If a mom can’t get her kids to fall asleep, what else is she supposed to do?
If we were sitting in a physical room right now, and I’d asked you how many of you have heard of melatonin, I’m guessing all hands would go up.
And if I’d asked how many of you have taken or given melatonin, I’m pretty sure most hands would be up.
But if I asked you what melatonin looks like, I bet you’d be thinking of a nice little bottle that has the word “MELATONIN” printed in thick black letters and comes with little pills or gummies inside. And I’d say: uh-uh-uhhhh. Not so fast, my dear.
What is melatonin?
Plain and simple, melatonin is a hormone.
So: what is a hormone? A hormone is a chemical substance that the brain releases to tell the body to do something. (Science lesson over now, kay? You can pay attention again)
And, melatonin tells the body to do a whole host of tasks, including optimizing your body for sleep.
Whose bodies make melatonin? Everyone’s.
Who needs melatonin? You got it: everyone.
And… who’s deficient in melatonin? Well… quite nearly no one. There have been some studies that point to a deficiency in melatonin for those on the autistic spectrum, but aside from that specific group, we all have the ability to create the melatonin our bodies need for us to
- Fall asleep
- Stay asleep
- Sleep well
I’ve got hormones, how ‘bout you?
I’ve got melatonin, you’ve got melatonin… So what’s the difference between the bottled little tablets or gummies and the stuff that our brains send racing through our bloodstream?
Well, let me answer that by asking you this: what’s the difference between thyroxine (the name of the T4 thyroid hormone) and synthroid? What’s the difference between oxytocin and pitocin? What’s the difference between human insulin and synthetic insulin?
And then let’s take it a step deeper: what’s the difference between synthroid, pitocin, and synthetic insulin as a group, vs. the melatonin you purchase at your local health food store or grocery?
There are a few differences:
- The first group of synthetic hormones mentioned are used when there is a deficiency of that hormone within the body to affect the outcome needed vs. melatonin is used even when the body is capable of producing the hormone.
- The first group of synthetic hormones are FDA regulated, measured, given by prescription only, and dosed properly vs. melatonin is treated as a “natural remedy” and is available for purchase over the counter – even though it is also a hormone, and one that plays a role in puberty.
- The first group of synthetic hormones are only available to the public after being tested for efficacy and screened for potentially problematic outcomes vs. melatonin which, in addition to the fact that it is not dosed, FDA regulated etc., also does not have any true studies that prove its efficacy and safety (which means that, no that bottle of melatonin in the store is not proven to be safe – you can read more on that HERE.)
How to fix the problem without melatonin
When children (or adults!) struggle with sleep, the problem is not their ability to produce melatonin. They can make enough melatonin just fine, thank you very much. The problem usually boils down to one of three things (or a combination of some or all):
- Lack of sleep hygiene preventing optimal melatonin levels.
Could there be something causing a problem with your/your child’s melatonin levels? Yes, yes, and yes! But giving synthetic melatonin is putting a band-aid on this (and may also teach the brain to stop producing its own melatonin – not a good idea).
Set your child (or yourself) up for sleep success by setting the stage for sleep by removing all screens from the hour or two before bedtime, having a bedtime routine, having a cool and truly dark (like the type of pitch-dark that you get in a blackout!) sleeping environment.
- Not having the tools to calm down their brains and bodies to go. to. sleep. (This tends to be more common with particularly bright and deep thinking children/adults).
When children are very active mentally during the day, it can be hard to relax the mind – as well as the body – to allow sleep to come. Help your child relax her body with guided relaxation – either one that’s pre-recorded or by guiding your child through a full body relaxation yourself.
If your child (age 3-4 on up) has struggled with falling asleep for a while now, he may not believe that he can fall asleep (and the melatonin has been acting as a placebo!). Teach him about how his body works, so that he understands that he can fall asleep. As you’re going through the bedtime routine, talk about how his brain and body are getting ready for sleep. And, most importantly, you need to believe that he can fall asleep on his own, as well. (Did I say enough here to convince you yet?)
