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Melatonin use among children ages 1 to 13 years was common, an online survey of parents showed.

The prevalence of melatonin consumption in the past 30 days was 5.6% in preschoolers, 18.5% in school-age kids ages 5 to 9, and 19.4% in "preteens" ages 10 to 13, reported Lauren Hartstein, PhD, of the University of Colorado at Boulder, and colleagues.

Preschoolers consumed melatonin for a median length of 1 year, Hartstein and co-authors said in a research letter. This duration rose to 18 months for school-age kids, and to 21 months for preteens.

In a 1.3% of U.S. parents reported that their children consumed melatonin in the past 30 days, the researchers noted.

"We were surprised to find that nearly one in five school-aged children and pre-teens had taken melatonin in the past 30 days," Hartstein told MedPage Today in an email. "Additionally, we found that parents are giving melatonin for long periods of time, with many young children continuing to take it for a year or more."

"Our findings suggest that many parents are looking for solutions for their children's sleep difficulties," Hartstein added. "Given the still limited research on melatonin use in children, it is recommended that parents discuss any concerns regarding their child's sleep and possible treatments with their pediatrician or a sleep specialist."

Last year, the American Academy of Sleep Medicine issued a health advisory encouraging parents to seek medical advice before giving melatonin to children. The advisory came on the heels of a that showed the number of calls to U.S. Poison Control Centers due to pediatric melatonin ingestions increased 530% from 2012 to 2021.

Moreover, a laboratory analysis in 2023 indicated that of 25 gummy products analyzed, 22 were inaccurately labeled, with only three products containing an amount of melatonin within 10% of the quantity declared on the label.

"Except in autism, melatonin efficacy and dosing have not been established, and indications will likely vary across age groups," Hartstein and co-authors pointed out.

"Dissemination of information regarding safety concerns, such as overdose and supplement mislabeling, is necessary," they added. "Clinicians should discuss with parents the factors associated with sleep difficulties and effective behavioral strategies."

The researchers assessed survey data for 993 children and adolescents with a mean age of about 6. The sample included parents of 450 preschoolers (ages 1 to 4), 368 school-age kids (ages 5 to 9), and 175 preteens (ages 10 to 13). About 53% were girls.

The online questionnaires asked about children's sleep-related practices, including melatonin use in the past 30 days. Surveys were conducted from January through April 2023.

Median melatonin dose was 0.5 mg in preschoolers, 1 mg in school-age kids, and 2 mg in preteens. The timing of melatonin administration was consistent, a median of 30 minutes before bedtime for each age group.

The frequency of mean melatonin use during the past 30 days did not differ significantly across age groups. Melatonin was most often administered either 1 day or 7 days per week.

Gummies were the most common form of melatonin used across all age groups (64.3%), followed by chewable tablets (27.0%), pills (6.3%), and liquid (2.4%).

"Widespread melatonin use across developmental stages may suggest a high prevalence of sleep disruption, which deserves accurate diagnosis and effective treatment," Hartstein and colleagues observed.

Study limitations included the survey's relatively small sample size and the homogeneity of the sample's demographics, the research team noted.

"Additional large-scale studies are needed to determine the specific indications for melatonin and to examine the effectiveness and safety of long-term use in children and adolescents," Hartstein and colleagues wrote. "Future work is needed to characterize the factors underlying parents' decision to administer melatonin to their children."

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