zombie apocalypse

Jenn’s Guide to Melatonin

One of the questions I get all the time is ‘You give melatonin to V right?  I think I want to start giving it to my kid, but I don’t know how much.”

I decided to put together a little FAQ, which turned into a bit of a novel.  Sorry.

But here is:

Jenn’s Guide to Melatonin


Now… first things first.

I am not a doctor, I only play one on Twitter.  This information only comes from my own personal experience and research.  It should NOT take the place of medical advice from your doctor or pediatrician.  Melatonin, like any drug, can have adverse effects, and as such, should be used carefully.  If you are considering using melatonin for your child, I strongly suggest consulting your child’s doctor or pediatrician to see if it’s right for them.

OK.  Now that’s out of the way.

What is melatonin?
Melatonin occurs naturally in your body.  It’s the magical substance that helps your body fall asleep by making you drowsy and lowering your body temperature.

So why would you need to take it in pill form if your body is already producing it?
There have been studies that prove that children on the autism spectrum don’t produce as much melatonin as normal.

It’s been my personal experience that this extends to a lot of kids with neurological or central nervous system impairments, as well.

These kids seem to fall into cyclical sleep patterns. I’ll use Vista as a specific example of what I mean by cyclical sleep.

At the beginning of her cycle she sleep like any normal kid.  The further she gets into her sleep cycle, the less she sleeps, until, at the peak of it, she might sleep an hour or two a night.  The rest of the time she’s wide awake.  Eventually her body becomes so exhausted that it forces her to start sleeping more and more, until we’re back at the beginning of the sleep cycle again.

One full sleep cycle for Vista lasts about 2 months.  So she might go without sleep for weeks at a time.

I, on the other hand, cannot go without sleep for weeks at a time.  I turn into a zombie.  (true fact – the zombie apocalypse is going to be caused by exhausted parents)

So, this is when we turned to our pediatrician crying “we can’t do this anymore *sob*” and he told us that
a) we were silly for waiting so long to talk to him and
b) to put her on melatonin, stat, or he would call the loony bin and tell them I was on my way in

How do I know if melatonin is right for my child?
Melatonin is not a cure all pill.  And it is certainly not right for every kid.

If your kid throws a temper tantrum every night when they go to bed, this is a behavioral problem.  Melatonin will not magically fix the issue.

If your kid likes to get up super early every morning, I can guarantee you that melatonin will not fix this issue (personal experience speaking here).

If, however, your kid just doesn’t seem able to sleep at night, or wakes repeatedly, then melatonin might help.

Melatonin is not meant for newborns or very young children.  Every parent with a baby is sleep deprived.  It’s a right of passage.  Get used to it.

By the time your child is 2 or 3yrs old, though, they should definitely be sleeping a full 8-10+ hours.

This is where I recommend you talk to your pediatrician/doctor, though, to see if they think this is a behavioral issue or a possible melatonin deficiency.

OK, my doc recommended melatonin.  How much do I give?
Again, I would talk to your doctor, but here is my personal experience with dosing…

Start slow and work your way up.  I cannot stress this enough.  Do not slam your kid onto a high dose of melatonin, because this is definitely a case where more does not equal better.

Too much melatonin can cause vivid, horrible, night terrors.  These will keep you up all night and can make kids afraid to sleep.  So, I say again – start at a low dose and SLOWLY work your way up.

Most melatonin comes in 3mg doses, as that is a ‘typical’ adult dose.  Check with your health food store to see if they care a 1mg dose for kids.  This will make it much easier to get an accurate dosage.

There are different forms that melatonin comes in – capsules, sub-lingual (pills that you put under your tongue), and strips (that you put on the tongue that melt).  We usually use the capsules and open them into a cup of milk that Vista takes half an hour before bedtime.

Start with 1mg.  Try this for a week, minimum.  Give it time to work.

If 1mg isn’t working, go up to 2mg.  Stay there for a week or two to see if it helps.

Continue like this, slowly increasing the dose, 1mg at a time, until it starts working.

How will I know if it’s working?
Oh, you’ll know.

The first morning you wake up and realize you got to sleep through the entire night rather than getting up with your kid for the first time in who knows how long?  Yeah, that’s when.

What’s the highest dose I can give my child?
The generally accepted answer to that is 9mg/night.  However, I don’t know anyone who has ever needed to give their child anywhere close to that.

Most people I know eventually settle in the 2-4mg range with their kids.

Do I have to give it every night?  How long should they be on it?
There’s no easy answer to this as it depends on your child.

First off, yes, you need to give it every night, while you’re using it.  And you should leave them on it a week or two, once you find the dose that works.

Sometimes that week or two is all kids need to reset their sleep clocks and they start sleeping through the night on their own.

You can try backing off the dose and see if the sleep problems come back.  If they do, return to the dose that was working.

Vista has been on melatonin for over a year and a half.  We have tried taking her off it, and the sleep issues returned, so her pediatrician recommended we leave her on it for the foreseeable future.

Over the past year and a half we have slowly increased her dose.  She was on 3mg for quite a while.  It’s only in the past few months that, due to a change in medication, we’ve had to bump her up to 4.5mg/night.  Now that her meds have been properly adjusted, we will probably try and take her back down to 3mg.

Will melatonin make my kid drowsy during the day?  Should I give it to them for naps?
No and definitely NO!

I have used melatonin myself.  You do not feel drowsy or ‘hung over’ like you can with sleeping pills.

Melatonin is meant for use at night.  It will not help your children nap and can actually throw off their natural sleep rhythms if you try and use it for that.

When do I give it to my child?
You want to give it to them half an hour to an hour before you want them to go to bed.   This gives it time to work.

This does not mean however, within an hour your kid is going to magically collapse in a pile of sugar plum dreams.

Unlike sleeping pills, melatonin does not put you to sleep, it merely prepares your body to sleep.

There have been times that we give Vista her melatonin at 7:30pm and she still ends up being awake until 9:30pm or later.

Where it does help is that, once your child finally decides to settle down to sleep, they’ll drift off faster and stay asleep.

Is there anything else I should know before giving my child melatonin or taking it myself?
Melatonin, like any drug, can cause adverse effects in people with health issues.  Always check with your doctor before starting to take it.

If you’re pregnant or breastfeeding, you should definitely not take melatonin.

A site I find to be a good resource is http://melatonin.com.  They have information on dosing, cautions, and research.

If there’s anything you think I’ve missed, or information that you feel is incorrect, please let me know.

Zombie Apocalypse

So, yes, Bil and I did manage to finally get out on Sunday for a few hours.  The lady who came to do respite for V was wonderful.  V didn’t even cry!!  Big win for us.  And we’re hoping to make it a weekly thing.

I was going to write all about it here, in more detail, but then Ali asked me to guest post for her.  And my brain cells are shot lately, so I wrote up a lovely post over on her blog about our dinner out, and how the zombie apocalypse is going to come and how mommy bloggers are totally going to rock it.  Or something like that.

PS.  For those who made the zombie list, thanks, and…uh… sorry about that.

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