Melatonin is a dietary supplement regulated by the U.S. Food and Drug Administration (FDA) and available over the counter in a variety of delivery formats in the United States. Melatonin supplements may help regulate circadian rhythm to address insomnia in adults and primary sleep disorders in children. (2)(5)(6) Adults may opt for melatonin supplements over certain pharmaceuticals used for sleep issues that may lead to dependency. However, it’s important for all consumers to understand the realities of melatonin side effects. Recently, a report released by the Centers for Disease Control and Prevention (CDC) detailed a dramatic 530% rise over the last ten years in pediatric ingestions of melatonin, poisoning reports, and severe adverse events. (4) So how much melatonin is too much melatonin? Keep reading to learn more about how this commonly used sleep aid is being unintentionally ingested by children leading to overdose and posioning.
What you need to know about the rise in melatonin poisoning
In the past two years, melatonin use has dramatically increased, leading to an increased risk of children ingesting these products unintentionally. As a result, melatonin-related poison control center reports accounted for 4.9% of all pediatric ingestions reported in 2021. (4) The majority of these melatonin ingestions were unintentional, involved male children under five years of age, and occurred at home. Thankfully, most children were asymptomatic, but a small percentage of children were hospitalized and required intensive care. (4)
A number of factors may be contributing to an increase in melatonin poisoning in children and toddlers, including:
- There has been a rise in consumer demand due to an increase in insomnia concerns during the pandemic, sparking substantial 150% growth of the national melatonin market from 2016 to 2020. (4)
- Melatonin products are available in chewable and gummy formats—both of which are very appealing to a child.
- The largest increase in pediatric ingestion was seen at the onset of the pandemic, during daycare and school closures.
- Products may not be stored safely at home, resulting in easy access for children when unattended.
- Generally, low-quality over-the-counter melatonin products have a high variability in dose compared to label claims (-83% to +478%), lot-to-lot variability that may sometimes approach 465%, and contamination concerns with adulterants like serotonin (5-HTP). Chewables typically have the highest variability in dose compared to other delivery formats. (1)(3)
The bottom line
Reported melatonin poisonings are on the rise, especially among young children. Keep your children safe by storing all supplements in a secure, safe place. If your child experiences a melatonin overdose, contact poison control at 1-800-222-1222 in the U.S. or 1-800-268-9017 in Canada, or call 911 in the event of a medical emergency.
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- Erland, L. A., & Saxena, P. K. (2017). Melatonin natural health products and supplements: Presence of serotonin and significant variability of melatonin content. Journal of Clinical Sleep Medicine, 13(02), 275–281.
- Garfinkel, D., Laudon, M., Nof, D., & Zisapel, N. (1995). Improvement of sleep quality in elderly people by controlled-release melatonin. The Lancet, 346(8974), 541–544.
- Grigg-Damberger, M. M., & Ianakieva, D. (2017). Poor quality control of Over-the-Counter melatonin: What they say is often not what you get. Journal of Clinical Sleep Medicine, 13(02), 163–165.
- Lelak, K., Vohra, V., Neuman, M. I., Toce, M. S., & Sethuraman, U. (2022, June 2). Pediatric melatonin ingestions. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/71/wr/mm7122a1.htm?s_cid=mm7122a1_w
- Lemoine, P., Nir, T., Laudon, M., & Zisapel, N. (2007). Prolonged-release melatonin improves sleep quality and morning alertness in insomnia patients aged 55 years and older and has no withdrawal effects. Journal of Sleep Research, 16(4), 372–380.
- Wade, A. G., Ford, I., Crawford, G., McConnachie, A., Nir, T., Laudon, M., & Zisapel, N. (2010). Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: A randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety. BMC Medicine, 8(1), 51.