The Sleep Crisis: Addressing Melatonin and Tech as Sleep Aids

The Screenagers Podcast - A podcast by Delaney Ruston, MD - Lunedì

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In this episode of the Screenagers podcast, Dr. Delaney explores the alarming rise of sleep deprivation among teens starting in 2012, coinciding with the rise of screen time. Featuring clips from Screenagers: Elementary School Age Edition and insights from experts Lauren Hale, PhD, and Judith Owens, MD, the episode delves into new brain science around kids and sleep deprivation and health risks linked to melatonin.  Listeners are provided practical advice on how to promote healthy sleep habits, including preventing dependency to digital devices and melatonin.  Time Codes: 00:00 Introduction to Screenagers Podcast 00:29 The Sleep Deprivation Epidemic 02:08 Scientific Insights on Sleep and Brain Health 03:47 Impact of Devices on Sleep 06:23 The Melatonin Debate 08:33 Melatonin Usage and Risks 12:49 Melatonin and Puberty 14:00 Concerns About Long-Term Melatonin Use in Children 14:43 Marketing Melatonin as a Natural Sleep Aid 15:36 The Dangers of Conditioning Kids to Need Sleep Aids 18:03 Parental Strategies for Managing Device Use 19:28 Real-Life Examples of Device Management 21:19 Encouraging Better Sleep Habits in Teens 23:14 Final Thoughts on Melatonin and Sleep Dependency 25:11 Conclusion and Podcast Information Resources: Lauren Hale, Ph.D.  Bio: https://publichealth.stonybrookmedicine.edu/faculty/LaurenHale Study #1 “Researchers followed nine and ten year olds, and at baseline, they collected data from the kids, from the parents, and analyzed brain skins. Then they followed up with them two years later. The kids, who were insufficient sleepers Compared to the kids who were sufficient sleepers, had changes in their brain development, especially in areas like the basal ganglia and the temporal lobe. And this corresponded with worse mental health outcomes, worse behavioral outcomes, and measurements of intelligence were lower. This is concerning that insufficient sleep among kids may have lasting consequences. Um, brain development, and possibly into adulthood.” Yang, F. N., Xie, W., & Wang, Z. Effects of sleep duration on neurocognitive development in early adolescents in the USA: a propensity score matched, longitudinal, observational study. The Lancet Child & Adolescent Health, 6(10), 2022.   Study #2 “My team and I analyzed numerous studies in which we included youth age 6 to 17. And we showed that just having a mobile device, which includes a phone, a tablet, In the bedroom, even if they didn't use it, was associated with almost a two fold risk of insufficient sleep duration.” Carter, B., et al. Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis. JAMA Pediatrics, 170(12), 1202–1208, 2016. Judy Owen, M.D.  Bio: https://www.childrenshospital.org/directory/judith-owens Study #1 "Recent study... over 500 percent increase in accidental ingestions of melatonin... poison control center reports of a child accidentally taking melatonin." Centers for Disease Control and Prevention. (2022). Pediatric Melatonin Ingestions — United States, 2012–2021. Morbidity and Mortality Weekly Report, 71(22), 725–729.   Study #2 "...study that was published out of Canada a few years ago that looked at a wide range of preparations of melatonin that were labeled as being five milligrams. And they... analyzed, with a specific chemical test, how much melatonin these preparations actually contained. It ranged from zero milligrams to 20 milligrams. And in addition to that, about a quarter of the samples they tested had serotonin... Serotonin is what we call a precursor of melatonin. So serotonin is metabolized into melatonin." Erland, L. A. E., & 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.   Study #3 "We know that melatonin... has an effect on reproductive hormones... There may be some impact on pubertal development of melatonin. Melatonin in humans could potentially have two different effects. It could delay the onset or the beginning of puberty development because it has these suppressing effects on reproductive hormones, or alternatively, if you stop melatonin use in a prepubertal child... you could actually trigger them into early puberty... We have data in animal models that suggests that melatonin has these effects. We don't have that evidence yet in humans... One study looked very short term on the effects of melatonin in children with autism and measured their reproductive hormones as well as some other chemicals in the body and brain and did not find any effect in the short term, but again, the long term meaning of melatonin... years worth of use of melatonin." Boafo, A., Greenham, S., Alenezi, S., Robillard, R., Pajer, K., Tavakoli, P., & De Koninck, J. (2019). Could long-term administration of melatonin to prepubertal children affect timing of puberty? A clinician’s perspective. Nature and Science of Sleep, Volume 11, 1–10.

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