Melatonin. Harms and Benefits.

One of the best-known ways to improve sleep quality is to take melatonin-based medications. They are believed to be better and safer than a number of sleeping pills. If you are interested in this supplement or have been taking it for a long time, it is important for you to be aware of all of its features. This drug is much more complex than a simple sleeping pill.

Key Points

• Melatonin is a hormone that regulates the sleep-wake cycle.
• Supplemental melatonin intake can be helpful in some cases. But not for everyone.
• Melatonin can cause side effects. Daytime sleepiness, headaches, and nausea reduce the effectiveness of some medications.
• The dosage of melatonin is better to choose with a doctor. Since the causes of sleep disturbances are individualized, and melatonin is sold in an extremely high dosage for most patients. 
• If you are having trouble sleeping, it is best to try to establish an evening routine. Using these practices will help you fall asleep easily and sleep soundly without having to rely on melatonin supplements all the time.

How Urgent is the Problem of Insufficient Sleep?

According to a CDC study, more than a third of adults have regular sleep problems and sleep less than 7 hours a night.

The National Sleep Foundation notes that different age groups need different amounts of sleep. Pay attention to the chart, it can help you determine if you're getting enough sleep.

Recommended Sleep Duration for Healthy People

In some cases, sleeping an hour more or less than the normal range may be acceptable depending on the individual's circumstances. Sleep recommendations for newborns cannot yet be determined with certainty. The sleep needs of this age group are individualized.

If you find that you are consistently getting too little sleep or have trouble falling asleep, it's advisable to consult a doctor to assess the melatonin levels in your body.

What is a Melatonin Supplement?

Over the past few years, melatonin has become the most prevalent over-the-counter supplement for addressing sleep issues.

This supplement is available in various forms—tablets, dragees, capsules, drops, and even gummy bears. Melatonin effectively initiates sleep, but this doesn't necessarily mean that a melatonin tablet will cure insomnia; the issue is more complex than that.

Melatonin supplements primarily help restore the body's circadian rhythm. Circadian rhythms are the natural 24-hour cycles that govern physical, mental, and behavioral changes in the body, which respond to light and darkness in the environment.

These rhythms influence sleep, body temperature, hormone production, appetite, and other physiological processes. Disruptions in circadian rhythms have been linked to various conditions, including obesity, diabetes, depression, bipolar disorder, seasonal affective disorder, and sleep disturbances.

Who Should Take Melatonin Supplements

Melatonin has two main indications for use.

1. Sleep Disorders 

Insomnia, disturbed shallow sleep with frequent awakenings, sleep disorders in children, night and shift work (effect not proven).

2. Biorhythm Disruption

Disruption of melatonin production on the background of external negative factors.

Expected Effects of Melatonin Supplements

• Restore Healthy Sleep-Wake Cycles

Melatonin supplements can help re-establish normal circadian rhythms, which dictate our natural sleep patterns.

• Adaptation to Time Zone Changes

They can ease the body’s adjustment to new time zones, reducing the impact of jet lag.

• Accelerate Sleep Onset

Melatonin has a mild sedative effect that can help users fall asleep more quickly.

• Improve Sleep Quality

It can contribute to deeper, more consistent sleep without frequent awakenings and can normalize the phases of sleep.

• Energizing Wake-ups

By improving sleep quality, melatonin can help individuals wake up feeling more refreshed and alert.

How Melatonin Works in the Body

Melatonin plays a crucial role in how our body manages the sleep-wake cycle.

• Reception of Light and Darkness

Melatonin production is influenced by light exposure. Photoreceptors in the eyes detect light and darkness, sending signals to the brain.

• Signal Transmission

These signals are transmitted to the suprachiasmatic nucleus (SCN) in the brain, which is the body's master clock. It processes this information and uses melatonin to communicate changes in light and darkness to the body.

• Melatonin Production

The pineal gland, located in the brain, synthesizes melatonin predominantly at night. As darkness falls, melatonin levels in the blood rise, signaling to the body that it's time to sleep.

• Systemic Impact

The rise in melatonin levels encourages sleep by calming the body and lowering alertness. As dawn approaches and light increases, melatonin production decreases, which helps wake us up.

• Widespread Role

Beyond regulating sleep, melatonin is involved in various biological functions, including modulation of mood, immune response, and antioxidant defenses. It is synthesized not only in the pineal gland but also in other areas such as the gut, liver, and retina.