And, particularly with older children, teens, or adults who know the negative effect of not getting the sleep they need, oftentimes they become stressed when they can’t fall asleep – for fear of what tomorrow will look like. Ironically, it’s that very stress that prevents sleep from being able to come!
Some relaxation (mentioned above) will help, but so will letting go of control. Recognize that ultimately, we can only do our hishtadlus in any given situation, and the rest is up to Hashem – both falling asleep, as well as how much energy we have during the next day. If you’ve done everything you can to help yourself fall asleep, and sleep is still not coming, experiment with letting go of making yourself fall asleep, and just allow yourself to relax. You can visualize yourself in Hashem’s hands, or visualize Him sending you sleep, without you needing to make it happen.
- It’s behavioral.
All of our children need to have love, security, attention, and some level of control over their lives. Different children need different amounts of each, and some are, by nature, more “needy” than others.
When our children don’t get these emotional needs met in positive ways, they will seek out ways to get them in the easiest ways they know, which, unfortunately, often end up being negative, and also usually end up happening during pressured times of the day: the morning routine and bedtime.
If your child is seeking out that control, security, and attention/love during bedtime (especially if it’s in a negative way, ie by being yelled at, consequenced, etc.), the best way to ensure that they fall asleep easily is to BOTH:
- Give them the love/security/attention/control they need during the daytime – before you hit the time they’re supposed to be going to sleep.
- Remove that attention/control/etc. from the bedtime/evening situation.
Here are some ideas of how to give your child what they need during the day (for a variety of ages):
- Small silly choices: if it doesn’t matter to you, let them choose. What she wants in her hair, which shoes he wants to wear, what clothing/pajamas to wear today, you brush his teeth first or he does, choose which book for bedtime, walk fast or slow, hold him or hold his hand, etc. Any place that you can turn a command (put on your pjs!) into a choice (which pjs do you want to wear tonight?), let him take control there.
- Asking advice. It may sound funny to ask your child for advice, but when used in an appropriate scenario and structured properly, it can help a child feel that you’re confident in him/her and also give some control and attention. Here are some examples:
- (for an older child) “Shany, can you help me out with this? I know you love making fancy lunches for yourself, and I love that you’re able to put together lunches that you’ll enjoy. Sometimes the process ends up starting really close to bedtime, and you end up either being rushed or not getting enough sleep to be able to wake up refreshed the next morning. What do you think a good solution for this would be?”
- (for any child) “Moshe, what do you think: the baby’s throwing all of his sweet potatoes on the floor! What do you think he would want to eat today?”
- (for a younger child) “Hmm… what do you think we should do, Chava and Shimmy: there is only one mango left and BOTH of you want to have it! What is a way that everyone can get something they like?”
- Meaningful moments. If you can give each child special time with you/your husband daily, you’re a superstar. For most of us, though, finding that time every day can be difficult, and that’s where meaningful moments come in. Simply noticing your child (“I see you’re playing with blocks now, Yossi”), giving a random hug, pat on the back, kiss etc. just because, or grabbing a minute to whisper something that you appreciate about them in their ears.
Simultaneously, create appropriate rules/guidelines about what you expect in the evening, including when bedtime routine starts, when lights go off, and after which point they need to stay in bed and/or you will not go to them anymore. Remember that just making rules won’t mean they’re actually going to be followed; it’s up to you to follow through and enforce the guidelines you’ve put into place. When changing a habit, it is also often helpful to reinforce the change for your child with small, appropriate, and immediate rewards and consequences when you’re just starting out.
Editor’s Note: Some children take melatonin under dr. supervision or on occasion. Consult with your own medical professional on whether occasional use is fine for your child.
Thanks so much, this is exactly what I needed to read right now.
Glad you found it helpful, Chaya!
Chaya Shifra
Sigh. I have one who has had sleep issues even before he was born. (Anyone else have one who you began feeling moving around a 9 weeks and Never. STOPPED?)
Me!! I thought I was the only one! SAME!
