Risks of Melatonin Overdoses Highlighted in Recent Studies

In Germany, concerns are growing regarding the potential for melatonin overdoses, particularly among children. Melatonin, a hormone produced by the pineal gland from serotonin, is crucial for regulating the body's sleep-wake cycle. The synthesis of melatonin is inhibited by daylight and stimulated by darkness, peaking around 3 AM.

A study published in 2008 in the journal Sleep Medicine Clinics highlighted that one in four children experiences behavioral sleep issues, regardless of neurodivergence. However, there is a significant lack of reliable data concerning the use of melatonin in non-neurodivergent children, making it difficult to establish guidelines for effectiveness, dosage, and duration of use.

Despite these uncertainties, melatonin-infused gummy candies have gained popularity as a sleep aid for children, particularly in the United States. Research published in the JAMA journal in 2023 noted an increase in melatonin use among American children, rising from 1.3% pre-COVID-19 to much higher rates currently. These melatonin products are available over the counter in the U.S., but studies have shown significant discrepancies between the labeled and actual melatonin content in these products. In some cases, the melatonin levels were found to be up to four times greater than indicated, and additional ingredients like serotonin or CBD were also detected.

The metabolic process of melatonin is slower in children than in adults, leading to a heightened risk of overdose. Symptoms of melatonin overdose can include nausea, excessive drowsiness, and migraines. The long-term effects of these overdoses are currently unknown due to insufficient data. Alarmingly, in the United States, there have been reports linking melatonin gummies to two fatalities and nearly 300 children requiring intensive care.

From 2012 to 2021, the American Association of Poison Control Centers recorded 260,435 pediatric melatonin exposures, with an annual increase of 530% in reported cases. The number of hospitalizations and serious outcomes resulting from overdoses also rose, with gastrointestinal, cardiovascular, and central nervous system symptoms being the most common. Of the 27,795 patients treated, 4,097 (14.7%) required hospitalization, and 287 (1.0%) were admitted to intensive care, including five children who needed ventilatory support, two of whom were under the age of two.

There is a significant risk that children may mistake melatonin gummies, which are marketed as sleep aids, for regular candy, leading to accidental overdoses. Reports from Australia have indicated a rise in inquiries to poison control hotlines regarding melatonin overdoses, underscoring the need for increased awareness and caution.