By understanding how melatonin works, individuals can better appreciate its impact on sleep and overall health, making informed decisions about its use in their daily routines.

Melatonin as a Sleep Hormone

Melatonin plays an important role in the quality of our sleep.

• It acts as a mild sleeping pill.
• It has an inhibitory effect on the endocrine system and reduces the production of hormones (including stress hormones).
• Controls breathing during sleep.

Additional Effects of Melatonin on the Body

Beyond its role in sleep, melatonin serves several vital functions that contribute to overall physical and psychological well-being.

Antioxidant Properties

Melatonin acts as a powerful antioxidant. It combats free radicals, harmful compounds that cause oxidative stress and cellular damage. By neutralizing these radicals, melatonin helps to slow down cellular aging and promotes a longer lifespan.

Mental Health Benefits

Its antioxidant effects also extend to mental health, where it can mitigate symptoms of mood disorders and cognitive decline.

System-Wide Benefits

The widespread synthesis of melatonin in various body tissues, including the brain, liver, and gut, underscores its integral role in a range of physiological processes from mood regulation to digestive health.

Understanding these multifaceted roles of melatonin can help individuals make informed decisions about its use as a supplement for improving sleep and enhancing overall health.

Antidepressant Effects of Melatonin

Melatonin exhibits a mild antidepressant property, making it a potentially beneficial supplement for mental health. Research indicates that an inadequate production of melatonin may contribute to the onset of seasonal affective disorder (SAD), a type of depression that occurs at the same time each year, typically during fall or winter. By potentially boosting melatonin levels, individuals may experience an alleviation in the symptoms associated with SAD, enhancing overall mood stability.

Protection Against Cancer

Studies suggest that melatonin's regulatory effects on cell function extend to cancer prevention. Melatonin has been found to play a role in inhibiting the uncontrolled division of cancer cells, thus potentially reducing the risk of tumor development. This protective mechanism is particularly significant in the context of its antioxidant properties, as it may help safeguard cells from oxidative stress that can lead to cancerous changes.

Forms of Melatonin

Melatonin is available in various forms to suit different needs and preferences.

Important! Please note that melatonin is not a sedative or sleeping pill that will help you fall asleep in five minutes. It's a hormone that controls your perception of light. When the sun goes down, the pineal gland in the center of your brain starts releasing melatonin into your bloodstream. The higher the level of the hormone, the faster you'll want to sleep. Melatonin supplementation is one way to increase the amount of this hormone, but it won't start working instantly.

Melatonin needs to build up in the body to induce sleepiness in you. The level of sufficient concentration in the blood after taking the pill will rise in about 30-90 minutes.

"Sleep hormone" will help you get a better night's sleep, but it's not guaranteed to solve all your problems. A 2013 study found that melatonin supplements help people fall asleep only 7 minutes faster and sleep 8 minutes longer on average. This is just a small improvement in quality of life, and it doesn't address underlying health issues.

Melatonin Dosage

The correct dosage of melatonin is not easy to find. The brain produces less than 0.1 g of melatonin per night. In supplements, however, melatonin is usually much more, averaging between 2 and 12 mg. This amount seems excessive. Especially in the context of studies in which melatonin reduced insulin sensitivity and insulin production. You can get a condition similar to a hangover from an overdose of melatonin. You'll wake up disoriented, take more hours to sleep than usual, and spend the next 24 hours feeling foggy in the head.

Approximate Doses of Melatonin for Different Situations

We have given the data that doctors use in their practice. This is an example of using melatonin supplements for different symptoms. As you can see, the dosage can vary greatly.

Recommended Melatonin Doses for Various Conditions

The dosage of melatonin supplements can vary significantly depending on the intended use and individual needs. Here are some common scenarios and the typical dosages used.

How Long Can Melatonin Be Taken?

• If melatonin for sleep does not help after a week or two, you should stop using the supplement. 
• If sleep problems continue, it is worth talking to your doctor. 
• If melatonin seems to be helping, it is safe for most people to take it at bedtime for one or two months. The most common period of daily use is up to six months for adults and up to three months for children.

Large studies are needed to determine if it is effective for all forms of insomnia and especially for long-term use.