Anyway, we've done it all– sleep hygeine, regular bedtimes and routines, schedules, screens off 2 hrs before bed (more difficult with homework on chromebooks), consultations with pediatric neurology, now attempting to schedule a sleep study. Melatonin has been the ONLY thing that has even slightly assisted this child's sleep. 30mg of it– which has been approved by his drs. We try to get him off, which may work for a week, maybe 2, and then we're back on, always trying the lowest dose possible.
So please don't knock it. Yes its a hormone. But with certain children, it may be the only way to get enough rest to be at their best during the day. (And yes, this kid has serious combined-type ADHD. He does very well and is developing coping strategies.)
Hi Brenda,
I’m sorry that you’ve struggled so much with your child’s sleep, and so admire all the hard work that you’ve clearly invested in meeting his needs.
The goal of this post was not to knock melatonin, it was to create awareness about melatonin overuse, and understanding that it is not the be-all-end-all of children’s sleep difficulties. As I mentioned above, most are giving OTC melatonin without guidance from a doctor (or with guidance from a doctor who is not up to date on the research) — and, as that’s clearly not the case for you, melatonin may truly be the correct option for you and in your situation.
I’m not here to give anyone personal advice, and definitely not medical guidance; my goal is to raise awareness and to educate.
Kol haakvod to you for knowing your child, being his advocate, and finding medical professionals who can offer the best possible solutions for your circumstances.
Best,
Chaya Shifra
This 100%! I have ADHD myself and always needed melatonin. My brain simply won’t turn off, no matter how exhausted I am. I’ve tried all the techniques here, but they only apply to (and are only relevant for) neurotypical people. It’s not one size fits all.
Hi Mindy,
Thanks so much for your comment and input.
Because there are so many factors, and discussing them all would fill a book, I was limited by what I was able to include in this post, and, yes focused on the most commonly helpful techniques. The goal of this post was to provide information about melatonin, as well as what some other options might be for those who have not yet tried them. While those who are not neurotypical may need more specialized recommendations, that does not mean that *none* of these would be helpful for *anyone* who is not neurotypical.
And, of course, any time a professional (regardless of the subject matter) is writing a blog post for the public at large, they are going to have to use generalizations even though, as you mentioned there is no one-size-fits-all (because there can’t be!).
For yourself – if you have not yet, seeing a qualified CBT-I therapist, who specializes in helping adults with insomnia, may help you find the specialized techniques you need to enable you to fall asleep more easily.
Thank you again for your input in the conversation!
Best,
Chaya Shifra
Thank you so much for this article. I can personally attest to this because I have a 9 year old daughter who is a deep thinker & a bit of an anxious child & has such a hard time falling asleep at night. I gave her melatonin for a long time & one day after consulting with a wise & experienced pediatrician, weaned her off of it & changed my whole mentality of obsessing about when she’ll fall asleep. She (& I) became more relaxed & she falls asleep so much easier & bedtime isn’t as much of a struggle. It’s worth the effort because with most kids it’s possible to fall asleep with out the melatonin ( it’ll just take time & patience) Thanks again for a great article!
Hi Tzippy,
I’m so glad that you appreciated this article, and that you had that wise pediatrician to turn to to help you through weaning your daughter off of melatonin. It is such an empowering feeling for our children (and ourselves!) when we see that they are able to do it on their own.
Chaya Shifra
Hi tzippy,
I’m wondering if you can share with us readers some tips on weaning off of melatonin. My son is 12 years old and has been taking it for a few years. He is also a deep thinker and would be up until 12, 1 am.
This article is great! Thank you for publishing! You talk about relaxation techniques for children over age 4. Any specific suggestions?
Hi Miri!
You are so very welcome – I’m glad that you benefitted from this article. Some ideas for relaxation techniques might be from something as simple as deep breathing (3-4 counts in, 6-8 counts out), or something a little bit more complex like guided relaxation. You can talk your child through their bodies, head to toe, and have them feel each part of the body relax in turn (kind of like the SandMan game I used to play when I was a kid – do you know what I’m talking about?). You can also have them imagine a light, or feel your touch and use that to guide them in relaxing each part of their bodies.
