Though produced naturally, melatonin is also available as a supplement in the form of pills and gummies to help those struggling with sleep. These supplements are used by adults to deal with their sleep problems, those with melatonin deficiency, and especially children with neurodevelopmental conditions like autism or Attention Deficit/ Hyperactivity Disorder (ADHD). While melatonin may be available over-the-counter (OTC), it may be considered safe if prescribed in the right dosage or taken in moderation.
Overdose of melatonin can cause side effects in both adults and children, says Dr Ilin Kinimi, consultant Pediatric Pulmonology and Sleep Medicine, Manipal Hospitals, Bangalore. However, usage of melatonin is best when it is consumed for a short period (less than two weeks) and at least two hours before bedtime if prescribed by an expert, says Dr Shyam Sundar CM, consultant Endocrinologist and Diabetologist, SPARSH Hospital, Bangalore. Excessive usage can lead to melatonin toxicity or poisoning, he adds.
CDC report shows melatonin poisoning in children
A weekly report by the Centers for Disease Control and Prevention (CDC) published in 2022 showed that from 2012–2021, the annual number of pediatric ingestions of melatonin increased by 530% with a total of 260,435 ingestions reported. Pediatric hospitalizations and more serious outcomes also increased, primarily because of an increase in unintentional melatonin ingestions in children aged 5 years and below.
Most children (84.4%) were asymptomatic. Among those with reported symptoms, most involved the gastrointestinal, cardiovascular, or central nervous systems. Among all melatonin ingestions, 4,555 (1.6%) resulted in more serious outcomes. Five children required mechanical ventilation, and two died. Both deaths occurred in children aged <2 years (3 months and 13 months) and occurred in the home.
Dr Yishan Xu, a licensed clinical psychologist and board-certified behavioral sleep medicine specialist (DBSM) says that Melatonin is not regulated by the US Food and Drug Administration (FDA), so it can contain a lot of extra ingredients in addition to melatonin.
Melatonin is not the same as sleeping pills, it can only prepare us to be ready for sleep but cannot make us fall asleep. Relying on something to make us sleep is never a good strategy, added Dr Xu.
Unregulated melatonin supplement usage in infants
When compared to Western countries, overdose of melatonin supplements in children aged below 5 years is less common in India. However, experts say the incidence of parents putting their infants on melatonin supplements is on the rise. “Parents are giving melatonin supplements to help promote better sleep in infants without an established circadian rhythm, frequent awakenings, and nighttime crying episodes.
“Melatonin supplements are largely believed to be harmless and are easily available over the counter. While the utility of melatonin to improve sleep in a select population of children with neuro behavioral disorders has been established, parents must exercise caution against indiscriminate usage which can be potentially dangerous,” says Dr Tejal Risbud Rao, senior consultant neonatologist & pediatrician, at Kauvery Hospital, Bangalore.
Is melatonin overdose common in adults?
It is not a surprise that many individuals, especially night-shift workers, tend to rely on melatonin supplements to overcome sleep issues like insomnia and jet lag. However, no such cases of melatonin overdose have been reported in adults so far, says Dr Sundar.
However, he mentions that in some cases like those with sleep-related disorders, sleep specialists might have prescribed melatonin supplements to be used only for a short duration. However, the individual might often end up using it for a prolonged period leading to overdose.
What are the alternatives to melatonin supplements?
Experts say that melatonin is usually recommended for individuals who are night-shift workers or those having jet lag and for children with neurodevelopmental disorders like autism, who have trouble falling asleep. But the long-term use can lead to adverse effects on a person’s health. They suggest the following ways to promote better sleep instead of relying on melatonin.
1.Maintain a consistent sleep schedule
At least seven hours of sleep is recommended for individuals to stay healthy. However, often they get less than seven hours of sleep affecting their overall health. Hence, going to bed and waking up at the same time every day, including weekends helps in maintaining the body’s sleep-wake cycle, thereby naturally promoting sleep.
2. Create a good sleep environment
Ensure the room is cool, dark, and quiet. Being exposed to light, especially in the evenings can make it difficult to fall asleep. Therefore, avoid using gadgets like smartphones before bedtime as the blue light emitted from these gadgets can interfere with sleep.
Following relaxation techniques like meditation before bedtime can help relieve stress and promote better sleep.
3. Manage daytime naps
Napping during the daytime for more than 30 minutes can leave an individual groggy. Hence, limiting daytime naps to less than 30 minutes can help promote better nighttime sleep.
4. Avoid heavy meals and stimulants before bedtime
Having large meals before bedtime can cause acid reflux, thereby disrupting sleep. Ensure to have your food at least an hour before going to bed to avoid discomfort. Drinking stimulants like alcohol and coffee close to bedtime can delay sleep.
5. Engage in physical activity
Regularly doing physical activities like walking, running, or going to the gym can help reduce sleep latency thereby promoting restful sleep. However, experts recommend avoiding strenuous exercises late in the evening or close to bedtime as it can have adverse health impacts.
Takeaways
- Melatonin is a natural hormone produced in the body, which regulates the sleep-wake cycle of an individual.
- Melatonin supplements available in the form of pills and gummies when not taken in the right dosage can lead to overdose.
- Creating a good sleep environment and avoiding heavy meals and stimulants like alcohol before going to bed helps to promote sleep.
