Melatonin in children

The commercialization of melatonin in children It was, in the beginning, like that light at the end of the tunnel that we all wanted, but, despite its initial free sale, the Spanish Association of Pediatrics has warned of the need to regulate its use, define its indications and be prescribed by

Sleep disorders in the child population

Approximately 30% of children carry it at some point in their development and 18% of adolescents complain of insomnia in the pediatrician's office. Nighttime rest is essential in the child's development, behavior, learning and growth, therefore, it is one of the activities necessary to ensure good health. In the case of young children, the most frequent cause is usually the presence of bad habits, on the other hand, in adolescents, inappropriate routines are combined (playing video games at night, stress or drinking exciting drinks, for example) with a difficulty initiating sleep due to a delayed endogenous melatonin secretion curve.

What is melatonin?

La is a neurohormone produced by the pineal gland, located in the brain, at night. Its secretion is regulated by our circadian rhythm or "biological clock" (day-night), so that it stops being manufactured with exposure to light. This small detail has made it possible to carry out studies where a decrease in its synthesis is observed at night if we are exposed to white or bluish light. On the other hand, to help our body synthesize the correct amount of melatonin at night, sleeping in the dark is the best option. The production of melatonin begins at three months of life, its maximum production is between 8 and 10 years old and, during old age, its levels decrease to 10%.

Which functions has

Its functions are as follows:

• Regulate sleep and synchronize the sleep / wake cycle: this function would justify its use in situations where the biological clock is altered, such as jet lag or night work shifts.
• Effects on the immune system.
• Antioxidant action and slows aging (melatonin is popularly called the "youth hormone").
• Protection against the development of some tumors.
• Protection of bones.
• Regulates the acidity of the gastrointestinal tract.
• Regulates blood pressure.

Melatonin use in children: how, when and why

There are few studies in children with melatonin, and the few that we have it seems that melatonin can benefit difficulties in initiating sleep and a decrease in nocturnal awakenings, in this case, in children with neurodevelopmental disorders. The current indications for the use of melatonin in children apply from six months of age and are as follows:

• Childhood insomnia: when the child has chronic difficulty sleeping, both in the onset of sleep and in its quality of sleep, which causes alterations in the child and in their family environment.
• Phase delay syndrome: it is characterized by a delay greater than two hours in socially accepted times, in the onset of sleep and waking up.
• : it is a neurological disorder characterized by the urgent need to move the legs at rest and which worsens at the end of the day.

It is always recommended to start with the lowest starting dose and adjust the treatment according to the needs and response to it. The recommended amount of melatonin ranges from 1 to 3 mg per day and it is not recommended that treatment be prolonged for more than four weeks in infants. In young children it can be given for a longer time.

IMPORTANT

It is convenient that the use of melatonin is controlled by the pediatrician and is accompanied by sleep, environmental and nutritional hygiene measures.

Side effects of melatonin in children

Studies in children are scarce, therefore, most of the reported side effects are in adults who took melatonin. The most common side effect related to overdose is drowsiness. Others are: headache, dizziness, nausea and liver problems. In children, its use for a short period of time (four weeks) seems quite safe. In the long term, however, there is not yet enough information. A potential risk is its possible is the appearance of the advance of puberty in children and there is also controversy in its protective effect or not of children with epilepsy. Caution is therefore recommended in the use of melatonin in children with:

• Autoimmune diseases.
• Hematological tumors.
• Poorly controlled asthma.
• diabetes.
• Active epilepsy.

Other ways to treat sleep disorders that modulate melatonin secretion

• Routines before going to sleep: a bath, a glass of hot milk or avoiding the use of screens.
• Regulate the times of going to sleep and getting up.
• Avoid very long naps or that end after 5:00 p.m.
• Create a pleasant and quiet bedroom environment with a temperature between 19 and 22ºC.
• Play sports, but not late in the day.
• Waking up with light in the morning favors the onset of sleep at night.
• Restrict the use of screens at least one hour before going to sleep.
• Avoid stimulating drinks: tea, coffee, cola drinks ...
• Eat dinner at least half an hour before going to sleep.
• Tryptophan is the amino acid from which our body produces melatonin, therefore, the consumption of foods rich in tryptophan (taken in moderation) promote sleep, such as milk.

• • In children, its use for a short period of time (four weeks) seems quite safe. In the long term, however, there is not yet enough information.
  • The current indications for the use of melatonin in children apply from six months of age and are in infantile insomnia, phase delay syndrome, and restless legs syndrome.
  • It is important that the use of melatonin is controlled by the pediatrician and is accompanied by sleep, environmental and nutritional hygiene measures.

Pediatric specialist