Let me know if that helps!
Chaya Shifra
Something else to consider – i have a child who is sensory and couldn’t fall asleep or would keep waking up.
He would come into my room frequently and I would let because that’s the only way he would sleep.
I kept trying to stay away from melatonin but would inevitably give it to him a few times a week.
Someone told me about a weighted blanket, i didn’t buy it i just had a really heavy blanket at home and that really helped!
BH
Hi Malka!
I’m glad you were able to find a solution that worked for you! If your child is sensory, then a weighted or heavy blanket can be helpful in calming the CNS, or you can ask your OT for specific ideas based on your child’s needs.
Love that you shared what worked for you here!
-Chaya Shifra
Hi. I used melatonin on my 4 year old son last summer
When I wanted to wean him off I started giving him a vitamin at night instead
Any recommendation for a 4 year old who wakes up during the night (she still has a paci- hopefully not for too much longer, but not sure that’s the only cause), sometimes will go right back to sleep with a parent’s calming, other times takes a long time to fall back asleep?
And the part that is even more challenging , her brother who shares her room (6 yrs old) will often wake up from her if it’s 4am or later (prior to that, he is a pretty deep sleeper), and he cannot fall back asleep. He typically wakes up around 6 or slightly before, so he has had almost his full amount of sleep but not quite, and he rarely falls back asleep if he was awakened. (There is no other bedroom to separate them on an ongoing basis- have tried putting one of them in our room on a short term basis when needed… but this did not have any long term gain)
Thank you!
Hi there,
Thanks for commenting with this question. I understand how difficult it must be that your 4 yo keeps waking up at night, and wakes your 6 yo as well.
While every single family and situation is so different, the foundation is always the same: to get to the root of *why* she’s having those wakes. The paci could definitely be a cause, but is there something else going on as well? Screentime before bed? Light pollution filtering into the room? Is there something behavioral going on? What does she ask for when she wakes? All of these are clues that can lead you to the root cause.
Once you’ve determined why she’s waking, create a plan to address it, move your 6 yo out for a shot transition period, and then you’ll be able to move him back in once she’s sleeping better.
Hope that helps!
Chaya Shifra
Two more great tips to help kids and adults fall asleep
for kids – boring stories read to them on podcast. I found https://app.kidslisten.org/pod/The-Calm-Kids-Podcast and my four year old was asleep within minutes.
For adults, Natural Calm brand magnesium powder helps me get a great night’s sleep.
Im surprised there was no mention of making sure kids get enough outdoor time during the day in order to fall asleep at night. I’m not an expert, but I learnt that the sun suppresses the bodies natural melatonin, and then when I gets dark out, all the melatonin is released and signals our bodies to go to sleep. I have found that when my kids spend a good amount of time outside, they always sleep better, especially when their toddlers and still struggling with sleeping through the night. I’m sure the fresh air also helps.
Hi Naomi,
Thanks so much for your comment and input.
You are absolutely right; time outside – for the sunlight, physical activity and fresh air – is absolutely one of the factors that enables children (and adults!) to sleep well.
Because there are so many factors, and discussing them all would fill a book, I was limited by what I was able to include in this post. I so appreciate you adding this information to the discussion!
Best,
Chaya Shifra
Hi, Chaya Shifra!
I was reading the article and thought to myself, "This sounds just like something Chaya Shifra would write"… and sure enough :).
Hi Adina!
Yep, it’s me! Hey right back at you 😉
Chaya Shifra
I always wonder when mothers say their kids NEED melatonin to sleep… hmm we give our kids processed foods with sugar and caffeine and wonder why they won’t fall asleep?
(I’m actually unfortunately not one of those that manage to serve healthy – but I see a stark difference on the nights my kids have caffeine or not. We used to allow any soda on Friday night and when we switched to one cup of caffeine free (sprite! Nothing healthy!) it was game-changing!
Even if you would never let your kids have soda his Rebbe probably gave him one as a reward … oh and then we wonder why the English teachers have such a hard time!