Millions of Americans use melatonin pills to help themselves sleep at night. <\/p>\n\n\n\n
Despite the growing popularity of melatonin<\/a> (recent research<\/a> finds use of the supplement has grown as much as 500 percent in the past two decades), it\u2019s unclear how many people are using it correctly or getting the results they\u2019re seeking.<\/p>\n\n\n\n \u201cIt\u2019s great that people are focusing on their sleep, and melatonin may help,\u201d says Michael Grandner, PhD<\/a>, director of the Sleep and Health Research Program at the University of Arizona College of Medicine in Tucson. \u201cBut it\u2019s often not used correctly,\u201d he adds. <\/p>\n\n\n\n Melatonin<\/a> is a hormone naturally produced by the brain in response to darkness, and it helps regulate the body\u2019s sleep-wake cycles, or circadian rhythm. Dietary supplements that many people use to help themselves sleep contain synthetic versions of melatonin made in a lab, according to the National Institutes of Health<\/a>.<\/p>\n\n\n\n While melatonin supplements<\/a> have long been recommended by the American Academy of Sleep Medicine<\/a> to help treat certain sleep disorders caused by circadian rhythm disruptions \u2014 such as jet lag or sleep issues caused by shift work \u2014 recent guidelines<\/a> also caution against taking it for insomnia<\/a> or in other situations where it is difficult to fall asleep or stay asleep.<\/p>\n\n\n\n Melatonin may help with jet lag or shift work\u2013related sleep disorders because those situations are typically caused by disruptions to the body\u2019s internal clock, or circadian rhythm. Melatonin (the natural kind your body produces and supplement versions) is one of the hormones that helps set your body\u2019s internal clock and keep body functions on schedule. The supplement doesn\u2019t tend to help with insomnia or other sleep disorders because the underlying causes of those issues are different. <\/p>\n\n\n\n \u201cInsomnia \u2014 especially chronic insomnia \u2014 is rarely a problem that can be fixed by melatonin,\u201d Dr. Grandner says. \u201cThat is not what it\u2019s for.\u201d<\/p>\n\n\n\n Many people still try melatonin for insomnia, Grandner says, in part because they\u2019re worried about the potential for addiction and dangerous side effects with several types of prescription sleeping pills<\/a>.<\/p>\n\n\n\n Melatonin does tend to have less risky potential side effects than certain prescription sleep aids<\/a>, Grandner says, but he adds that \u201cmelatonin is not a good alternative to prescription sleep medications. It does not work as a sedative<\/a> and it is ineffective in most cases of insomnia.\u201d<\/p>\n\n\n\n Prescription sleeping pills that are sometimes used to help treat insomnia can come with some serious side effects, like prolonged drowsiness, hallucinations, and addiction, according to Mayo Clinic<\/a>. In 2019, the U.S. Food and Drug Administration<\/a> (FDA) added a black box warning to the packaging of certain sleeping pills, including eszopiclone<\/a> (Lunesta), zaleplon<\/a> (Sonata) and zolpidem<\/a> (Ambien), because of the risks of sleepwalking<\/a>, sleep driving, and engaging in other activities while not fully awake, which had resulted in deaths among patients taking the medications.<\/p>\n\n\n\n Melatonin is thought to be a safer option, because there is no evidence of such risks. But it\u2019s worth noting that, because it\u2019s a supplement, melatonin hasn\u2019t been tested or regulated as stringently by the FDA<\/a>, compared with prescription drugs. <\/p>\n\n\n\n Common side effects associated with melatonin use can include headache, dizziness, nausea, and drowsiness, according to Mayo Clinic<\/a>. Less often, it can cause depression, anxiety, confusion, and disorientation. Melatonin can also lead to potentially dangerous interactions with a wide variety of medications including drugs to manage blood pressure<\/a> and diabetes, oral contraceptives, blood thinners<\/a>, and certain antidepressants<\/a>.<\/p>\n\n\n\n Those side effects are based on short-term usage at low doses, says David Neubauer, MD<\/a>, an associate professor in the department of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine in Baltimore. And many people today are taking higher doses over longer periods of time, he explains. <\/p>\n\n\n\n Many studies that have found melatonin safe and effective looked at doses of no more than 5 to 10 milligrams at most, one recent study<\/a> suggests. <\/p>\n\n\n\n \u201cLow doses typically are optimal,\u201d Dr. Neubauer says. People should be taking 3 milligrams at most, and doses as low as 0.5 milligrams to start with, he adds.<\/p>\n\n\n\n Anyone considering melatonin should still talk to their doctor first, says Muhammad Rishi, MD<\/a>, a sleep disorders specialist at the Indiana University School of Medicine in Indianapolis. <\/p>\n\n\n\n \u201cLike other medications, melatonin use needs to be supervised by a practitioner with experience in treating sleep disorders<\/a>,\u201d Dr. Rishi says. \u201cLike any other medication, there are certainly appropriate uses of melatonin \u2014 and similarly, possible adverse effects if not use appropriately.