By: Elizabeth Obigwe, B.Sc. Anatomy. Freelance Writer; with medical review and editorial support by the DLHA Team
Melatonin supplement for sleep problems. Is it safe? Does it work?
It is difficult to function properly without sufficient sleep because sleeping is how your body recharges itself. Yet, even the best sleepers have trouble sleeping sometimes. When this happens, we tend to look for ways to improve our sleep and get the adequate rest that we need.
Melatonin supplement, also simply called melatonin, is one of the sleep aids that many people use and it’s becoming even more popular these days. But how safe is melatonin for sleep problems? Does it work?
This article will discuss some important facts about the use of melatonin as a sleep medicine, including;
It will also look at other ways that you can improve your body’s natural melatonin production without taking drugs.
Melatonin commonly known as ‘sleep hormone’ is a hormone in your body that contributes to regulating sleep and wakefulness. Melatonin is produced naturally by the pineal gland.
The gland sits centrally at the top and backend of what is called the brainstem. The brainstem is a region that connects the cerebrum (commonly called the brain) and cerebellum in your skull with your spinal cord in the bones of your spine (see figure. 1). Other organs like the eye, bone marrow, skin, and gastrointestinal tract are also known to produce some level of melatonin [1].
Illustration of a brain that is cut into two halves showing the location of the pineal gland and related brain structures
Natural melatonin is highest in the bloodstream at night and reduces with the brightening of the day.
In promoting sleep, melatonin does not work as a sedative. Rather, it prepares the body for sleep by putting it in a state of quiet wakefulness that helps to facilitate sleep.
Melatonin supplement is a man-made product that is designed to function just like the natural hormone. It is available as tablets, capsules, liquid and gummies.
When melatonin is taken at bedtime, it mimics the natural increase in melatonin levels that occurs during the night, thereby preparing your body for sleep.
As the day turns into night, the absence of light signals the brain to increase melatonin production, making you feel sleepy. This rise in melatonin levels helps prepare your body for sleep by lowering body temperature and slowing down other processes, signalling that it's time to rest.
When melatonin levels are high, you naturally start to feel more relaxed and drowsy, making it easier to fall asleep. Conversely, when morning light hits your eyes, melatonin production decreases, helping you wake up and feel alert. This cycle of melatonin production in response to light and darkness helps keep your internal body clock (known as circadian rhythm or sleep-wake cycle) in sync with the day-night cycle, promoting healthy sleep patterns.
Related: Normal sleep: What Africans should know
As melatonin supplements mimic the natural rise in melatonin levels that occur at night, it could help if you have trouble falling asleep. This can be especially useful if you have disrupted sleep schedules, such as in shift working or dealing with jet lag due to travelling across different time zones. By taking melatonin supplements at the right time, you can help reset your internal clock and improve your ability to fall asleep.
Melatonin is generally considered safe for healthy sleep when used appropriately by people with sleep problems. It not only improves the duration of sleep but the quality as well [2]. It is particularly good for short-term use and for addressing specific sleep issues like insomnia and circadian rhythm disorders. Unlike other sleep medications, melatonin is better tolerated and has a very low potential for dependence.
One study that used melatonin to induce sleep in South African children in order to attain their electroencephalogram (a recording of brain activity) noted that, unlike other sleep inducers, melatonin did not present any interference in the recording of brain activity. Also, the children were able to go home after they woke up without showing any form of persistent drowsiness [3].
Melatonin is mostly known for its benefits in managing sleep disorders. However, there are bits of evidence that show that it might also be beneficial for managing other health conditions that are not sleep-related. Below are some of the benefits of melatonin in managing both sleep-related and non-sleep-related health problems.
Related: Sleep disorders - An African Perspective: Types and Symptoms
People with insomnia have difficulty falling asleep, staying asleep, and having good quality sleep. This is one of the most common types of sleep disorder globally including in young and older African adults, as natural melatonin production tends to decrease as you get older [4]. Melatonin may help people dealing with primary insomnia to fall asleep faster as well as improve sleep quality and total sleep time [2]. It is more effective in children, adolescents and the elderly [4].
DSPS is a condition that affects the circadian rhythm, causing you to go to bed later than normal and wake late as well — about 3 to 6 hours later than the usual time. It is more common in adolescents and melatonin has been found helpful in managing the condition [5].
If you tend to act out your dreams while sleeping by kicking, talking, crying, laughing, etc., you may be suffering from REM sleep behaviour disorder. A study showed that melatonin may serve as a useful addition to other medications (e.g., clonazepam) for treating RBD [6].
