What to Know About the Rise of Nighttime Melatonin and CBD Use Among Teens

Teenagers today have a lot on their minds. After living through a global pandemic, parents losing jobs, and uncertainty about the future, teenagers have a hard time getting restful sleep. A recent Sleepopolis survey found 55 percent of parents reported their teens had trouble sleeping.

What’s keeping kids up? Sleepopolis asked, and parents said this is what most concerned their teens:

1. School performance: 48 percent
2. Their appearance: 40 percent
3. News stories (current events and politics): 34 percent

Teens most commonly reported problems with sleep latency, or falling asleep (51 percent) and trouble waking up (36 percent). When Sleepopolis asked teens what stopped them from falling asleep, here were their top three responses:

1. My future: 77.7 percent
2. Money issues: 63.3 percent
3. Friendships and relationships: 63.3 percent

In an effort to help their kids get better rest, 34 percent of parents said they have tried giving them melatonin or other sleep supplements. And while many report these supplements do the trick, some worry they aren’t a long-term answer. In this article, we’ll dig into what makes melatonin and CBD work, and when you might want to start looking for other sleep aid options.

What Are Melatonin and CBD?

Melatonin and CBD are two popular sleep aid supplements and they each work differently to get the job done. And when it comes to children, “melatonin, the hormone that primes us to start feeling sleepy, begins to be released later in the evening when our kids hit adolescence,” as author Lisa Lewis recently told Dr. Shelby Harris, Sleepopolis’s Director of Sleep Health, in an episode of Sleep Talking With Dr. Shelby.

Melatonin

What it does “Melatonin is a hormone naturally produced by the body’s pineal gland that helps regulate sleep-wake cycles,” Stewart Parnacott, NP, certified nurse anesthetist and instructor at Baylor College of Medicine tells Sleepopolis. Your sleep-wake cycle refers to your body’s internal clock, or circadian rhythm, which melatonin can help get back on track. (1)

When taken as a supplement, melatonin can help you fall asleep faster and sleep better, Parnacott says. The Food and Drug Administration (FDA) does not regulate supplements the same way they do medications, and are not held to the same standards. (2) Even so, melatonin is the first choice of the American Academy of Family Physicians (AAFP) for insomnia treatment. (3)

How it helps you sleep “[Melatonin] plays a major role in sleep/wake cycles and how the body manages and responds to circadian rhythms,” Dr. Rebekah Diamond, MD, professor of pediatrics at Columbia University and author of Parent Like A Pediatrician tells Sleepopolis. “Melatonin supplements seem to work by mimicking the body’s natural hormone and helping promote sleep through the same pathways.” (3)

Common forms and dosages Melatonin can be taken in several forms: (3)

• Oral tablet/gummy/liquid
• Liquid spray
• Rectal suppository
• Transdermal patch

The FDA doesn’t recommend any specific dosage for melatonin, but studies have used 0.1 to 10 milligrams (mg) given up to two hours before bedtime. If you check your local pharmacy, you may find tablets or gummies usually contain 1mg to 10mg each. Your healthcare provider can help you start with the right dosage for you or your teen. (3)

Long-term effects “Melatonin is generally considered safe for short-term use, and most studies have not shown any long-term effects with appropriate dosing,” says Parnacott. (3)

“Melatonin can interact with other medications or other medical conditions, which makes more serious effects possible,” Diamond cautions. “Long-term safety data is still developing so it’s hard to say whether or not there are long-term effects.” 

Cannabidiol (CBD)

What it does CBD, or cannabidiol, comes from the cannabis plant. Unlike THC, or marijuana, which comes from the same plant, CBD has no psychoactive effects. Instead, some claim it can treat pain, inflammation, anxiety, nausea, and vomiting, and some studies suggest it can improve psychosis and protect the brain. (4)

How it helps you sleep Experts propose CBD can help treat insomnia, sleep-disordered breathing, restless legs syndrome, narcolepsy, and parasomnias by attaching to certain brain receptors. (5,4) “While research on CBD’s effects on sleep is still in its early stages, some studies suggest that CBD may help promote better sleep by addressing anxiety and stress, which are common factors affecting sleep quality,” Parnacott says.

However, Diamond urges caution. “There isn’t yet enough evidence to say if or how CBD promotes sleep. Like any substance, it has the potential for side effects and therefore it is not something that can be recommended for routine use, especially in children and teenagers,” she says. 

