Inadequate pediatric sleep is a major public health concern, especially for adolescents.1-3 In fact, about 70% of teens in the United States routinely sleep less than the 8 to 10 hours recommended by experts.4 These rates are particularly alarming considering poor and insufficient sleep is linked to impaired academic performance5, lower cognitive functioning6,7, poor emotional regulation8,9, worse mental health10-13, and negative physical health consequences such as increased risk of obesity.14-17
There are several evidence-based behavioral interventions to optimize sleep in youth.18 However, pediatric patients with sleep problems rarely receive treatment recommendations to improve their sleep difficulties19,20 which is compounded by the fact that there is an extreme shortage of behavioral sleep medicine providers in the United States. For example, in Los Angeles, California, the ratio of residents to behavioral sleep medicine providers is 1,000,000 to 1.21
Considering these barriers to accessing behavioral interventions, many professional and parents have turned to over-the-counter melatonin as a mean to treat sleep difficulties in adolescents.1,22 Melatonin use in children has significantly increased over the past decade, and it is listed as the second-most used natural product within a child population by the National Institute of Health.23 Further, adolescents are the most likely age group to be recommended melatonin for sleep difficulties.24 Though melatonin is considered a dietary supplement and is not regulated by the Food and Drug Administration like a typical medication, the general consensus remains that melatonin is a safe compound with only mild adverse side effects, such as headache, sleepiness, nausea, and dizziness.25 However, a vast majority of the findings on the safety and effectiveness of melatonin to treat sleep problems come from children with neurodevelopmental disorders or other medical conditions. Despite healthy, typically developing teens being at high-risk for sleep difficulties, there have been no large-scale, experimental studies examining melatonin use in this population.
Researchers at Loma Linda University are actively recruiting participants into a study that will help fill this gap. Dr. Tori Van Dyk from the School of Behavioral Health and Dr. Sunitha Nune from the School of Medicine are partnering to conduct an experimental examination of melatonin to better understand potential side effects and impact on sleep and daytime functioning in healthy, typically developing teens. Teens who participate in this study would wear a wristwatch-like device called an actigraph that objectively measures sleep and would complete a brief daily questionnaires for a 5-week period. During part of this time they would take melatonin and for the other part would take a placebo, both blinded to the participant. Participants and a parent or guardian would also attend three office visits to complete additional testing and questionnaires. Monetary compensation up to $250 to $350 is provided to those who participate.
To participate in the study, adolescents must be between the ages of 13 and 17 and have a self-reported problem with sleep (difficulty falling asleep, staying asleep, waking up, insufficient sleep, etc.). Adolescents may not have a diagnosis known to effect sleep such as epilepsy or a BMI over 30.
Written by Dr. Tori Van Dyk and Brooke Iwamoto
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- Owens J. Classification and epidemiology of childhood sleep disorders. Primary Care: Clinics in Office Practice. 2008;35(3):533-46.
- Carter KA, Hathaway NE, Lettieri CF. Common sleep disorders in children. American Family Physician. 2014;89(5):368-77.
- Wheaton AG, Olsen EOM, Miller GF, Croft JB. Sleep duration and injury-related risk behaviors among high school students—United States, 2007–2013. Morbidity and Mortality Weekly Report. 2016;65(13):337-41.
- Dewald JF, Meijer AM, Oort FJ, Kerkhof GA, Bögels SM. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep medicine reviews. 2010;14(3):179-89.
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- Kuula L, Pesonen A-K, Martikainen S, Kajantie E, Lahti J, Strandberg T, et al. Poor sleep and neurocognitive function in early adolescence. Sleep Medicine. 2015;16(10):1207-12.
- Vriend J, Davidson F, Rusak B, Corkum P. Emotional and cognitive impact of sleep restriction in children. Sleep Medicine Clinics. 2015.
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- Van Dyk TR, Thompson RW, Nelson TD. Daily bidirectional relationships between sleep and mental health symptoms in youth with emotional and behavioral problems. Journal of Pediatric Psychology. 2016;41(9):983-92.
- Steinsbekk S, Wichstrøm L. Cohort Profile: The Trondheim Early Secure Study (TESS)—a study of mental health, psychosocial development and health behaviour from preschool to adolescence. International Journal of Epidemiology. 2018;47(5):1401-i.
- Blake MJ, Allen NB. Prevention of internalizing disorders and suicide via adolescent sleep interventions. Current Opinion in Psychology. 2019.
- Carson, V., Tremblay, M. S., Chaput, J.-P., & Chastin, S. F. (2016). Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses. Applied Physiology, Nutrition, and Metabolism, 41(6), S294-S302.
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- Stone, M. R., Stevens, D., & Faulkner, G. E. (2013). Maintaining recommended sleep throughout the week is associated with increased physical activity in children. Preventive Medicine, 56(2), 112-117.
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- Chervin, R. D., Archbold, K. H., Panahi, P., & Pituch, K. J. (2001). Sleep problems seldom addressed at two general pediatric clinics. Pediatrics, 107(6), 1375-1380.
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- Andersen LPH, Gögenur I, Rosenberg J, Reiter RJ. The safety of melatonin in humans. Clinical Drug Investigation. 2016;36(3):169-75.