5mg to 6mg, but most children take 1 to 2mg. Your child will most likely fall asleep more quickly (usually 15 to 40 minutes faster). They may sleep for slightly longer (usually 20 to 40 minutes). Your child may also wake a little earlier in the morning.
Side effects include headache, nausea, sleepiness, and bedwetting. Most side effects are mild and settle by themselves.
Melatonin can also interact with other medicines. This includes medicines you have bought from the pharmacy or supermarket, as well as natural remedies. You need to talk to your child's doctor about all your child's medicines before starting melatonin.
You need to be careful if your child has a health condition such as:
If your child does have one of these conditions, melatonin may not be suitable.
In some children, melatonin works to start with, and then stops working. This may happen if the dose is too high for your child. If this happens, see your doctor. They may suggest stopping the medicine and starting again at a lower dose.
All children should stop melatonin for at least a week each year. During that week, you can see if your child still needs melatonin.
The content on this page has been developed and approved by the Paediatric Sleep Medicine Clinical Network, Paediatric Society New Zealand.
This page last reviewed 10 December 2020.
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Links
[1] https://kidshealth.org.nz/problems-getting-sleep
[2] https://kidshealth.org.nz/tags/sleeping-sound
[3] https://kidshealth.org.nz/node/2542?language=zh-hans
[4] https://www.sleepwake.ac.nz/what-we-do/covid-19-resources/sleep-for-parents-and-babies/
[5] https://www.sleepwake.ac.nz/what-we-do/covid-19-resources/childrens-sleep-for-parents/
[6] https://www.sleepwake.ac.nz/what-we-do/covid-19-resources/childrens-sleep-for-children/
[7] https://www.sleepwake.ac.nz/what-we-do/covid-19-resources/sleep-for-teenagers/
[8] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F2259%3Flanguage%3Dzh-hans