SIOUX CITY — Harmful exposures to a popular over-the-counter sleep aid have skyrocketed amid the COVID-19 pandemic, according to data from the Sioux City-based Iowa Poison Control Center.
“Over the last few years, we’ve noticed that our numbers are increasing on exposures to melatonin. We’re seeing a lot more kids who are getting into it,” said Tammy Noble, the IPCC’s education coordinator.
The IPCC’s trained nurses and pharmacists recorded 789 melatonin exposures in 2020, nearly a 50% increase from the 523 exposures recorded in 2018. Exposures fell slightly in 2021 to 764, but still remained well above the total number of melatonin exposures tallied in 2018 and 2019 During that four-year period, 67% to 71% of melatonin exposures reported to the IPCC involved children under 6.
Melatonin, a hormone produced by the pineal gland in the brain, plays a role in regulating the sleep-wake cycle. Even though natural and synthetic versions of melatonin are sold in pill, liquid and gummy form at pharmacies, big box stores and gas stations, melatonin is not officially approved by the US Food and Drug Administration for any use.
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Dr. Steven Joyce, a MercyOne Internal Medicine and Pediatrics physician, said the global COVID-19, which is in its third year, has “worsened” just about every aspect of mental health, which sleep is closely connected to. Therefore, it’s likely more people are turning into melatonin to cure their sleep problems.
“I think we’ve seen an increase in all sorts of anxiety-related issues with sleeping,” said Joyce, who speculates that the majority of young children being exposed to melatonin are accidentally getting into their parents’ supply. “There are certainly parents who are giving their kids melatonin for sleeping.”
Bill Drilling, co-owner of Drilling Pharmacy in Morningside, described melatonin sales as “steady.” He said he has suggested melatonin to customers who are having trouble sleeping. However, Drilling said children under 12 should not take melatonin unless they are using it under a doctor’s supervision.
“Part of the problem is there’s not really a good over-the-counter sleep medication,” said Drilling, who advises adults wanting to try melatonin to take one 3 milligram dose at night to start with and see how they feel. “(Melatonin) is something that is naturally occurring in the body, but research shows the level of melatonin goes up at night. So, they’re kind of hypothesizing that a higher melatonin level helps people sleep.”
According to Nielsen data, Americans spent nearly $826 million on melatonin supplements in 2020, an increase of nearly 43% from the year before.
Noble thinks the ease at which melatonin can be purchased is one of the reasons why some adults have resorted to consuming it and even giving it to their children. Since melatonin doesn’t always come sealed in child-resistant packaging and parents may not be storing it properly, Noble believes children are accidentally getting ahold of it at the bedside and taking too much.
“It looks like candy. It’s available in tablets, chewables, gummies and even liquid,” she said. “Because kids like the taste of it, they may be more inclined to just eat one or two. They may go after the bottle and eat a whole bunch.”
Most of the time, Noble said a melatonin exposure involving children can be managed at home. She said drowsiness, lethargy and fussiness are common side effects. The following symptoms warrant a trip to the emergency room: confusion, unsteadiness while walking, irritability that can’t be consoled, slow breathing while napping, hallucinations, tremors and slurred speech.
It’s OK to let the child nap, but you want to make sure that you’re checking on them frequently to make sure they’re easily arousable, they’re breathing normally, they’re changing positions that you would normally expect a child to do,” said Noble, who said she is not aware of any children having died from melatonin exposure.
Joyce said melatonin is difficult to overtly overdose on, and, he isn’t aware of any fatalities, either. He noted that melatonin is only available in European countries by prescription.
“Just giving a pill to fix a sleep problem isn’t necessarily the best way, especially in young children,” he said. “We have very little evidence to show that melatonin is effective to any significant degree in kids, or adults for that matter. It can help people fall asleep a few minutes earlier, but in overall sleep quality and such, the data is not really robust in providing it’s effective.”
Joyce said adhering to a consistent bedtime, turning off the TV, and putting away smartphones, computers and other blue light-emitting devices earlier on in the evenings are key in maintaining good sleep hygiene.