Melatonin and Treatment Breaks
Melatonin is a medication used to help children and young people establish a regular sleep pattern. However, the long-term safety of melatonin use in children has not been fully studied, so it should not be used indefinitely. Once a regular sleep pattern is achieved, some children may be able to maintain sleep without melatonin or may need a lower dose.
To check if melatonin is still needed, it is recommended that all patients have a treatment break every 6 months. Your specialist would have discussed this with you when melatonin was first prescribed.
Important:
Melatonin is not known to cause dependency and there are no known harmful effects if treatment is stopped suddenly. Taking breaks from melatonin helps assess if your child still needs it.
When is a good time to consider a treatment break?
It is important that you choose a time that is suitable for your family and circumstances where sleep disruption will have the least impact. School holidays are often a good time to consider a break.
How to carry out a treatment break. There are two possible options:
1. Stop melatonin completely for 1 to 2 weeks. This can be done at any dose.
2. Reduce the dose gradually. The dose can be reduced by up to 2 milligrams every 4 to 6 weeks, at a pace that feels comfortable for you and your child.
What happens during a treatment break?
If there is no change in sleep (e.g. no issues getting to sleep, waking up, or sleep quality), then melatonin should be stopped. Inform your GP.
If the sleep problems return, restart the melatonin and increase back up to the dose that works. Inform your GP of the new dose, if lower than before and plan another treatment break in 6 months.
Good sleep hygiene: Good sleep habits are important for healthy sleep, whether or not melatonin is used. Maintaining good sleep hygiene will support your child’s sleep even if your child’s sleep, even if melatonin is stopped.
Sleep hygiene advice is available from the following websites: Headspace Relaxation Tips - The Sleep Charity
Dr Gabrielle Pendlebury MBBS MSc MRCPsych LLM is a UK Consultant Child and Adolescent Psychiatrist with specialist expertise in neurodevelopmental conditions in children and young people.
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