Could melatonin relieve self-harm in children?

By Steven Reinberg

health day reporter

MONDAY, March 27, 2023 (HealthDay News) — For children who are depressed or anxious, taking melatonin may help them get a good night’s sleep and therefore reduce their risk of harming themselves, according to new research.

The risk of self-harm increased before melatonin was prescribed and decreased by about half after children started taking the supplement, the study found. Teenage girls with depression or anxiety were most likely to benefit.

“This suggests that melatonin may be responsible for the reduction in self-harm rates, but we cannot rule out that the use of other psychiatric medications or psychotherapy may have influenced the results,” the lead researcher said. Sarah Bergen, from the Department of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm, Sweden.

“Melatonin is a natural hormone, and we believe the results are due to improved sleep,” she said.

The study cannot prove that melatonin caused the decline in self-harm, only that there appears to be a connection.

Of the more than 25,000 young people in the study, 87% suffered from psychiatric disorders in addition to sleep problems.

“Melatonin was probably just part of their treatment,” Bergen said. “We found that controlling the use of antidepressants did not significantly alter the results, but it is possible that other medications or psychotherapies contribute to the observed results.”

For the study, his team identified nearly 25,600 young Swedish people between the ages of 6 and 18 who were prescribed melatonin.

Most had at least one psychiatric disorder. Attention deficit/hyperactivity disorder (ADHD), anxiety disorders, depression or autism spectrum disorders were the most common. Girls were about five times more likely to harm themselves than boys, the study authors noted.

Self-harm can include cuts or burns, broken bones, and other behaviors that can cause injury or lead to suicide attempts.

“Melatonin does not have serious side effects and is not addictive, so its use to improve sleep in children and adolescents could be an important intervention strategy leading to a reduction in self-injurious behaviors in this population,” Bergen said.

An expert who reviewed the results agreed that the reduction in self-harm observed in the study is the result of better sleep.

“If you improve your sleep, your anxiety or your depression, your suicidal thoughts, your self-harming behavior all decrease,” said Dr. Sanjeev Kothare, director of the division of pediatric neurology at Cohen Children’s Medical Center in Queens, NY. .

Kothare said melatonin can help improve sleep if used correctly.

“One to three milligrams of melatonin should be taken an hour before sleep onset for best effectiveness,” he said. “It should not be repeated the same night because it will not work. You should not take more than 3 to 5 milligrams because it can be harmful.”

With or without melatonin, practicing good sleep habits makes a big difference, but Kothare said it can be hard for kids to stick with them.

The keys to getting a good night’s sleep are relaxing at 9 p.m. without a phone, tablet, TV, or computer. At 10 p.m., you can take melatonin if needed to help you fall asleep, Kothare said.

This pattern should become the norm for weekdays and weekends, with no naps during the day, he advised.

“Remove naps and maintain similar schedules on weekdays and weekends. Don’t have caffeinated beverages after two in the afternoon and don’t turn off lights at night,” he advised. “Use melatonin wisely and pack all the gadgets when it’s time to sleep.”

The results were published online March 23 in the Journal of Child Psychology and Psychiatry.

More information

To learn more about melatonin, visit the US National Center for Complementary and Integrative Health.

SOURCES: Sarah Bergen, PhD, department of medical epidemiology and biostatistics, Karolinska Institutet, Stockholm, Sweden; Sanjeev Kothare, MD, director, division of pediatric neurology, Cohen Children’s Medical Center, Queens, NY; Journal of Child Psychology and PsychiatryMarch 23, 2023, online