Common forms and dosages CBD comes in liquid, capsules, and gummies. This supplement has no recommended dosages for sleep. A quick internet search will show you dosage amounts all over the map, from 10mg to 50mg per capsule or gummy. CBD can cause liver damage in large amounts and it’s always smart to check with your provider before you begin any new medication or supplement. (4)

Long-term effects No one yet knows the long-term effects of CBD. (6) It is a fairly new phenomenon, and studies are too new to know all the risks. “CBD is generally well-tolerated, but more research is needed to understand its long-term effects fully,” Parnacott says.

Melatonin Use In Children Is on the Rise

Melatonin has taken the sleep aid market by storm, with overall U.S. sales increasing from $285 million in 2016 to $821 million in 2020. (7) According to the American Academy of Sleep Medicine, parents have upped their use of melatonin for their kids, too. (8)

Many parents swear by melatonin, and plenty of kids have slept better on this supplement. (9) But some worry their kids will need to take melatonin forever, and don’t know when or if they should try taking it away. If kids need melatonin to sleep, will their dependence on it extend through adolescence?

When Can Kids Quit?

“For children and teens using melatonin, it is essential to discuss the use of sleep aids with their healthcare provider,” says Parnacott.  “As children’s sleep patterns naturally evolve with age, parents should consider weaning a child from melatonin when they consistently exhibit improved sleep patterns and no longer require supplemental aid.”

“The evidence we have suggests that the body doesn’t become physically addicted to melatonin, but people can become dependent on it for sleep,” says Diamond, who also encourages parents to discuss weaning medications with their child’s healthcare provider.

CBD Use Surging in Teens 

With CBD more widely available, teens may be trying the supplement more. One small survey of 200 teens in an emergency room found 40 percent of them reported using CBD. The average age of users was 17, and the reported use was higher in females. (10) CBD research is still in early stages, so the full scope of teen use is still unknown.

Is CBD Addictive?

Experts say they don’t know yet if CBD is addictive. (11) “There’s not enough information to say whether or not CBD is habit forming,” says Diamond.

“However,” urges Parnacott, “any dependence on sleep aids can be concerning, and it is essential for parents and teens to address the root causes of sleep difficulties rather than relying solely on supplements.”

How to Help Your Child Stop Taking Sleep Aids

Sometimes kids need help sleeping, and that’s just fine. But what happens when they’re ready to kick the supplement habit? 

Take it Slow

“To wean a child from a sleep aid, it is crucial to do so gradually,” says Parnacott. “Reducing the dosage slowly and monitoring the child’s sleep patterns during the transition can help ensure a smooth adjustment.”

Hone Their Nighttime Routine

To set your child up for successful sleep-aid weaning, give them a predictable pre-bed routine and follow good sleep hygiene practices. You can do that by: (12)

• Discouraging snacking right before sleep
• Encouraging physical activity in the day
• Getting them out into sunlight during the day
• Keeping bedtime and wake time the same each day
• Limiting screens before bed
• Making their bedroom cool and dark
• Trying colored noise

The more clues you can give their body that it’s bedtime, the better they will settle down for sleep. 

Try Cognitive Behavioral Therapy

Cognitive behavioral therapy for insomnia (CBT-I) is done by a trained provider to discover the way you think, how you feel, and how these things might affect your sleep. Some studies suggest CBT-I is just as effective as sleep medications but with longer-lasting benefits and no side effects. (13)

Another study found CBT-I combined with sleep hygiene, relaxation techniques, and other factors helped people fall asleep 19 minutes faster and stay asleep better than those who didn’t use it, all with no side effects. (12)

When to Get Help

If you’ve tried all you can to help your child sleep–with supplements or without–and they continue to have trouble snoozing, you can give your provider a call. “Any concern you have is reason enough to call the pediatrician! It’s great to make separate appointments to discuss any question or issue, including problems around sleep,” says Diamond. 

“Parents should consider consulting a healthcare professional if their child experiences adverse effects from sleep aids or if sleep difficulties persist despite using supplements,” adds Parnacott. “Additionally, any unusual behavioral changes or concerns about their child’s overall health and well-being should prompt a discussion with a healthcare provider.”

You know your child better than anyone, so let your gut lead you. When in doubt, give your provider a call. If you have a tough sleeper, it’s easy to get discouraged. But know that you still have options! You can try our tips above, or call in reinforcements (i.e. your provider). Either way, you and your child can work together to get better rest for your whole family.

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Abby McCoy

Abby McCoy is an RN of 16 years who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She has practiced nursing all over the world from San Fransisco, CA to Tharaka, Kenya. Abby loves spending time with her husband, four kids, and their cat named Cat.