In an attempt to battle sleep deprivation and serious health repercussions it can cause, more and more people take melatonin supplements, a move that could prove more harmful.
The Centers for Disease Control and Prevention estimate a third of Americans fail to get enough sleep each night. Even pre-pandemic, melatonin use climbed fivefold, according to a study in the Journal of the American Medical Society (JAMA).
Problems can arise, however, when people turn to melatonin products – from pills, gummies and oral drops to lotion and nasal spray – and get varying amounts, said Dr. Priya Bakaya, a sleep specialist with the Hartford HealthCare Ayer Neuroscience Institute Sleep Center at Backus Hospital.
The supplement, which can help people fall asleep faster and stay asleep longer, is not regulated by the Food & Drug Administration, so formulations can vary in strength and concentration, she said. A 2017 study in the Journal of Clinical Sleep Medicine found the content of more than 70 percent of products offered from 83 percent less to 478 percent more melatonin than what’s listed on the package.
“People consider melatonin a supplement because it’s available over the counter. However, it’s a hormone,” Dr. Bakaya said, adding taking too much can have lingering effects on the body.
Melatonin is secreted by the body’s pineal gland in response to decreased light, a process Dr. Bakaya said is mediated through the suprachiasmatic nucleus as part of the body’s circadian timekeeping system. Melatonin production increases as it gets dark and decreases with light, signaling the brain it’s time to sleep and wake.
There is certainly a use for melatonin supplements in some patients, she continued.
“This can be for chronic phase delay like delayed sleep phase disorder, or acute disturbance like jet lag,” she said. “It has also been used for children and adolescents with sleep onset insomnia associated with special conditions like autism spectrum disorder and ADHD.”
Dosing for circadian phase delay starts at 0.5 milligrams each day, taken about 30 minutes before bedtime. Preschool children with sleep onset insomnia can take 1 to 2 milligrams, and up to 5 milligrams in adolescents. For adults, Dr. Bakaya said typical doses range from 3 to 5 milligrams.
“A 2005 review stated that short-term use of less than 10 milligrams per day appears safe in adults,” Dr. Bakaya reported. “Long-term safety data of pediatric and adults is scarce but reassuring with no serious side effects noted.”
Instead, higher melatonin intake, she said, can trigger such adverse reactions as:
- Somnolence (excessive sleepiness).
- Hypotension (low blood pressure) or hypertension (high blood pressure).
- Gastrointestinal upset.
Taking melatonin for extended periods also can cause brain receptors to respond less. Most people, Dr. Bakaya suggested, should take melatonin for short periods for that reason.
To help get more sleep, Dr. Bakaya suggested establishing a stable sleep/wake routine you follow seven days a week.
Good sleep hygiene includes:
- Choosing soothing bedtime rituals like a warm bath or meditation.
- Avoiding screen use too close to bedtime.
- Minimizing caffeine intake.
- Putting up dark curtains in bedroom.
- Keeping the room temperature cool.
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