Desperate to get more sleep—and especially after 2020, which was an epically bad sleep year for many people—3.1 million Americans turn to melatonin to get better rest. The supplement’s popularity is growing, but how much do we really know about this natural sleep aid? We spoke to doctors and sleep experts to answer all our questions about melatonin and how it really works.
What is melatonin?
“Melatonin is a hormone made from tryptophan that we make naturally,” says Dr. Anthony Kouri, MD and spine surgery fellow at Johns Hopkins. “It primarily comes from the pineal gland and regulates the sleep-wake cycle, circadian rhythm and other seasonal rhythms.” At night, melatonin production rises around 9 p.m. to help wind the body down and by about 9 a.m., melatonin production all but disappears. Though the hormone tends to function on a set day/night schedule, it’s greatly affected by light. If you’re exposed to light, even at midnight, your brain will stop producing melatonin. Whether you’re enjoying the sun at noon or checking Instagram in bed, they both have about the same effect on the hormone. Scientists still aren’t sure exactly how melatonin affects sleep, but there seems to be a fairly solid connection. “Though melatonin is not essential for sleep, we tend to sleep better when it is secreted,” Dr. Kouri says.
How do melatonin supplements work?
Basically, melatonin supplements add more melatonin to the mix. “Our bodies produce melatonin naturally to help us start to fall asleep,” says Dr. Nicole Avena, Ph.D., assistant professor of neuroscience at Mount Sinai School of Medicine. “Taking the supplement can be helpful for people who have trouble settling down naturally to sleep.” By increasing the amount of melatonin, you give your body even more signals to go to bed, which may help you fall asleep faster and get higher quality sleep through the night. “Melatonin regulates the natural sleep-wake cycle,” adds Dr. Cinthya Pena Orbeaof Cleveland Clinic’s Sleep Disorders Center. “Levels start to increase in the evening by reaching the highest levels before bedtime.” People who work night shifts, have jet lag, or experience delayed sleep phase disorder (when you can’t get to sleep until very late and have trouble waking up early) also turn to melatonin for help. Since the hormone helps regulate the circadian rhythm, melatonin may help in reestablishing the regular day/night sleep schedule. Melatonin dosage can vary, as every person reacts differently to the hormone. “Since some people are more sensitive than others to the effects of melatonin, it is best to start off low and increase your dose as needed,” Dr. Avena says. “Doses of 0.2-5 mg are considered safe.”
Why is melatonin so popular?
According to the American Sleep Association, 50-70 million Americans have a sleep disorder, 30% of adults have occasional insomnia, and 35.3% of adults get less than seven hours of sleep in a typical day. Prescription sleep aids can be addictive or come with serious side effects that result in your eating and driving while you’re still asleep. So, people are attracted to melatonin as a natural solution. Unlike other hormones, our brains make melatonin and it naturally occurs in food(pistachios in particular). Since it shows up in food, melatonin is considered a dietary supplement, which means it doesn’t need approval from the Food and Drug Administration and isn’t as closely controlled as prescription medicine, according to the National Sleep Foundation. In fact, it’s the only hormone supplement that’s available over the counter. Since melatonin supplements aren’t “drugs” and don’t have the scary side effects of other sleep aids, people have been flocking to this all-natural option.
Can you overdose on melatonin?
Technically, yes. “High doses can result in increased drowsiness, but it is not particularly dangerous,” says Dr. Carl W. Bazil, MD, director of the division of Epilepsy and Sleep at Columbia University. You certainly won’t die from too much melatonin, but it can be unpleasant. Dr. Avena says that nausea, irritability, dizziness and headaches are common side effects from taking more than you need. How much is too much? “Keep the dose low: 1-3 milligrams,” saysDr. Rebecca Robbins, sleep researcher and co-author of Sleep for Success! “No more than 5 milligrams is typically advised.”
Can you mix melatonin and alcohol?
In short, probably not. “Some of the biggest safety concerns with mixing alcohol and melatonin include drowsiness, difficulty breathing, dizziness and risk of falling,” says Dr. Kouri. Dr. Avena recommends waiting at least 2-3 hours after drinking alcohol to take melatonin.
What about weed and melatonin?
Since many states have legal forms of marijuana, it’s important to know how the drug can affect melatonin. “Marijuana will increase your melatonin levels naturally, so if you use it, there is no need to take a melatonin supplement,” says Dr. Avena. “If anything, you may end up with some of the unwanted side effects of melatonin overdose.” Mixing weed and melatonin isn’t terribly dangerous, but again, it’s not recommended. Also, using marijuana as a sleep supplement is something you should ask your doctor about before trying, if the drug is legal in your area.
