Melatonin is a hormone naturally produced by the pineal gland in the brain. It plays a key role in regulating the body’s circadian rhythm, telling us when to sleep and wake. The production of melatonin typically increases in the evening as it gets dark, helping to promote sleepiness and prepare the body for rest.
Over-the-counter melatonin supplements are widely used in the United States, often marketed as a natural sleep aid. While melatonin can be helpful in specific situations, it is important to understand when it is appropriate to take and how it affects sleep. Every individual is different, so there are many factors to consider with your physician to determine if melatonin is an appropriate and effective treatment for you. Some of these factors include age, medical history, and the sleep problem you are treating.
According to the American Academy of Sleep Medicine (AASM), melatonin is generally most effective for circadian rhythm sleep-wake disorders, such as delayed sleep-wake phase disorder (DSWPD), jet lag, and shift work disorder1. In these cases, melatonin may help reset the body’s sleep-wake cycle when taken at the correct time and dosage before the desired bedtime. However, for common insomnia, melatonin is not recommended as a first-line treatment. Behavioral therapies are considered a more effective and long-lasting treatment to encourage sleep, and Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first-line treatment for insomnia1. Melatonin may be less effective for those with primary insomnia or poor sleep hygiene, and its use in children or older adults should be approached with caution and medical supervision.
Melatonin is generally considered safe for short-term use in healthy adults when taken in low doses, however, a 2017 study published in the Journal of Clinical Sleep Medicine analyzed melatonin supplements and found that 71% of products contained more melatonin than listed on the label2. Since melatonin is sold as a dietary supplement, it is regulated less strictly by the Food and Drug Administration (FDA) than a prescription or over-the-counter drug would be. Side effects are usually mild and may include dizziness, headache, or daytime drowsiness. It’s important to know melatonin should be used with care, especially since regulation of over-the-counter melatonin products vary so significantly. Under the care of a physician, dosage can be adjusted, and side effects can be managed.
At our sleep center, we emphasize a comprehensive approach to treating sleep difficulties. Melatonin may be one part of a larger treatment strategy, particularly for circadian rhythm disorders. We strongly recommend consulting a sleep specialist before starting any sleep aid, including melatonin, to ensure the safest and most effective care based on individual sleep patterns and medical history.
If you’re struggling with sleep, we’re here to help. Schedule an evaluation with our board-certified sleep team to determine the cause of your sleep issues and the best path forward—whether that includes melatonin or other clinically supported therapies.
The contents of this article have been provided by Advantage Therapy and Sleep Centers. Advantage is a regional leader in providing patient-centered healthcare through managing and operating Comprehensive Outpatient Rehabilitation Facilities and Sleep Centers. Advantage manages Shore Medical Center's Sleep Center which provides a welcoming, home-like environment to generate positive outcomes and long-term treatment assistance. Shore's Sleep Center is located at 710 Centre Street in Somers Point. To learn more or schedule an appointment call 609.477.7036.
References:
- Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-wake rhythm disorder (ISWRD). J Clin Sleep Med. 2015;11(10):1199-1236. doi:10.5664/jcsm.5150
- Erland LAE, Saxena PK. “Melatonin Natural Health Products and Supplements: Presence of Serotonin and Significant Variability of Melatonin Content.” J Clin Sleep Med. 2017;13(2):275–281.
