A Parent's Guide to Sleep Aids

Little bodies need a lot of sleep. Did you know that kids do their best learning and all of their growing while they sleep? Although it’s crucial for our little ones to get a good nights’ sleep, the process can be a real hassle.

Our pediatricians always recommend conservative measures first. Kids should have a routine sleep schedule: Going to bed and waking up around the same time each day. A warm bath or a soothing environment can help them wind down, too. But when all else fails, it may be time to reach for the occasional sleep aid.

Let’s look at two common over-the-counter (OTC) sleep aids to determine the pros, cons, efficacy, and risks of each: Melatonin and Diphenhydramine (Benadryl®).

Is Benadryl® a Safe Sleep Aid for Children?

Benadryl® is one of the oldest and most frequently used OTC medications for kids. It’s an antihistamine: Intended to relieve allergy symptoms like watery eyes or a runny nose. The active ingredient that causes drowsiness is called diphenhydramine.

Diphenhydramine is very potent: It works faster than melatonin, taking effect in about 30 minutes. But unfortunately, diphenhydramine tolerance can occur, meaning it can lose its efficacy if taken more than three days in a row.

In most cases, doctors do not recommend using Benadryl® as a sleep aid for kids. It’s not approved for use as a children’s sleep aid and there are several risks associated with taking it.

Risks of Benadryl® as a Sleep Aid

Benadryl® stays in your system for 16 hours, meaning it can have lingering sedative effects after waking up. This can slow down a child’s reflexes and impair their motor skills. In fact, pilots are not permitted to fly for 30 hours after taking one dose of Benadryl®.

Benadryl® can have an opposite effect. Hyperactivity occurs in roughly 10-15% of children who take Benadryl®.

Sleep is not its intended use. Benadryl® affects REM sleep by keeping a person in a light sleep state and preventing them from entering deeper, more restful, and restorative stages of sleep.

Finally, it’s not safe for all children. Children under age two should not take Benadryl® for any reason as antihistamines can cause life-threatening side effects like convulsions, rapid heart rates, and decreased levels of consciousness.

Is Melatonin a Safe Sleep Aid for Children?

Melatonin is a hormone our bodies make in response to darkness. As night falls, melatonin levels go up, signaling to your body that it’s time to fall asleep. Melatonin supplements typically contain a lab-made version of melatonin.

Melatonin does not work as fast as diphenhydramine; it can take up to a couple hours to kick in. But when compared to other sleep aids, melatonin does help people fall asleep an average of nine minutes faster than usual, and it may improve sleep quality by a small amount.

Pros and Cons of Melatonin for Children

Pro: Melatonin is naturally occurring in our bodies. This supplement helps the pineal gland in our brain signal to our bodies that it’s time for sleep. Children who have a rocky sleep-wake cycle due to inconsistent bedtime, screen-time after dark, or hyperactivity disorders can benefit from occasional melatonin.

Pro: Melatonin is not habit-forming. It’s been studied and found safe for occasional restlessness in adults and children. However, melatonin has not been approved by the FDA for childhood sleep disorders.

Con: Melatonin is a supplement, not a drug, so the industry is unregulated. As a result, the actual concentration of melatonin contained in different products and formulations varies. Learn more about finding reputable sleep supplements here.

Con: The side effects of taking melatonin as a child are not fully known. Some parents have reported symptoms like bedwetting, drowsiness, headaches, and agitation. Parents should also be aware of the risk of accidental overdose and work closely with their child’s pediatrician on the use of melatonin.

Melatonin Dosage for Children

If your child is struggling to fall asleep or get sufficient sleep, discuss trying melatonin with their pediatrician. Melatonin is a possible short-term strategy for helping kids achieve quality sleep. Though research is limited, studies of select groups of children provide promising evidence of melatonin’s efficacy.

• Preschoolers (under age 5) can take between 1 - 2 mg melatonin
• School-age children (6 to 12) can take 1 - 3 mg melatonin
• Adolescents to adults (13+) can take 1 - 5 mg melatonin

Always start with the lowest possible dosage that provides results. Keep your doctor informed about how much they take and any concerns.

How Much Sleep Should My Child Get?

The American Academy of Pediatrics recommends minimum and maximum hours for each age group in a 24-hour period. They are:

• Ages 4-12 months: 12-16 hours (including naps)
• Ages 1-2 years: 11-14 hours (including naps)
• Ages 3-5 years: 10-13 hours (including naps)
• Age 6-12 years: 9-12 hours
• Age 13-18 years: 8-10 hours

Sleep aids are a temporary option for occasional restlessness. If your child struggles with adequate sleep or if you have concerns about a hyperactivity disorder, please contact their pediatrician to create a holistic plan around better sleep. You can check out our Northern Utah pediatricians here.