Is melatonin safe for kids?
Adults aren’t the only ones who have trouble sleeping. One study found melatonin to be very effective in helping children get to sleep easier and stay asleep through the night. Now, this is only one study with a small sample size, so definitely see a pediatrician before starting your child on the supplement. But, if a child has extreme trouble sleeping, melatonin may be a helpful tool in getting some rest.
Why does melatonin affect people so differently?
You might have a friend who swears by melatonin, only to have a coworker tell you that the supplement did absolutely nothing for them. How can the reactions be so different? Part of the reason is because people have trouble sleeping for all kinds of reasons and melatonin can’t solve all the sleep problems. “Many people take melatonin for insomnia, but if they don’t address the other reasons their body is staying awake (work stress, personal stress, bad sleep habits, etc.) it will not help,” says Dr. Bazil. If you don’t put your phone (or tablet or laptop) away, you might also be affecting the melatonin’s efficacy. “Blue light can inhibit melatonin,” said Dr. Avena. “So if you take a supplement and then look at a screen while waiting to fall asleep, you might be hindering the ability of melatonin to make you sleepy.”
Is it safe to take melatonin every night?
According to Dr. Orbea, melatonin is generally safe for short term use and when it is taken in appropriate amounts. “The FDA doesn’t regulate supplements so there are always concerns about purity of melatonin products,” she adds. “Therefore, it is advised that its usage should be under a doctor’s supervision for side effects and possible drug interactions as well. Although there are not guidelines set for a safe dose of melatonin, overuse increases the likelihood of unwanted side effects such as headache, dizziness, drowsiness.” Still, Dr. Avena and Dr. Bazil both agree that the supplement is likely safe to use every night, as long as you stay under a five milligram dose.
Do melatonin supplements really work?
Interestingly, a systematic review of melatonin studies found that melatonin supplementation did very little to help with insomnia, shift work, or jet lag. Another review found no proof that melatonin helped people get to sleep faster. Still, other experts found the supplement effective. Dr. Obea notes that melatonin is recommended to people who have sleep disorders. Dr. Avena feels melatonin is a helpful sleep aid, while Dr. Bazil said “it can definitely be useful if there is a circadian rhythm component to the sleep problem.” Since the studies on melatonin have such mixed to negative results, few experts wholeheartedly recommended the supplement, though they feel melatonin is perfectly safe to try. “Some people may benefit from melatonin while others may not,” said Dr. Robbins. “If you don’t see a difference within the first 1-2 weeks, stop taking melatonin.”
What are other options for getting better sleep?
Melatonin may or may not help you head off to dreamland, but there are many things you can do to increase the chances of a good night’s sleep. “The healthiest way to fall asleep is to have a healthy sleep schedule that you can keep all seven days of the week,” said Dr. Robbins. She recommends relaxing before bed, avoiding spicy foods at night, keeping the bedroom cool, wearing breathable PJs so your body temperature stays level, and going to sleep at about the same time every night. After you’ve established a soothing sleep routine, be careful of blue light. “Using devices such as laptops and smartphones in bed can lead to disrupted sleep,” said Dr. Kouri. Take a break from all screens at least 30 minutes before you go to bed. This will help your natural melatonin production (and ease any Facebook FOMO anxieties) to help you get to sleep. Melatonin supplements have mixed results, but are perfectly safe to try if you’re curious. Just make sure to start at a low dose (1 milligram), avoid mixing with alcohol, and keep screens away from the bedroom.
Sources
Cinthya Pena Orbea, MD at the Cleveland Clinic Sleep Disorders CenterRebecca Robbins, sleep researcher and co-author of Sleep for Success!Carl W. Bazil, MD, director of the division of Epilepsy and Sleep at Columbia UniversityAnthony Kouri, MD and spine surgery fellow at Johns HopkinsNicole Avena, Ph.D., assistant professor of neuroscience at Mount Sinai School of MedicineAmerican Sleep Association: “Sleep and Sleep Disorder Statistics”Nutrients: “Dietary Sources and Bioactivities of Melatonin” Sleepfoundation.org: “Melatonin and Sleep” Nutrition Journal: “The effectiveness of melatonin for promoting health sleep: a rapid evidence assessment of the literature”Clinical Pediatrics: “Melatonin in Children and Adolescents with Insomnia: A Retrospective Study”BMJ: “Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis”
