0902 Parental Decision-Making Around Pediatric Melatonin Use: Initiation and Discontinuation Patterns in Typically Developing Children

Abstract Introduction Melatonin, a widely available over-the-counter supplement, is frequently used by caregivers to manage pediatric sleep difficulties despite limited guidance on its long-term safety and effectiveness. Understanding caregiver experiences with melatonin, including reasons for use, perceived effectiveness, and barriers to use, is critical for informing clinical practice and guiding families toward evidence-based behavioral sleep interventions. This study addresses this gap. Methods Caregivers (N=389, Mage=37.85, 51.9%-female) of school-aged children (ages 8-12, Mage=9.40, 45.5%-female) with insomnia (defined as >30 minutes of sleep onset latency or wake after sleep onset on >3 nights in the past week) reported on their past experiences using melatonin to improve their child’s sleep. Analyses in SPSS examined the proportion of parents who reported prior use of melatonin and why or why not they had given their children melatonin. Results Almost half of caregivers (48%) indicated melatonin was ineffective for their child’s sleep, while 36% found it helpful, and 15% had never used it. Among those who had tried melatonin for their child, the most common reasons were provider recommendation (57%), ease of use (56%), perceived effectiveness (53%), and availability (46%), with fewer citing affordability (21%). Caregivers who discontinued melatonin for their child noted concerns about reliance (41%), lack of effectiveness (37%), side effects (36%), cost (24%), or resolution of sleep problems (22%). Caregivers who never used melatonin cited reluctance to medicate (40%), concerns about side effects (38%), safety concerns (25%), lack of provider recommendation (15%), perceived ineffectiveness (13%), or cost (5%). Conclusion Findings highlight the widespread use of melatonin among caregivers, with mixed perceptions of its effectiveness and notable concerns about reliance, side effects, and safety. Given the high rate of perceived ineffectiveness, discontinuation, and hesitancy to use melatonin, families may benefit by having clinicians emphasize behavioral sleep strategies as first-line interventions. Future research should examine long-term outcomes of pediatric melatonin use, clarify appropriate indications, and compare supplement use with evidence-based behavioral sleep interventions. Support (if any)