Melatonin, Does It Work?

Sleep is important! Sleep has restorative functions, metabolic functions, and cognitive functions. In other words, sleep gives our body time to repair, organize thoughts and memory, and conserve energy. Not getting enough sleep can have significant health impacts and make you irritable, exhausted, and anxious. A health supplement called melatonin has been promoted as a sleep aid, but does it actually work? This article is going to address that.

What Is Melatonin?

Melatonin is a compound that our body produces naturally every day. It plays a vital role in the sleep cycle. During the night or when we usually go to sleep, our body produces melatonin to synchronize and help move our body into a sleep state. This is why having a sufficient amount of melatonin can be very significant in our sleep health.

The level of melatonin changes throughout the day, with the highest level at night when the body gets ready for a resting state and the lowest during the daytime during the body’s wakeful period. Over time, this rise and fall of melatonin levels become a pattern as the body starts to recognize and memorize the pattern. When this happens, we refer to it as entrainment. This is also why when you go on a vacation in a different time zone, sometimes you get jet lag, but after some time, the body gets used to the new time zone and becomes “entrained” to that time zone.

Not only does the level of melatonin fluctuate during the day, but the level of melatonin also changes as we age. Children have the highest level of melatonin. This is one of the reasons why they nap so much! This peak level of melatonin increases the older we get. This results in the elderly having the least amount of melatonin. In some, the level of melatonin is almost negligible. This is one of the reasons why older people have so much trouble with their sleep.

Another reason why many of us have problems with sleep is all of the artificial light that comes with our electronics. This artificial light turns off the mechanism that generates melatonin. And when melatonin isn’t being produced as it should, we can say hello to sleep disturbances and insomnia. Not good!

Benefit of Melatonin

The idea behind melatonin supplements is to provide melatonin to the body in the hope that it can go in and perform like natural melatonin that our body produces. By replenishing the melatonin deficiency that we may have, the body may be able to go back to its normal sleep cycle and resolves any insomnia or sleep disorders that we may experience.

Melatonin has been recommended for insomnia and any scenario where the normal sleep cycle may be shifted, such as working a new graveyard shift and jet lags. Studies have shown that melatonin can help to reduce the time it takes to fall asleep. One study published in 2018 reported that melatonin supplementation taken once daily over a four-week period effectively improves total sleep time and early morning wake time in middle-aged patients with insomnia.

The benefit of melatonin in people with sufficient melatonin, good sleep hygiene, and normal sleep/wake cycle has yet to be shown definitive benefit, so that no solid recommendation can be said for this population. But in patients with a low amount of natural melatonin, such as the elderly or those with insomnia, melatonin can be beneficial in improving the onset of sleep and quality of sleep.

How To Use Melatonin

The key with melatonin is to start low! Especially if you have never used melatonin before, start with 1 to 2 mg a night. And plan ahead. This supplement needs time to get into your body and even more time for it to start working. I would say take the tablet at least 1 to 2 hours before you plan on going to sleep.

Remember that this may or may not work for you, so if, after a few nights, you don’t think it’s working. Don’t force it. It’s probably not going to work for you. Just because our body produces it naturally doesn’t mean that you should take a bucketful of it. This leads to the next question. Is melatonin safe?

Side Effects of Melatonin

Melatonin supplements are considered safe for most people, but yes, they can have potential side effects like any other medications or health supplements. Some of the common side effects of melatonin are dizziness, headache, and nausea. The upper level of melatonin dose has not yet been established, but there have been reports of grogginess, confusion, and nightmares with high doses of melatonin. As was said before, start with a low dose (1-2 mg) of melatonin.

Another thing that I would like to point out about melatonin and any other health supplements. In the United States, health supplements are not that regulated. What manufacturers put in the bottle and how much don’t need to be verified by the FDA before being put on the shelf. So before you get a bottle of melatonin, check into the manufacturers. Please make sure they are reputable or put their products through a certification process like a USP-verified mark or cGMP.

The next warning point is that just because melatonin is considered a health supplement doesn’t mean it won’t interact with other medications because it can. Melatonin has to be processed inside our bodies. This process is the same one that many drugs go through as well. If you’re unsure whether your medication will interact with melatonin, please ask your healthcare provider or pharmacist. It is always better to be safe than sorry.

My last point on melatonin safety is about children. The number of children who accidentally overdose on melatonin increased by 530% over the last decade. While the use of melatonin may be warranted on some occasions, healthcare providers should be consulted before you make any decision to give melatonin to kids.

Conclusion

In conclusion, melatonin is a natural compound that plays an important role in our sleep cycle. In those who are not producing enough melatonin, whether by being older or constantly exposed to artificial light, the use of melatonin can help improve the quality of sleep or alleviate symptoms of jet lag. The decision to use melatonin should be made with care because it is not without potential side effects. It is best to consult with your healthcare provider before taking any supplement, especially if you are unsure, pregnant, breastfeeding, or taking any other medication.

Reference

1. Xu H, Zhang C, Qian Y, Zou J, Li X, Liu Y, Zhu H, Meng L, Liu S, Zhang W, Yi H, Guan J, Chen Z, Yin S. Efficacy of melatonin for sleep disturbance in middle-aged primary insomnia: a double-blind, randomised clinical trial. Sleep Med. 2020 Dec;76:113-119. doi: 10.1016/j.sleep.2020.10.018. Epub 2020 Oct 17. PMID: 33157425.

2. American Academy of Sleep Medicine. Health Advisory: Melatonin Use in Children and Adolescents. 2022 Sept. https://aasm.org/advocacy/position-statements/melatonin-use-in-children-and-adolescents-health-advisory/