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Melatonin should be last resort for child’s sleep problems

Q. My 8-year-old daughter has always had a difficult time falling asleep. Someone suggested melatonin supplements. Is melatonin a safe sleep aid for children? Are there any long-term side effects?

A. Sleep problems are common in childhood, but the majority are behavioral and can be managed without medication.

It’s important to promote healthy sleep hygiene, which includes:

• Regular sleep and wake times.

• A consistent bedtime routine.

• Avoiding light stimulation such as television and computers after dinner.

• Eliminating distractions at bedtime.

• Avoiding caffeinated beverages.

• Setting firm limits at bedtime.

If sleep problems persist, it may be time to loop in a health care provider. Some children may require a sleep study, medical testing or an anxiety evaluation. If medical issues are ruled out, melatonin is a reasonable next step.

Melatonin is a chemical naturally secreted by the pineal gland. It helps regulate sleep-wake cycles. Studies have demonstrated that taking supplemental melatonin about 90 minutes before bedtime can promote sleep. It is generally accepted as a safe medication for adults and children but should be used only when other causes are ruled out.