When Melatonin Will Not Help

If insomnia is associated with psycho-emotional agitation, then taking melatonin will be completely ineffective. This hormone does not make the body fall asleep, but only gives a signal that it is time to sleep. Therefore, if you are tormented by anxiety, you will not see any effect.

How to Help Get Sleep Without Taking Melatonin

Melatonin levels increase about two hours before bedtime. You can create optimal conditions for this process.

• Dim the lights before bedtime.
• Stop using your computer, smartphone, or tablet. The blue and green light from these devices can neutralize the effects of melatonin.
• Go to bed in a cool, dark room.
• Put a humidifier in your bedroom if you have low humidity in your home. Optimal settings are 40-60%.
• Limit your caffeine intake after noon. You can buy a soothing tea (such as Tulsi tea) to brew in the evening.
• Don't drink alcohol.
• Add meditation, foot baths with epsom salt, or warm showers to your evening routine.

You can help program your body to produce melatonin for sleep at the right time of day by getting daylight in the morning and afternoon. This can be done by taking a walk outdoors or sitting by a sunny window.

The CDC recommends setting the same bedtime and wake-up time every day of the week, even on weekends.

Risks of Taking Melatonin

Melatonin is considered safe for short-term use. For example, to restore sleep patterns. Even taking a single extreme dose is unlikely to cause harm. There is not yet enough data on long-term use to consider it completely safe.

It is recommended to stick to low doses of melatonin to avoid side effects, which typically include increased dreaming, nightmares, or morning drowsiness. Common side effects of short-term melatonin supplementation (occur in 1 out of 100 people).

• headache
• drowsiness
• dizziness
• nausea
• feelings of irritability and restlessness
• dry mouth
• dry and itchy skin
• arm or leg pain
• strange dreams

You may be tempted to take more melatonin to sleep better, but too high a dose can cause side effects that can further disrupt your sleep.

Serious Side Effects of Taking Melatonin

Serious side effects are rare. Less than 1 in 1,000 people. You should contact your doctor immediately if you begin to feel depressed or sad, your vision becomes blurred, confusion, fainting, bleeding, unexplained bruising, or blood in the urine. In rare cases, a serious allergic reaction may occur.

What to Do if Side Effects Occur

• Drowsiness or tiredness during the day - do not drive or ride a bicycle. Do not drink alcohol as you will feel even more tired.
• Headache - make sure you get enough rest and drink plenty of fluids. Don't drink a lot of alcohol. Talk to your doctor if your headaches last longer than a week or are very severe.
• Stomach pain and nausea - take melatonin only after meals. Depending on the intensity and duration of the pain, consult your doctor.
• Dizziness - sit or lie down until you feel better. Do not drive, ride a bicycle, or drink alcohol.
• Irritability and restlessness - if this does not go away within a few days, stop taking the supplement and see your doctor.
• Dry mouth - chewing gum may help.
• Arm or leg pain - if it doesn't go away within a few days, stop taking the medicine and see your doctor.
• Strange dreams or night sweats - if it does not go away within a few days, stop taking the medicine and see your doctor.

Why Melatonin Should Be Prescribed by a Doctor

Melatonin has become widely known and commonly used in recent years, leading to its widespread availability and use in high doses. However, it is crucial to consult a doctor before using melatonin, especially in high doses or for long periods. Here are the reasons why professional guidance is essential.

Drug Interactions

Melatonin should not be taken without medical advice. It is especially important to consult before taking the supplement for pregnant and lactating women, patients with autoimmune diseases, seizure disorder, heart disease, high blood pressure and depression. Supplementation may affect the effects of medications.

The list of medications that are best not to take along with the supplement is quite long. Anticoagulants, antiplatelet drugs, and any supplements that reduce blood clotting when combined with melatonin increase the risk of bleeding.

Antidepressants and hormonal contraceptives cause excessive sleepiness and may worsen side effects. Diabetes medications may work worse because melatonin reduces insulin sensitivity. Anticonvulsant drugs and immunosuppressants also work worse. So if you're taking medications, it's a good idea to consult your doctor before buying melatonin.

High doses of vitamin D reduce the production of natural melatonin.

Melatonin Is Regulated as a Dietary Supplement

In the United States, melatonin is classified as a dietary supplement, meaning it is available over the counter without a prescription. However, unlike prescription medications, dietary supplements are not subject to the same strict regulations. As a result, not all melatonin products are created equal.

