Is It Safe to Take Melatonin for Better Sleep? Experts Weigh In.

Photo credit: Luis Alvarez - Getty Images
Photo credit: Luis Alvarez - Getty Images

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Sleep issues have been on the rise since the pandemic started, and new research has found a growing number of adults are turning to supplemental melatonin to help them conk out at night.

The study, which was published in JAMA, analyzed data from 1999 to 2018 and found that melatonin use increased even before the pandemic began. For the study, researchers analyzed data from 55,021 adults from 1999 to 2000 and 2017 to 2018 cycles of the National Health and Nutrition Examination Survey (NHANES). The researchers found that overall use of melatonin supplements increased from 0.4% of participants in the 1999 to 2000 cycle to 2.1% in the 2017 to 2018 cycle.

Study participants also started taking melatonin in higher doses over time, the researchers found. The findings “may raise safety concerns, especially given that the actual content of melatonin in marketed supplements may be up to 478% higher than the labeled content, and that evidence supporting melatonin use for sleep disturbances is weak,” the researchers wrote.

Melatonin use has only gone up since the pandemic started, with Business Insider reporting that Americans spent $825,559,397 on melatonin supplements in 2020—a 42.6% year-over-year increase.

With all of this, it’s understandable to have questions about melatonin and how it can impact your sleep. Here’s what you need to know.

What is melatonin?

Melatonin is a hormone that your brain makes in response to darkness, per the National Center for Complementary and Integrative Health (NCCIH). Melatonin helps regulate your circadian rhythms, i.e. your internal clock, and can help you to fall asleep.

“The hormone is for the timing of sleep,” says Christopher Winter, M.D., of Charlottesville Neurology and Sleep Medicine and author of The Sleep Solution: Why Your Sleep Is Broken and How to Fix It. “It’s not a sedative, though. It’s not meant to knock someone out.”

While melatonin is naturally produced in your body, there are also melatonin dietary supplements that mimic the hormone in your body.

How does supplemental melatonin work in the body?

“Exogenous melatonin—meaning melatonin that you consume—is exactly the same as the melatonin your body makes,” says Jamie K. Alan, Ph.D., an associate professor of pharmacology and toxicology at Michigan State University. “It also works the same by promoting sleep.”

But while supplemental melatonin should work the same was as the melatonin your body makes in theory, using melatonin supplementation can be “complicated,” Dr. Winter says. “When you buy melatonin, nobody really knows what they’re taking,” he explains. “Research has found that some lots have no melatonin in it, and some have two to three times the amount that it says in the bottle.”

A lot of people are using supplemental melatonin to help them fall asleep at night, but Dr. Winter points out that research doesn’t support that this is helpful for chronic insomnia. In fact, practice guidelines from the American Academy of Sleep Medicine (AASM) says that there’s not enough strong evidence on the effectiveness or safety of melatonin supplementation for chronic insomnia to recommend its use.

"The best way to initiate sleep is to do it without the need of substances, including melatonin," says Noah Siegel, M.D., director of the Sleep Medicine and Surgery Division at Mass Eye and Ear. “Over time, there's a risk of developing a psychological dependence on it. People essentially will convince themselves that there's no way they're going to sleep if they don't take their melatonin.”

How to use melatonin supplements

Melatonin supplements do have a use, though. AASM recommends using melatonin as a treatment for issues with sleep timing, like jet lag disorder and shift work disorder.

“Sleep doctors will use it to help someone adjust the timing of their sleep,” Dr. Winter says. The exact timing of taking melatonin can take some trial and error to figure out, given that melatonin production naturally rises in your body when the sun goes down (and you typically don’t go to bed for hours after that).

If you want to ward off jet lag, Dr. Winter recommends using a calculator like Jet Lag Rooster to help you figure out the exact timing of when to take melatonin. For shift work, it’s a good idea to check in with your doctor about timing.

Dosage-wise, Dr. Siegel says that one to two milligrams taken a half hour or so before your bedtime should be plenty.

What are the side effects of melatonin?

Melatonin can come with some mild side effects, per NCCIH. Those can include:

  • Headache

  • Dizziness

  • Nausea

  • Sleepiness

Is melatonin safe?

In general, short-term use of melatonin seems to be safe, the NCCIH says. “Melatonin is thought to be incredibly safe,” Dr. Winter says. “There are few side effects and you really can’t hurt yourself with it.” That, he says, is “part of the reason why it’s taken off so much.” (The NCCIH does note, though, that there is a lack of research on the safety of melatonin use in pregnant or breastfeeding women, so it’s best to take a pass if you fall into one of these groups.)

However, there isn’t a lot of safety information on taking this over longer periods of time.

Research has also found that up to 26% of melatonin supplements contain the hormone serotonin, so it can be tricky to know if you’re actually getting what it says on the label.

If you’re having trouble sleeping and you’re considering using melatonin, Dr. Winter recommends checking in with your doctor first. “Outside of the occasional use helping with jet lag or shift work, I don’t think it’s useful,” he says.

Dr. Siegel agrees, noting that good sleep hygiene should be your first move—not using a supplement like melatonin. That includes keeping a consistent sleep and wake schedule, minimizing things that are stimulating before bedtime, and avoiding caffeine, alcohol, bright lights, strenuous exercise, and heavy meals in the evenings.

“If someone is really serious about fixing their sleep problem, melatonin is not the solution," Dr. Winter says. "You need to find a fix that’s more lasting and permanent than being dependent on a capsule for the rest of your life.”

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