Tuesday 26 September 2017

Dear David Coleman: My nine-year-old son has trouble falling and staying asleep. Would melatonin aid this problem?

Be careful of letting children use screens in the evenings or close to bedtime. Stock image
Be careful of letting children use screens in the evenings or close to bedtime. Stock image

Clinical psychologist David Coleman offers parenting advice in his weekly column.

Q. My nine-year-old son has a lot of trouble falling asleep and also staying asleep on his own. He has been like this since he was a baby. At the moment he goes to sleep on his own but it could take an hour and we have to check on him every five minutes until he is asleep. He then usually wakes up at about 1am and comes into our room. We bring him back to his bed but he could back into us 10 minutes later. With all the disruption one of us usually ends up sleeping with him. Someone suggested melatonin, do you think it would work?

David replies: Disturbed sleep in children is, typically, exhausting for them and for their parents. No wonder you and your partner end up sleeping with your son if that always works to help him sleep easily and soundly. Most people will do almost anything to try to get a decent night's sleep.

To address your specific question, about melatonin, I will direct you to your GP. I do have some knowledge of it, and it's use to help children sleep, but only from my own research, not from either personal experience or any medical expertise.

Melatonin is a naturally produced hormone. It is released as part of our circadian rhythm as it gets darker, and aids our sense of sleepiness as the light fades. During daylight melatonin isn't released.

Some of the studies that have been done have found that things like the blue light from screen based technology, before bed, suppresses the release of melatonin, possibly making it harder to get to sleep.

The melatonin that you get from a pharmacy is a synthetic version of the naturally produced hormone. There is good scientific evidence available to show that it can help children to fall asleep quicker, but there is little evidence that it helps children to stay asleep.

From what I have read, there are few side-effects to using melatonin and it seems to be safe for children to use. The main potential side-effects include headaches, increased bed-wetting and morning grogginess.

The one area where opinion is divided, about melatonin as a supplement to help children sleep, is in the potential impact it may have on puberty-related hormones. Animal studies suggest melatonin might interfere with development during adolescence, but there have been no long-term clinical trials with humans to determine if the same effects are present.

So, this is the reason to discuss it's use, fully, with your GP. The quality and dose of melatonin is also important so don't be tempted to just buy it online. Talk to your GP or paediatrician and get a tailored prescription for your son, and only if your GP or paediatrician thinks it might help him.

Alongside, or instead of melatonin, there are some other things you might want to consider for your son and his sleep.

In order to fall asleep we need to feel tired, and we also need to feel safe, secure and comfortable.

So, look at your son's activity levels, his diet and the balance between his levels of movement and use of screen-based technology. Be especially careful of letting him use screens in the evenings or close to bedtime as they are likely to be especially disruptive to his sleep.

Next consider his sense of security at bedtime. It sounds like he still relies heavily on you both in order to feel safe and secure enough to sleep. That isn't a problem per se. But, no doubt you'd like him to become a bit more independent in due course.

To achieve that, it might be worth increasing your levels of support for a short time before weaning him off them. So, perhaps it is worth setting up a mattress or camp-bed in your room for him. Being physically close to you might help him to sleep more soundly.

If, by being this close to you, he can get into the habit of sleeping for longer periods, or in the best case, all night, it might sustain him when he eventually moves back into his own room.

While having him in your room might seem like a retrograde step, I think it could be the springboard for his developing independence and regulation of his own sleep habits.

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