What is melatonin?
Melatonin is a hormone created naturally by our bodies to regulate sleep. Our brain produces melatonin in response to darkness--so when we notice that it's dark outside, our brains produce more melatonin. When we are exposed to light at night, such as the lights from screens or bright overhead lights, our brain may not produce enough melatonin to help us sleep.
How can melatonin be used?
Some people use melatonin supplements to help them fall asleep. Melatonin can also be used to help adjust the circadian clock (such as in jet lag or shift work). Dietary supplements are available in many forms, including pills, capsules, and chewable gummy forms. Melatonin, or amino acids that the body converts to melatonin, can also be found in many foods, including cherries, salmon, milk, and nuts.
When might melatonin be considered?
Melatonin is generally best used for occasional insomnia or jet lag. For individuals with chronic trouble sleeping, there is often an underlying cause that should first be identified and managed, such as reducing stress and improving sleep hygiene, before considering melatonin.
Sleep hygiene refers to the series of habits or behaviors that help you get to sleep. Habits such as putting away all screens an hour before bedtime, having a soothing cup of herbal tea, and meditating at a set time can help your body become accustomed to falling and staying asleep for the recommended seven to nine hours for adults.
Bedtime habits are especially helpful for children, whose sleep needs are greater and vary by age. Establishing a healthy bedtime routine at a young age will help them carry those habits into adolescence and adulthood. For example, when your child first gets a phone, establish a rule about charging phones overnight in a common area, to get ahead of electronics disrupting sleep in adolescence. Parents should model healthy sleep habits as well!
Is melatonin safe?
Taking melatonin supplements to help with sleep in the short-term is generally safe for most adults. The side effects are generally rare and mild, but may include vivid dreams or nightmares, excessive tiredness, and headaches. While melatonin comes in a variety of labeled dosages, for most people, a low dose (1-3 milligrams) is just as effective as a higher dose, and may come with fewer side effects.
While melatonin is generally safe for healthy adults to consume, the majority of over-the-counter melatonin supplements have the same drawback as any other dietary supplement--there's no regulation of the supplement industry, so buyer beware. A recent survey of more than 100 supplements that contained melatonin found only half of the products tested contained the amount listed on their labels. Many contained less than indicated on the label, and many contained more—in one case, more than 600 percent of the labeled dose! This is especially troublesome when considering using melatonin to help children sleep, as there's no way to make an informed decision about the dose children are receiving. Consider looking for a melatonin product that has received independent testing and verification from a third party testing laboratory.
Is it safe for kids?
Children and teens can also take melatonin, though in lower doses than adults. Studies of melatonin in animals have raised concerns about whether melatonin could affect the timing of puberty, but such effects have not been found in humans. Nonetheless, because melatonin is a hormone, and there is little data on its long-term effects, caution is advised for use in developing bodies. Always talk with your child's pediatrician before giving them supplements, and always use the lowest beneficial dose for the shortest amount of time. For example, some providers recommend using a short-term, low dose trial of melatonin while helping kids establish a healthier sleep routine.
All supplements and medications should be kept in a locked cabinet and out of reach of children. We have found that melatonin usage in children is increasing, and gummies are by far the most commonly used form of melatonin in this group. Gummies can be appealing to children and can be confused with candy or treats. In a 10 year study, more than 260,000 reports were made to poison control regarding excessive ingestion of melatonin in children and adolescents. Most of those cases were managed at home, but some did require hospitalization for observation.
Is there any reason to not take melatonin supplements?
Melatonin should be avoided in infants, individuals who are pregnant or breastfeeding, and individuals with dementia. As with any supplement, speak with your doctor before using it, particularly if you have any chronic health conditions or are on any other medications. Melatonin can interact with and diminish the effectiveness of certain medicines, including:
- blood thinners
- anti-seizure medications
- birth control
- high blood pressure medicines
- diabetes medicines
- immunosuppressants
- some antidepressants
I've tried melatonin and I still have trouble sleeping
Melatonin doesn't work immediately—ideally it should be taken 30 minutes before bedtime. But if you have tried taking melatonin and consistently have trouble falling asleep or staying asleep, talk with your primary care doctor about your concerns. It can be helpful to keep a sleep diary before making an appointment, in which you note the approximate time you fall asleep and wake up, what you were doing before you went to bed, any foods or drinks you may have had in the hours before bedtime, or if there are unusual stressors you're experiencing. Making a note of these could help you recognize some changes to make on your own, but also help your provider determine if a referral to a sleep specialist may be needed. Effective treatments are available, including CBT-I (cognitive behavioral therapy for insomnia). CBT-I is a brief, evidence-based treatment that involves restructuring the behaviors and thoughts that are maintaining the insomnia. Treatments for younger children may involve changing the ways parents respond at bedtime and during night wakings.
For more tips on living well, visit the Be Well blog.
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