The hormone melatonin is produced naturally within the body in dark environments to help sleep preparation and has been authorised for use in those aged 55+, and it is known as being a less addictive and safer alternative to insomnia drug treatments.
It has not been licensed for use any other age group to aid sleep yet 117,085 patients under the age of 18 have been given melatonin off label in 2017-18, which is the term for when a drug is given for an unapproved indication or in an unapproved age group. 69,280 prescriptions were given to patients under the age of 18 in Jan- April 2018 alone. The number of children given melatonin has increased by 25% in one year from 92,511 in 2015-16 according to data collected by the NHS business services authority after a freedom of information request.
The increase has been driven by the rise in the number of children over the age of 7 given the drug using the modified release form that releases the hormone more slowly than liquid and tablet forms increasing by 42% in 3 years.
Experts have expressed concerns that the hormone may be being over-prescribed by paediatricians due to there being very few alternatives to support children with insomnia and other sleep problems.
When given as a medicine it is typically made synthetically with short term side effects being thought to be minimal including nausea, headaches, dizziness, and drowsiness. In the long term animals studies raise concerns of melatonin possibly affecting puberty related hormones.
Dr. Michael Farquhar explains prescription melatonin is not a good or bad thing, being right for the right child in the right context: it should not be a quick fix, behaviour interventions are more likely to be effective in the long term and better paediatric principle.
Melatonin appears to be relatively safe in short and medium term use, according to the National Institute for Health and Clinical Excellence, beyond 18 months this picture is unclear.
Dr. Max Davie says evidence of it being prescribed inappropriately is mainly anecdotal and hard to police since there isn’t anything else to offer, and to put those numbers into context the numbers represent roughly 1% of the child population, however if you think it is valid to give to those with sleeping difficulty among those with ADHD, autism, and learning difficulties that number is closer to 5%.
Lack of sleep is an often overlooked health crisis. More and more children and teenagers are faced with a mounting sleeplessness crisis, the numbers of younger people being admitted to hospital with sleep disorders has sharply climbed in 6 years. This study highlights the need for sleep services within children’s health services, it is not simply enough to only have a bit of advice and if that fails having to fall back on melatonin.
