You might be using melatonin all wrong
Here’s what you should know
By the time sleep-starved people come to Jennifer Martin, a psychologist who specializes in insomnia, many have already “tried everything they can possibly buy over-the-counter,” she said. Chief among the options: supplements containing melatonin, a hormone that is produced in the body and influences sleep.
“What I’ve noticed about melatonin use is that it is going up — and during the covid pandemic, usage has gone up dramatically,” said Martin, president-elect of the American Academy of Sleep Medicine. Researchers have documented an increase in sleep-related problems since the pandemic began, and more than half of American adults surveyed in January reported using some kind of sleep aid, with 11 percent turning to nonmedicinal products such as melatonin or tea.
But Martin and other sleep experts are concerned that many people are taking melatonin out of the mistaken belief that it will help them fall sleep faster. Instead, the experts say, there’s not enough strong evidence that supplemental melatonin is an effective sleep aid for chronic insomnia, and some risk that taking it improperly may exacerbate, rather than help, sleep issues.
Interest in melatonin was climbing even before the pandemic, according to a research letter published in February in JAMA. The
report tracked usage trends among U.S. adults from 1999 to 2018 and found that melatonin use more than quintupled and that dosages were rising. While many sleep experts recommend supplementing only
with small amounts (typically less than 1 milligram, or between 1 and 3 milligrams), the researchers noted an increase in people who reported taking doses greater than 5 milligrams per day. But they emphasized that the use of “high-dose melatonin supplementation” generally remained low.
Here’s what sleep experts say you should know about melatonin.
Understand what melatonin is and how it works
Melatonin is the “darkness hormone,” said Mark Wu, a neurologist and sleep medicine clinician at Johns Hopkins University. And contrary to popular belief, it doesn’t promote sleep in the same way a sleeping pill might. “It’s really a nighttime information hormone,” he said.
The hormone, which is secreted by the brain’s pineal gland in the evening, serves as a signaling mechanism, said Bhanu Kolla, a professor of psychiatry and psychology, and a consultant at the Mayo Clinic’s Center for Sleep Medicine. “It starts telling the brain that it’s biological night” and time to sleep.
Sleep specialists often use low doses of melatonin, which is available only by prescription in many other countries, to help treat sleep timing problems, such as jet lag or shift work disorder. Depending on when it’s taken, small amounts can alter the timing of people’s internal clocks. In the case of jet lag, for example, the Mayo Clinic recommends taking melatonin in the morning if you fly west, and at night if you fly east to help your body adjust.
But although melatonin plays a key role in helping to regulate the daily cycle of sleep and wakefulness, taking it right before you want