Taking Melatonin Supplements? You Might Be Taking More Than You Actually Need
Melatonin, alongside other trusty over-the-counter sleep aids, is supposed to help you when you're having trouble falling asleep. Usually, melatonin supplements are designed to stop you from tossing and turning if taken properly within an hour of your desired bedtime. But you may wonder how these supplements exactly work — and what is the best amount of the OTC product to take if you really need a sleep aid?
"Melatonin is a hormone that is produced by the pineal gland which is located within our skull," explains Muhammad A. Rishi, MD, MBBS, who specializes in Pulmonary Medicine, Critical Care Medicine and Sleep Disorders for Indiana University Health Physicians. "Exposure to melatonin leads to regulation of various activities throughout the body, including regulation of body temperature, secretion of various hormones and indeed, when we feel sleepy and when we feel awake."
According to Dr. Rishi, our bodies naturally produce an estimated 10 to 80 mcg (micrograms) of melatonin per night — with levels typically increasing during the evening when the sun goes down, remaining high throughout the night and reducing significantly in the morning. But melatonin is also available in synthetic form as an over-the-counter-supplement, which mimics the natural hormone that's produced by your body.
Many people turn to these supplements to help them fall asleep — but as highlighted by clinicians at the American Academy of Sleep Medicine (AASM), there's actually little to no evidence that melatonin works as an effective sleep aid treatment for insomnia. It can, however, be an effective treatment for circadian rhythm disorders — meaning that you can take melatonin to adjust the timing of your sleep if you're jetlagged, working a night shift or if you have a delayed sleep-wake phase (i.e., you're a "night owl" and fall asleep very late and wake up very late the next day) and need to reset your sleep schedule.
Planning on taking melatonin to get to bed quicker tonight? Here's what you should know about proper and safe dosage, according to sleep experts.
How much melatonin is too much? Can you overdose on melatonin?
Taking too much melatonin can disrupt your circadian rhythm and cause unwanted side effects — so yes, you can technically overdose on melatonin. "Signs of melatonin overdose may include but are not limited to excessive sleepiness, dizziness, upset stomach, diarrhea, lethargy, low blood pressure and confusion," Dr. Rishi says. Officials at the American Academy of Sleep Medicine (AASM) also highlight chronic headaches, high blood pressure, vomiting or nausea, as well as increased hair loss as potential symptoms of a melatonin overdose.
It's important to note that melatonin is marketed as a dietary supplement in the U.S. (whereas it's available as prescription-only in many other countries) and is not regulated by the U.S. Food and Drug Administration (FDA) — which means there are no official safety guidelines on dosage, though the best products abide by the "USP Verified" program that establishes production standards guided by the U.S. Pharmacopeial Convention.
However, Dr. Rishi advises that adults should not take more than 5mg a night without talking to their doctor or medical provider. Any dosage higher than this threshold is more likely to trigger immediate side effects including headache and dizziness in some individuals, as highlighted in materials published by the Mayo Clinic.
There currently isn't enough research to determine the proper or safe dosage for children either, according to Dr. Rishi. A recent AASM health advisory indicated that melatonin poisoning is becoming increasingly common among children and teens; this may be due to the fact that popular chewable supplements may contain widely varying amounts of melatonin, or pack in additional hormones like serotonin, which can lead to an imbalance among children.
"Many sleep problems can be better managed with a change in schedules, habits, or behaviors rather than taking melatonin," the AASM advisory reads, adding that parents or caregivers should always speak to a pediatrician or medical provider before considering giving melatonin to children.
If you believe you've taken too much melatonin, you should contact Poison Control at 1-800-222-1222.
So, how much melatonin should I take?
There's no official standard dosage of melatonin that researchers have established as the optimal or ideal amount to take — and you'll find that melatonin is available to purchase in a wide range of strengths. In general, however, Dr. Rishi recommends a dosage of 3 to 5 mg (milligrams) for adults. As for children, you'll need clear any dosage recommendations with a pediatrician, who can provide guidance based on your child's complete medical history.
According to the AASM, however, it's possible for a small dose of melatonin to work better than a large dose; in fact, a dose of about 0.3 mg closely resembles the level of your body’s natural melatonin production. The "right" dose of melatonin can depend on factors such as your age, weight and individual sensitivity — so as a general rule, it's best to start with the lowest dose of melatonin possible and work up from there.
"Ideally, I'd start an adult on the low end of 0.2 mg yet most over-the-counter supplements start with much higher doses of melatonin which is honestly not necessary," says Stacy Mobley, NMD, MPH, a licensed naturopathic doctor. "I would not start a child on melatonin."
One important thing to note: Since melatonin is not regulated or quality controlled by the FDA, it's possible for the dosing on the label to correlate with how much hormone is actually within the supplement.
"Research shows that there is wide variability in what is on the label of melatonin supplements and what is actually in the bottle," Dr. Rishi warns. "If somebody does decide to use melatonin, the [AASM] recommends using formulations with USP mark, meaning that the manufacturer follows strict guidelines including making sure that the correct dose is in the bottle."
Is it safe to take melatonin every night?
You might be tempted to reach for a melatonin supplement every night — but doing so may have long-term impacts on your sleep schedule.
"Melatonin is likely safe for short-term use," Dr. Rishi says. "Unfortunately, long-term data is not available to know whether or not it is safe for chronic use." Additionally, melatonin should not be mixed with other sedatives or other medications such as anticonvulsants, contraceptive drugs, blood pressure drugs or diabetes medications, according to the Mayo Clinic.
Ideally, you should discuss the usage of melatonin with your primary care doctor — including the timing and dose that may work best for you — before you start taking the supplement.
You're unlikely to become dependent, have a diminished response after repeated use or experience a hangover effect on melatonin, unlike many other sleep medications, experts say. Still, you shouldn't rely solely on melatonin supplements to fix your sleep, Mobley advises.
"It is important to look at each person's situation and case to determine why they cannot fall or stay asleep," she explains. "There are many times it is due to habits rather than the body's inability or decrease in the production of melatonin. This is why I do not recommend melatonin as a first line of defense for losing sleep or inability to sleep."
Things to consider before taking melatonin:
So what can you do to get better sleep, instead of reaching for that bottle of melatonin every night? Dr. Mobley stresses the importance of healthy sleep habits, exercise and stress management — all of which can give you the "right building blocks" your body needs for a good night's sleep.
One of the most important things to do is practice good sleep hygiene, which refers to the various healthy habits and behaviors you engage in to help you have a good night's sleep. According to Dr. Mobley, this includes:
Avoiding light-emitting items and electronic devices close to bedtime. Not only can the mental stimulation keep you up, electronic devices also emit blue light that can reduce your body's production of melatonin. Stop using your phone, computer, television or other devices at least 30 minutes before bedtime.
Creating a relaxing bedtime night routine to help you wind down for sleep. Taking a nice shower or bath, meditating or praying, playing soothing music or stretching are a few of the activities that Dr. Mobley recommends.
Skipping coffee, caffeinated teas, soda and alcohol before bed. These substances can interfere with your ability to sleep as well as the quality of your sleep.
Exercising regularly. Dr. Mobley recommends exercising at least three times per week for 20-30 minutes at a time. Even if you don't have a gym membership or equipment, a great way to get moving is walking during the daytime — which will help increase serotonin levels that would likely be converted to melatonin later in the day, says Dr. Mobley.
Staying hydrated and eating healthy. Drinking enough water will keep the body working correctly and decrease any aches and pains that may flare up at night, says Dr. Mobley, while eating a healthy diet will help prevent most chronic illnesses.
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