Bedtimes became a hassle for Lorien’s neurodivergent son about a year after moving out of Vancouver to B.C.’s Kootenays. The lack of sleep that came with it was having an effect on his behaviour, his relationships and his happiness.
That’s why, after hearing a conversation in a health store that melatonin can be used for sleep, including with children, she thought she would give some to her son.
“One of the things that they had really emphasized in that conversation … [was] low dose is key,” she said. “What you want to do is give your child just that little tiny nudge towards sleepiness, not knock them off the cliff.”
Lorien, whose last name we’re not using to protect her child’s privacy, said it’s been working as expected so far.
“I started with just literal drops, and all of a sudden it was enough that at 20 minutes after taking them, we’d be all tucked in with our bedtime story and he would just feel sleepy,” she told The Current’sMatt Galloway.
Melatonin is a hormone that humans produce naturally through the brain’s pineal gland, and supplements can be bought over the counter as a sleep aid. And according to research in the U.S., it’s growing in popularity.
Dr. Michael Rieder, a pediatrics professor at Western University in London, Ont., says melatonin helps regulate a brain’s circadian rhythm — a system of physical, mental and behavioural changes that follow a 24-hour cycle.
“It’s been shown quite clearly, for instance, that if you have a disturbance in circadian rhythm … melatonin can help reset the circadian rhythm back to where it’s supposed to be,” he told Galloway.
An increasing number of parents are giving their restless children melatolin as a sleep aid, but some doctors are raising concerns about it. (Shutterstock)
Different effects on different kids
Dr. Suresh Kotagal, a professor emeritus in the department of neurology at the Mayo Clinicin Rochester, Minn., said it’s understandable why parents like Lorien turn to melatonin to help with their child’s sleep issues.
“Sleep is so important for children because it’s only when they have good, sound sleep at night that restorative functions in the brain start clicking,” he told Galloway.
“And the next day, after a good night of sleep, children are able to stay more alert and be happier and learn better.”
But he says that doesn’t mean melatonin is a suitable supplement for every child.
“In typically developing children who don’t have autism, I think I would look elsewhere for an answer to improving sleep rather than melatonin first,” he said.
Kotagal, who’s also the chair of the World Sleep Society’s task force, said there are studies that show the enzyme Acetylserotonin O-methyltransferase (ASMT), which is important for the body to make melatonin, is deficient in children with autism.
“So indeed, when we give melatonin to children with autism or other neurodevelopmental disabilities, we are improving or increasing the levels of melatonin in them,” he said.
Canadian sleep and drug safety experts say melatonin use has increased but that the supplement may not be beneficial for everyone. (CBC)
He and his peers are doing their own rigorous analysis of published data on melatonin use in children with autism and other neurodevelopmental disabilities between 2012 and 2022. They’re trying to learn more by studying roughly 850 neurodivergent children.
Still, he said evidence shows melatonin is helping children with autism and neurodevelopmental disabilities sleep better. But he says the evidence isn’t as clear with other children who just have difficulty sleeping.
Lorien’s son hadn’t yet been diagnosed with inattentive-type ADHD when she first got melatonin for him. But she said that at that point, “the risk of doing nothing was that my child was having a really, really hard time with sleep” and other aspects of daily life.
“So to me, the very small risk of the unknown was offset by the need to not just do nothing,” she added.
Melatonin won’t help everyone’s sleep issues, experts say
The use of melatonin as a sleep aid has significantly increased over the past two decades, but experts say it isn’t a cure-all, and taking too much can cause health problems.
Understanding the risks
Although the evidence for melatonin use in neurotypical children is soft, the supplement is widely used regardless.
That’s concerning to doctors such as Rieder, because he says there’s a risk of parents giving too much melatonin to their children.
“Melatonin doses that work in kids are very small. You don’t have to give a lot of melatonin to work,” he said. “The problem was if you give it [and] it doesn’t work, there’s a natural tendency to think, ‘Maybe they just need to go a little bit more.'”
Rieder said melatonin can be bought in a 10-milligram tablet, which is the right dose for an adult, but too much for a child.
But because it’s usually sold as an over-the-counter supplement in Canada, there’s no intermediary that can prevent parents from giving their children unnecessarily large tablets.
“You can go into your into your pharmacy and use a self-check and not even speak to a human person at all to get this dose,” he said.
According to data provided to The Current by SickKids, which operates the Ontario Poison Centre, the number of melatonin-related calls from Ontario, Manitoba and Nunavut for children five and under increased every year from 2017 (160 calls) to 2021 (438 calls.)
Lorien, who has started taking melatonin supplements along with her other child, understands this risk. That’s why she’s taking precautions such as breaks in usage to prevent overdose.
“We literally use scissors and we cut them into quarters in order to keep that dose low where we want the kids to be taking it,” she said.
Dr. Brian Goldman’s top five tips for overcoming insomnia
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Nevertheless, Kotagal suggests looking at other solutions to help tackle sleep issues.
He said if a child is below the age of two, nearby noise or medical issues may be the problem and those should be looked at first.
“When we come to older children, I would try behavioural sleep measures first. Go, if possible, discuss that with the primary care provider or sleep specialist.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
