Sleeping Pills And Kids?

By: Naré Panossian PA-C, Certified Pediatric Sleep Consultant

As there is so much hype about 4/20 and the connotations that come with it, I thought it would be only appropriate to discuss kids, drugs and sleep today.

Both sides of my family come from a small, farming village. They lived modestly and modern-day medicine was just emerging in their part of the world and they didn’t always have access to medications readily available. So, families at that time relied heavily on natural remedies-mint tea for belly aches, honey for cough and iodine in liquid form for just about any skin condition, to name a few.

As a child, my grandparents immigrated to the U.S. and that’s when I learned all of these natural home remedies as they were used on me too! As I furthered my education in medicine, I was fortunate enough to take a medical ethnobotany class and was amazed to learn that all these remedies actually have scientific basis! I don’t know why I was so surprised since my family had been using these remedies for years and they all seemed to survive. But, to learn the actual science was fascinating and it has been wonderful learning of other cultures’ natural remedies as well. Just think of how many times you have heard of people talking about turmeric in the last couple of years.

Now, with the internet and social media, you will undoubtedly see advertisements for “natural” cures and it is a booming industry. One of the big selling points of cures like these is that they are “natural.” We aren’t talking some lab-designed chemical to solve the problem. We’re using something that’s readily available in nature-like aspirin.

I should stipulate here that as a Physician Assistant, I’m not anti-homeopathy, nor am I anti-pharmaceutical. I feel health decisions are something that should be carefully considered by the individual with the advice of their healthcare provider. If probiotics will improve your gut health, I say go for it. If you need prescribed medications to lower your cholesterol, then you should take that too. But, anything you are going to put in your body, and every bit as importantly, your child’s body, should be evaluated for its efficacy and possible side effects, which is why I think we should have a quick talk about melatonin.

I have and continue to prescribe melatonin to adult patients but have also been alarmed by the increased rate I have seen parents giving their children melatonin. Melatonin has been touted by a lot of homeopathic experts as a safe, natural way of helping people get to sleep. In a lot of ways, that’s actually very true. But, there’s a whole lot more to understand about it before you take it yourself or give it to your child.

So what is it, exactly? Melatonin is a hormone that’s secreted from the pineal gland that helps to settle your body and mind down when it’s time to sleep. How exactly it does that is a very complicated process and would involve me to go into a lot more detailed biology that would probably bore most of you. So in the simplest terms, melatonin is your brain’s way of drawing the curtains for the night. Cortisol is its counterpart, which opens them back up, and the two together make up a large part of what we call our “body clock.”

An important point here is that melatonin is not a traditional sleep aid. As Dr. Luis Buenaver, a sleep expert from Johns Hopkins explains it: “Your body produces melatonin naturally. It doesn’t make you sleep, but as melatonin levels rise in the evening it puts you into a state of quiet wakefulness that helps promote sleep.”

How does our body know when to start producing melatonin? Quite naturally. When it starts to get dark, the body recognizes the onset of night, and gets the melatonin pumps up and running. That worked like a charm for a couple of hundred thousand years, until we invented the light bulb. And the television. And the smart phone. And the laptop. Nowadays, our eyes are flooded with so much artificial light that it can be difficult for our brains to determine when night is actually coming on, and it can interfere with melatonin production. That can mess up our body clocks and contribute to insomnia.

Now, in some cases, jet-lag and shift work being the biggest two, a melatonin supplement can help reset our body clocks if they’ve been thrown out of whack, but it’s not a solution to sleep issues. My first piece of advice to people who are having trouble sleeping is to turn off their screens a couple of hours before bed, turn down the house lights, and come up with a bedtime routine. Let your body know that it’s time to sleep, and it will do almost all of the leg work for you. Side note: This is not the case for insomniacs. People with psychological or physical conditions that inhibit their sleep should definitely consult with their health care providers.

Now, when it comes to kids, all of this information still applies. Newborns are something of an exception, as they don’t start producing melatonin and cortisol until they’re about 2 months old. Until then, they’re kind of flying by the seat of their pants, sleep-wise, as I’m sure you probably already know if you have any of your own. But past the 2 month mark, they start to establish a 24-hour light-dark sleep cycle, which is the standard sleep cycle that we follow throughout our lives.

So now we get to the big question: “Will giving my child melatonin help them sleep through the night?” And the answer is, “No it will not.” It might help them GET to sleep at night, but it will not help them stay asleep. This isn’t just my opinion, by the way. This is the general consensus of sleep specialist, researchers, and doctors worldwide. The National Sleep Foundation has found that, “…when scientists conduct tests to compare melatonin as a “sleeping pill” to a placebo (sugar pill) most studies show no benefit of melatonin.”

I do think being fully informed is important, of course. Melatonin is a hormone and can have serious side effects. There have also been studies that showed early sexual development in animal subjects given melatonin, but the link in human children hasn’t been established. Also, when children are started on it, they do have to be weaned off and it isn’t as simple as it seems and there can be rebound effects which can make sleep even worse for a time being. Again, I am not in any way against homeopathic or naturopathic medicine. Even in cases where the effects are psychological, and for some people, melatonin does indeed get them to sleep quicker and help them sleep through the night. If it’s just a placebo effect for some of them, no biggie. They’re getting the sleep they need and that’s vitally important in its own right.

But when it comes to young kids, I feel that it’s essential for us as parents to teach them the skills they need to fall asleep and stay asleep on their own. And here’s the good news. Kids and sleep go together like gin and tonic (wink, wink). They need a LOT of sleep, and for a short period in their lives, everything in their bodies is tuned to help ensure they get it. All they need from us is a little guidance and a determination to step out of the way sometimes so they can develop the ability to get to sleep and stay asleep on their own.

You can check out some of my other blog posts for tips on how to teach independent sleep skills or sign up for My Top 5 Tips to Getting Your Child to sleep. But giving them any kind of sleep aid whether it be melatonin or Benadryl, is definitely not the answer and it hasn’t been proven to be safe. Just like learning any other skill, it takes practice and time. There’s no supplement that can teach you how to play an instrument, teach you long division, or perfect your lasagna recipe. Sleep is, in essence, exactly the same thing. It’s a skill that needs to be developed, and once it is, it comes easily and naturally. So, before you reach for the pills, try establishing a predictable, consistent bedtime routine, shutting down the TVs and tablets a couple of hours before bed, and encouraging your child to fall asleep without feeding, rocking, or other forms of outside help. I promise you, the results will be better than anything you will get from a pill, and they will last them a lifetime.

Sweet Dreams!