It probably seems like everyone you know takes melatonin for sleep, right?
It’s not in your imagination. Melatonin is one of the most popular natural products, with over three million people using it regularly, according to a survey from the National Center of Complimentary and Integrative Health. The report also found the use of melatonin more than doubled between 2007 and 2012.
My husband uses melatonin on occasion, as have many of my friends. We’ve given it to our sons on occasion. Almost everyone I know with kids uses it at times. Those I know who take it report that it works, with few side effects.
Yet I often wonder: Is it too good to be true? Is melatonin really as effective as people say it is? And is it truly as innocuous as it sounds?
I took some time to dive into the research on melatonin, and this is what I found.
How Melatonin Works
Melatonin is a synthetic form of a hormone we all produce in response to darkness at the end of the day. Melatonin produces drowsy feelings, setting the state for sleep.
According to Luis F. Buenaver, Ph.D. and sleep expert from Johns Hopkins Medicine, we naturally produce melatonin about two hours before our bedtime. There are certain bedtime practices that can inhibit our body’s ability to produce melatonin, such as being exposed to too much light, particularly the blue and green lights from screens.
Melatonin supplements can be helpful for use on a short-term basis, said Buenaver, such as when you are recovering from jet lag, are experiencing insomnia, or when you have a sleep or work schedule that does not allow healthy sleep patterns. For example, if you are a shift worker and must stay awake all night several times a week, melatonin can get you back on track.
Is Melatonin Effective?
The sleep-inducing effects of melatonin aren’t all in your head. There have been quite a few reputable studies showing the effectiveness of the chemical.
For example, a 2017 review published in Sleep Medicine Reviews found melatonin to be effective for adult sleep disorders. Researchers looked at data from 12 randomized and controlled trials and concluded that melatonin works well to treat primary insomnia and delayed sleep phase syndrome. The reviewers also found that melatonin helps regulate the sleep-wake patterns in people who are blind.
Another review, published in the Journal of Pediatric Psychology in 2014, looked at the effectiveness of melatonin use for children. After reviewing 16 randomized and controlled trials, the researchers determined that melatonin had significant effects on childhood insomnia, nightwaking and sleep efficiency among neurotypical children. The researchers did not see similar effects among special needs children, although they urged more research into the potential positive effects on this population.
Is Melatonin Safe?
There are few reported negative side effects from melatonin usage, according to the CDC. The most common side effects include headaches, dizziness, nausea — and, of course, drowsiness.
Buenaver recommended melatonin usage be avoided among people who are pregnant or breastfeeding, those with autoimmune disorders, seizure disorders or people who suffer from depression. He also recommended discussing melatonin usage with your healthcare provider if you take medication for diabetes or high blood pressure.
It’s also vital to keep in mind, as the National Center of Complimentary and Integrative Health states, that while melatonin supplements are regulated by the Food and Drug Administration (FDA), because they are over-the-counter drugs, they do not receive the same level of scrutiny prescription drugs do. In other countries, for example, melatonin is only available by prescription and is therefore more heavily regulated.
Perhaps the most important point here is that while the short-term effects of melatonin appear to be minimal, we don’t know nearly as much about the long-term effects of taking melatonin. We lack this knowledge because melatonin hasn’t been on the market as a supplement long enough to study its lasting effects.
How To Use Melatonin the Right Way
One of the concerns medical experts have about long-term use of melatonin is how it might affect children as they are developing. According to the National Center of Complimentary and Integrative Health, the concern is that because melatonin is a hormone, it might disrupt puberty, hormonal development and menstruation.
But the unknown long-term side effects of melatonin are a concern for anyone who takes it. This risk doesn’t necessarily mean you shouldn’t take melatonin, especially if your doctor has cleared you to take it and you have discussed its usage. Nonetheless, you should use melatonin sparingly.
Experts like Buenaver recommend limiting your dosage of melatonin to one to three milligrams, and taking it conservatively — only when needed, rather than habitually.
“If melatonin for sleep isn’t helping after a week or two, stop using it,” Buenaver suggested. “And if your sleep problems continue, talk with your healthcare provider.”
At the same time, Buenaver said, if melatonin is working to help you with a sleep issue you are having, it’s safe to take it nightly for up to two months at a time.
The Bottom Line
Insomnia and sleep disorders are prevalent. It’s estimated that 10-30% of the population — and maybe as much as 50-60% — suffer from insomnia. Side effects of insomnia include depression, anxiety, attention deficits and an increased propensity toward accidents and errors.
When I consider how deeply chronic sleeplessness affects the lives of people I know, and I weigh this against the very few side-effects of melatonin, I don’t have a problem with my loved ones using it as a sleep aid on occasion.
I do worry about the unknown long-term side effects, especially when it comes to my sons. But it seems to me that taking the smallest effective dosage and limiting its use is a good solution here and has worked well in the two years my sons have taken occasional melatonin.
As with any supplement you are considering, you should always speak to your healthcare provider for advice and instructions on usage.
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