I was inspired to write about melatonin after scrolling through several Instagram posts about how all that mothers want is some alone time and good sleep (at least those that have small children). One of the first blog posts on this site was about how horrible my sleep is and how hard I have been working to improve this situation. I am happy to report that overall my sleep habits are much improved and I almost always get 7-8 hours of sleep and sometimes more on the weekend!
When I initially started working on my new sleep habits, I was recommended to try melatonin as well. I had tried it a few times in college but it gave me very vivid dreams that I did not enjoy, so I didn’t try it again until a couple of years ago. It worked quite well this time and I did not have any weird dreams. This got me thinking whether taking melatonin on a regular basis was a good idea or if I should look into it a little bit more. I noticed that if I took it every day for a week or two, it didn’t work as well.
This post is not medical advice and you should definitely consult with your doctor if you are thinking about using melatonin or have questions about your current use but I wanted to summarize some of the information out there for my readers. Melatonin is sold over the counter and does not have FDA approval.
First things first. What is melatonin? It is a hormone naturally produced by your brain in response to darkness. It helps set the circadian rhythm and with sleep. Light can interfere with melatonin production. Most melatonin found in supplements is made synthetically. It may help with jet lag, delayed sleep-wake phase disorder (people that have trouble falling asleep at typical times), some sleep disorders in children, and reducing anxiety before surgery. Many people use it for insomnia (trouble falling asleep and/or staying asleep) but there is not enough evidence around the efficacy and safety of melatonin for this condition (1).
Short-term use appears to be safe but again, there is not a lot of information regarding long-term use of melatonin. Mild side effects reported include headache, dizziness, vivid dreams, nausea, and daytime sleepiness.
The American Academy of Sleep Medicine practice guidelines from 2017 do not recommend melatonin as a treatment of chronic insomnia. The standard treatment is cognitive behavioral therapy. These guidelines are very long since they review many different pharmacotherapies but I wanted to share what they said about melatonin. They specifically mention 2 mg and not using it as a treatment for sleep onset or sleep maintenance in adults. They looked at 3 studies only in older adults >55 years old (a few more studies are mentioned but data quality is not good). Overall evidence quality was low. Essentially, there really wasn’t a lot of good evidence to say that it works and no systematic data regarding side effects, which is why they don’t recommend it (2).
Overall, short-term use of melatonin in adults seems relatively safe based on most of the literature. There is not enough information regarding true benefits and long-term side effects and nothing beats consistency and a good bed time routine when it comes to getting good sleep. If you or someone you know struggles with sleep, please let them know that meeting with a provider that can do cognitive behavioral therapy for insomnia may be a great first step. Talking with your doctor is also very important given the lack of regulation of non-FDA approved supplements. A recent study showed that there may be higher doses of melatonin in gummies than what is reported (3) but it didn’t look at pills.
I hope this was informative and can help kickstart conversations with your medical providers if you find that falling or staying asleep is a problem for you.
References
- NIH National Center for Complementary and Integrative Health. Melatonin: What You Need To Know. www.nccih.nih.gov/health/melatonin-what-you-need-to-know. July 2022.
- Sateia, MJ. et al. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice. J Clin Sleep Med. 2017.
- Cohen PA, Avula B, Wang Y, Katragunta K, Khan I. Quantity of Melatonin and CBD in Melatonin Gummies Sold in the US. JAMA. 2023;329(16):1401–1402. doi:10.1001/jama.2023.2296