It is all too common for children to complain about sleeping at night because they are too afraid of the 'bogeyman', but reality is that children can suffer from insomnia too.
Dr Darren Green joined News24Live in studio to discuss the use of melatonin supplements for a 10-year-old child who can't fall asleep at night.
He explained that there are broadly two forms of insomnia.
"You get difficulty initiating sleep, where you struggle to fall asleep at night; and then you have difficulty sustaining or maintaining sleep where once you have woken up, whether it is at three or four in the morning, you struggle to go back to sleep."
Green said that insomnia is a complex issue to deal with.
"The reason for that are the facets of looking at what the cause is in specific people and in this case a child are very detailed and complex.
"One has to spend time analysing for example; the onset of the insomnia, when did it start, the progression of it, did it get worse over a period of days, hours, or has it come on over years."
He pointed out that it is important to delve into the history of a patient and the family history of genetics.
"There are people who have a genetic link for example where people in families have been struggling to sleep from childhood right through to adulthood."
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Dr Green explained that melatonin is the hormone released by the pineal gland in the brain, which is the size of peanut, and plays a role in the natural sleep-wake cycle.
He said what is interesting is that it responds to light.
"The amount of light that is perceived and penetrates the eye has connections to these pathways in the brain that stimulates the pineal gland to release the hormone at certain times."
Although anecdotal reports on using melatonin for jet lag and insomnia have been proven and shown beneficial to many people in different age groups, not everyone responds to it, said Dr Green. He added that it is important to base the decision of using melatonin supplements on evidence-based medicine.
"It is not considered an evidence-based part of dosing or treating insomnia in terms of the correct dosage, how much to give, what the toxic effects are of giving too much so it is a little dangerous in the sense of that trial and error method," he said.
"You don't want to take any chances and run the risk of adverse effects of using too much of the drug".
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Dr Green said when it comes to treating a 10-year-old, one would certainly want to look at a very clear definitive history and look if there aren't any medical causes first.
''If this is a secondary insomnia, in other words it is secondary to a medical problem, the only way we are going to treat the root cause is by finding out what the medical problem is.
"If there isn't one then one can look at a primary or a genetic insomnia and those are difficult to treat," he said.
Dr Green strongly advised that parents consult a pediatric neurologist, have a full medical examination with a detailed history profile done before any decisions are made of using melatonin supplements.
Image: A child sleeping in bed from Shutterstock