\u201d <\/p>\n\n\n\n Doctors are growing increasingly concerned about melatonin because so many more people are using it \u2014 often at high doses for long periods of time \u2014 without ever seeking medical advice about their sleep issues. Some other common melatonin mistakes doctors see include:<\/p>\n\n\n\n Turning to melatonin if you notice you\u2019re not sleeping well shouldn\u2019t be your first play, Neubauer says. Try things that don\u2019t involve taking any pills (whether they\u2019re over-the-counter supplements or prescription sleep aids) first. <\/p>\n\n\n\n We can make changes to our routines that help increase our body\u2019s natural melatonin levels, Neubauer says. Bright light suppresses melatonin production, so dimming the lights a few hours before bedtime helps. Avoiding electronic screens, including smartphones, tablets, and laptops, during that time also helps natural melatonin levels rise in the evening.<\/p>\n\n\n\n This is the most common misconception about melatonin, Grandner says. Unlike many prescription sleeping pills, melatonin isn\u2019t a sedative. It works by signaling to your body that it\u2019s nighttime and encouraging your body\u2019s natural sleep-wake cycles to help you power down for the night.<\/p>\n\n\n\n That is why it can help shift your sleep patterns if you\u2019re struggling with things like jet lag or an irregular sleep schedule<\/a> because of shift work \u2014 and it is also why it\u2019s not going to do as much good for insomnia caused by other things.<\/p>\n\n\n\n To facilitate sleep, take melatonin<\/a> one or two hours before bed. <\/p>\n\n\n\n \u201cIt tells your body it\u2019s nighttime,\u201d Grandner says. But that process of your body powering down takes a little bit of time, just like when you naturally start to feel sleepy before bed (because of natural melatonin in the body), it\u2019s not an immediate effect. Take it too close to hitting your pillow, and the effect will start too late.<\/p>\n\n\n\n It may be tempting to take this when we wake up and can\u2019t fall back to sleep, but this timing is ineffective because our naturally occurring melatonin hormone levels are at peak levels already, says Naima Covassin, PhD<\/a>, a sleep researcher at the Mayo Clinic in Rochester, Minnesota.<\/p>\n\n\n\n Unless it is prescribed by a physician, melatonin should only be used for temporary problems falling asleep, Dr. Covassin says. <\/p>\n\n\n\n Long-term use typically isn\u2019t recommended, and it can increase the risk of side effects without solving the underlying cause of sleep issues. Other approaches, such as cognitive behavioral therapy<\/a>, might be better for people with persistent sleep problems, Covassin adds. Rare, more serious side effects can include depression, blurred vision, dizziness, and unexplained bleeding, according to England\u2019s National Health Service<\/a>.<\/p>\n\n\n\n \u201cMore is not necessarily better,\u201d Covassin says. Just like long-term daily use, high doses can increase the risk of side effects. If you don\u2019t get results with lower doses, you should talk to a healthcare provider to sort out what is causing your sleep problems and to determine a more effective treatment plan.<\/p>\n\n\n\n People don\u2019t always keep dietary supplements out of reach of children \u2014 and that\u2019s a dangerous mistake, says Rishi. <\/p>\n\n\n\n More and more kids are being treated in emergency rooms and hospitalized for melatonin overdoses<\/a>, and a few have died, Rishi warns. (That\u2019s also according to recent data reported by the Centers for Disease Control and Prevention<\/a>.)<\/p>\n\n\n\n Small doses of melatonin for problems like jet lag or a shifted sleep schedule are fine for a short period of time and with a go-ahead from a healthcare provider, Rishi says. <\/p>\n\n\n\n But taking high doses night after night hasn\u2019t been proven safe or effective in clinical trials, and the health effects of long-term exposure to melatonin supplements are unclear, he adds.<\/p>\n\n\n\n \u201cMelatonin use is becoming more common, as it is widely available as a supplement, it is cheap, and it is available without a prescription,\u201d Rishi says. \u201cIt is often mistakenly thought to be absolutely safe \u2014 I certainly find it very alarming.\u201d<\/p>\n\n\n\nAvoid These 7 Melatonin Mistakes<\/h2>\n\n\n\n
1. Popping a Supplement Without Paying Any Attention to Sleep Hygiene<\/h3>\n\n\n\n
2. Thinking Melatonin Makes You Sleepy<\/h3>\n\n\n\n
3. Taking Melatonin Just Before Your Head Hits the Pillow<\/h3>\n\n\n\n
4. Trying Melatonin in the Middle of the Night<\/h3>\n\n\n\n
5. Using Melatonin Every Day<\/h3>\n\n\n\n
6. Increasing the Dose if It Doesn\u2019t Work<\/h3>\n\n\n\n
7. Leaving It Out in Plain Sight<\/h3>\n\n\n\n
The Bottom Line<\/h2>\n\n\n\n