Can Melatonin Supplements Really Help You Sleep?

Can Melatonin Supplements Really Help You Sleep?

You may be surprised! Get the facts about this natural sleep aid.

Down every drugstore aisle you turn, there seems to be a supplement or product claiming to help you get better ZZZs, concentrate better or amp up your energy levels. Most of the time, it’s hard to decipher what—if anything—will work, and if it’s even safe.

Melatonin supplements have long been believed to be the nighttime sleep aid. In fact, it's the most commonly used sleep aid in adults and children, according to the National Institutes of Health (NIH). The Centers for Disease Control and Prevention (CDC) estimates that three million Americans took melatonin in 2012. But does it send you off to dreamland? If so, how much melatonin should you take, and when?    

In search of answers, we talked to Keith Roach, MD, associate professor in clinical medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital, to find out if melatonin truly is an effective sleep aid, along with tips for natural ways to sleep better.

What exactly is melatonin?
First things first. Sleep is regulated by our body’s exposure to light or darkness. Melatonin is a natural hormone produced in the pineal gland, a tiny gland deep in the brain. In the daytime, your pineal gland is inactive, but when it starts to get dark outside, it begins secreting melatonin. As melatonin is released into your bloodstream, you become tired and ready for sleep. Your melatonin levels stay high for about 12 hours. But when your body is first exposed to daylight, the levels drop, your body temperature rises and cortisol, a stimulating hormone, is secreted. Given that melatonin production starts when your surroundings begin to darken, bright and artificial lighting prevents its release—interfering with your sleep.

While melatonin is a hormone your body naturally produces, it's one of the few hormones you can buy without a prescription. But it’s important to remember that dietary supplements aren’t regulated by the FDA, and the downside is that many products provide inaccurate dosage information on the packaging. Some products may cause your melatonin level to rise up to 20 times what it should be! Or, alternatively, the supplement may not have any melatonin in it at all.

So, should you take melatonin?
Dr. Roach says it’s better that you don’t take any type of sleep medication. “We try to get people to sleep better without medication treatment, and at least two-thirds of the time, we’re able to do that. It’s shocking how often people aren’t doing everything they need to.”

So, before a supplement comes into play, most doctors recommend you first try these lifestyle habits:

  1. Power down all of your electronics and bright sources of light two hours before bedtime.
  2. Get out of bed if you’re unable to sleep: “You don’t want your bed associated in your mind as a place where you just lie there and get frustrated,” says Roach. If you can’t fall asleep within 20 minutes, go in another room and listen to quiet music, read with a dim light or practice some breathing techniques. Return to bed when you feel sleepy.
  3. Stick to a sleep and wake schedule, even on the weekends.
  4. Set your room temperature somewhere between 60 and 70 degrees.
  5. Avoid naps.
  6. Steer clear of alcohol, cigarettes and heavy meals beginning at least two hours before bed time.
  7. Don’t exercise too close to bed time—it’s best to work out four or more hours beforehand.
  8. Do things that can help you relax, like taking a hot bath or having a cup of chamomile tea.

4 things to keep in mind if you do take melatonin
If you’re practicing healthy sleep habits, but you’re still having trouble getting good ZZZs, your doctor may suggest that you try melatonin. “Melatonin is relatively safe and it doesn’t cause problems the way both over-the-counter and prescription medications do, which is why it may be worth a try for some people,” says Roach. But there are some things you should know before you head to the store:

  1. The timing and dosage of melatonin matters most. If melatonin is going to be helpful to your biological clock, the right dosage has to be taken at the right time. If you take too much at the wrong time, you could be tired during the day and wide awake at night.

    Roach says age plays a role in how much and when you should take melatonin. “For younger adults in their 20s, 30s and even into their 40s, taking it mid-afternoon is normally most effective, and half a milligram should be plenty,” says Roach. “But older people may be able to take a slightly larger dose—one milligram—an hour or so before bedtime.” Talk to your doctor about the dosage that’s right for you.
  2. Its effectiveness depends on your symptoms. Melatonin is more likely to work for people who wake up very early in the morning, which could indicate a circadian rhythm problem, or for those who aren’t able to fall asleep right away, says Roach. “For those who wake up after an hour or two of sleep, it’s probably not effective.”
  3. It’s a short-term fix. Your healthcare provider is probably only going to recommend melatonin for the short-term. The testing that’s been done so far has shown it’s safe for three months. “After that, who knows,” says Roach. He also points out that if you’ve been taking it for three months and not sleeping better, it’s just plain not working so you should stop and talk to your healthcare provider. You may have a more serious sleep condition, such as obstructive sleep apnea or narcolepsy, which would require different treatment. Roach also says that early morning wakening could be a sign of major depression, and he would screen for that.
  4. Some people shouldn’t take melatonin. Although melatonin is safer than other sleep medications, even over-the-counter options like diphenhydramine, Roach says there are some circumstances that may prevent your doctor from recommending it, like:
  • You’ve had a bad reaction to melatonin in the past
  • You’re taking other prescription sleep medication
  • You’re pregnant or breastfeeding
  • You have health conditions such as autoimmune disorders, diabetes, depression or high blood pressure

The bottom line
When it comes down to it, there appear to be no major safety concerns and the biggest complaint Roach gets about melatonin is that it just doesn’t work. But, more research is needed to fully understand melatonin’s effectiveness. It’s better to see your healthcare provider before you start taking it, especially if you practice healthy sleep habits without any positive results. 

Medically reviewed in January 2020.

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