Parent reported melatonin use characteristics, effectiveness, and adverse effects among children in foster care compared to children in the community

Purpose To examine characteristics of child melatonin use including parent perceptions of safety and effectiveness among children in foster care versus the community. We also sought to understand how prior adverse child experiences (ACEs), child sleep problems, and bedtime routines/interactions might predict melatonin effectiveness. Methods This online survey-based study collected data from N = 292 parents of children (4-12 years) currently in foster care (n = 128) and the general community (n = 164) who used melatonin at least once in the past 30 days. Results Children in foster care were more likely to be given melatonin every night compared to children in the community, although average dosage did not differ between groups. Children in foster care were also more likely to take melatonin closer to bedtime than community controls and for sleep problems other than insomnia and sleep phase shifting (e.g., nightmares). The groups did not differ in terms of parent-perceived effectiveness or number of adverse events, but children in foster care were more likely to believe that they could not sleep without taking melatonin. Further, fewer child sleep problems predicted greater melatonin effectiveness in both groups, while fewer ACEs and number of prior foster care placements predicted greater effectiveness in the foster care group. Conclusion These results provide insight into characteristics of melatonin use among children in foster care and in the community while also highlighting a need to educate parents and practitioners about behavioral interventions and sleep problems for which melatonin is and is not indicated.