For example, the actual amount of melatonin in a supplement may not always match what’s listed on the label. A 2017 study analyzed 31 different melatonin supplements and found that the actual melatonin content varied significantly, from 83% to 478% of the labeled dose. This inconsistency raises concerns about the reliability and effectiveness of melatonin supplements.

Safety Concerns for Different Groups of People

Certain individuals should be cautious when using melatonin, as its effects can vary based on age, health conditions, and other factors.

• People with dementia. The American Academy of Sleep Medicine issued guidelines in 2015 advising against melatonin use for individuals with dementia.
   
• Older adults. Melatonin may take longer to be eliminated from the bodies of older adults compared to younger individuals, potentially leading to daytime drowsiness and an increased risk of falls or confusion.
   
• Pregnant and breastfeeding women. There is insufficient research on how melatonin affects pregnancy and breastfeeding, so its use is not recommended without medical supervision.
   
• People with allergies. The effects of melatonin on individuals with allergies are not well-studied, making it unclear whether it could trigger adverse reactions.
   
• Children. Not all children benefit from melatonin. A 2022 study found that the number of children exposed to melatonin and reported to U.S. poison control centers increased fivefold over the past decade. The highest hospitalization rates were among children under five years old.
• Tolerance to melatonin. Some individuals experience reduced effectiveness of melatonin over time. After an initial improvement in sleep, their bodies may develop a tolerance, making melatonin less effective.

Given these concerns, it’s best to consult a healthcare provider before using melatonin, especially for long-term use or in vulnerable populations.

Melatonin and Jet Lag: What You Need to Know

Melatonin is often recommended as a simple fix for jet lag, but the reality is more complex.

• Avoid taking melatonin on the plane. Doing so can further disrupt your circadian rhythm instead of helping to reset it.
• Be aware of potential side effects. Melatonin can cause dizziness, nausea, and headaches, which may worsen the fatigue already caused by travel.

To minimize jet lag, experts recommend using online jet lag calculators, which consider your departure and arrival locations, flight duration, and usual sleep schedule. These tools can help determine the best time to take melatonin for optimal effectiveness. Two popular options include.

• Jet Lag Rooster
• Fleet Street Clinic Jet Lag Calculator

For best results, take 0.5 to 3 mg of melatonin 30–60 minutes before bedtime for up to four days after your trip to help your body adjust to the new time zone.

Melatonin and Shift Work

Shift workers often struggle with sleep disturbances due to disruptions in their circadian rhythm. While some people report benefits from melatonin, studies on its effectiveness for shift workers have been inconclusive.

If your job affects your sleep schedule, it’s best to try natural relaxation techniques first—such as maintaining a consistent bedtime, limiting screen time before sleep, and creating a dark, quiet sleeping environment. These methods can help regulate your sleep without relying on supplements.

Does Melatonin Affect Dreams?

One of the most common side effects of melatonin is intensely vivid dreams. Many people report that their dreams become more detailed and lifelike, though scientists are still unsure why this happens.

For some, melatonin can trigger nightmares. If this occurs, consider reducing your dosage or discontinuing use altogether.

Can You Get Enough Melatonin from Food?

Certain foods naturally contain melatonin, including.

• tart cherry juice
• pistachios
• almonds
• cashews
• brazil nuts
• chestnuts

However, dietary sources alone are not enough to produce a noticeable effect on sleep patterns. While these foods may support overall health, they typically do not provide melatonin levels high enough to regulate sleep in the same way supplements do.

Final Thoughts: Is Melatonin Right for You?

Melatonin can be a helpful tool for improving sleep, but it’s not a one-size-fits-all solution. While it may aid in adjusting to jet lag or mild sleep disruptions, it’s not a cure for chronic insomnia or stress-related sleep problems. Additionally, the lack of regulation in melatonin supplements means you may not always get the dosage listed on the label, and potential side effects, such as daytime drowsiness, dizziness, or vivid dreams, should not be overlooked.

Before taking melatonin, it’s best to try natural sleep strategies like maintaining a consistent bedtime, reducing screen exposure at night, and creating a sleep-friendly environment. If sleep issues persist, consult a healthcare professional to explore underlying causes and find the best long-term solution for your health.

In the end, melatonin is most effective when used wisely, as a short-term aid rather than a nightly habit.