US researchers are sounding alarms over the increasing trend of melatonin use among school-aged children, with nearly one in five reported to be taking the sleep hormone, according to a study in JAMA Pediatrics. The safety and efficacy of melatonin products, available over the counter in child-friendly forms, are questioned due to a lack of comprehensive regulation and data. Concerns are heightened by a 530% increase in melatonin ingestion reports to poison control centers from 2012 to 2021, predominantly among children under five, with over 94% unintentional and 85% asymptomatic cases. Lead author Lauren Hartstein urges heightened awareness among parents, clinicians, and the scientific community, emphasizing the need for more research before declaring melatonin safe for long-term use in children. Melatonin, a circadian rhythm-regulating hormone, is classified as a prescription drug in many countries, but in the US, it is available over the counter, including in child-friendly gummy formats. The study surveyed 1,000 parents, revealing that 18.5% of five- to nine-year-olds and 19.4% of 10- to 13-year-olds had taken melatonin in the past month. Almost 6% of one- to four-year-olds were also administered melatonin. The authors caution against routine use, highlighting inconsistencies in melatonin product content and potential risks associated with insufficient understanding of their composition. They stress the importance of behavioral changes as the primary approach to address underlying sleep issues.