This condition is found only in blind people who have lost the ability to perceive light. People with this condition often have issues of short night sleep and daytime sleeplessness. Melatonin has been shown to help improve the sleep-wake cycle in people with this syndrome [5].
Melatonin is used for treating symptoms of jet lag and work shift disorder such as daytime sleepiness caused by alteration of the sleep-wake cycle [7].
Migraine: Studies have shown that melatonin may be beneficial for relieving migraine attacks in both adults and kids [8, 9]. One of the studies showed that 3mg of oral melatonin at bedtime reduced migraine frequency. [9]
Improving comorbidities associated with chronic insomnia: Insomnia often increases the risk of other conditions like nocturnal high blood pressure (arterial hypertension), diabetes mellitus, and metabolic syndrome. Evidence suggests that melatonin may help to improve these conditions. However, the studies on this are not conclusive [4].
Other conditions that have been observed to improve with the help of melatonin include; tinnitus (ringing or buzzing noise in the ear), cardiovascular diseases, and eye health. However, the evidence available is not sufficient to draw conclusions.
Because melatonin or melatonin supplements are generally considered safe, they are sold over the counter and are not strictly regulated in most countries. As a result, many supplements contain active ingredients that are different from what the label says.
One study found that of the 31 different supplements analyzed, more than 71% had over 10% more or less melatonin content than what the label stated. The difference ranged from −83% up to +478%. Also, 26% of the supplements were found to contain contaminants like serotonin [10].
Hence, although melatonin supplements are readily available, it is important to talk to your healthcare provider before buying and using them to help you make a better decision.
Although melatonin is generally considered safe and non-toxic for use by both adults and children alike, more studies are needed on the consequences of its long-term usage.
The few cases of adverse effects that have been recorded were mostly as a result of taking higher doses. There were also negative effects caused by the timing of the dose and interaction with other medications. [11, 12]
Nonetheless, these adverse effects were considered minor, temporary, and easy to manage. They include;
People with short or long term sleep problems in almost every age group can safely take a melatonin supplement. Children under age 3 years are excluded.
It is advisable to have a talk with your primary care provider before giving melatonin supplement to children with sleep problems as the common causes are often behavioural. [13]
Although it is generally considered safe, melatonin may not be good for some people. It is best to talk to your doctor before taking any medication to make sure it’s safe for you. Below are some of the groups of people that should avoid taking a melatonin supplement or at least seek medical advice before doing so. [11, 12, 13]
1. Pregnant or Breastfeeding Women: There is limited research on the safety of melatonin supplements during pregnancy and breastfeeding. It’s best to consult a healthcare provider before use.
2. People with Autoimmune Diseases: Melatonin can influence immune function and might worsen autoimmune conditions like rheumatoid arthritis, lupus, or multiple sclerosis.
3. Individuals with Depression or Other Mental Health Disorders: While melatonin can help with sleep disorders, it might also affect mood and should be used cautiously in people with depression or other mental health conditions.
4. People with Allergies to Melatonin: Although rare, some people might have an allergic reaction to melatonin supplements.
5. Individuals with Liver or Kidney Disease: Melatonin is broken down (metabolized) in the liver and excreted by the kidneys. People with liver or kidney disease might process melatonin differently, leading to potential side effects or toxicity.
6. People Taking Certain Medications: Melatonin can interact with various medications, including:
Melatonin dosage varies widely depending on the type of sleep disorder and the age of the person taking it. The dose can vary from 1mg to 10mg and is usually taken between 30 minutes to 2 hours before bedtime.
For instance, for primary insomnia in children and adolescents, the recommended dose is 1-3 mg/night for preschool children, 2.5-5 mg/night for school-age children, and 1-5 mg/night for adolescents [4].
With melatonin, it is usually advised to start with a lower dose and increase gradually if you do not see any results. Keep in mind that taking higher doses of melatonin does not guarantee faster results. In fact, higher doses that exceed the natural concentration produced by your body may be unwise [4].
Even worse, taking a melatonin dose that is too high can lead to overdose and this is more common in children. There are reports of increasing cases of melatonin overdose in children [11]. Hence, it is best to talk to your healthcare provider when deciding on the dosage to take.
Before you start taking a melatonin supplement for sleep problems, it may be better to first consider some sleep hygiene/lifestyle behaviour changes that might help improve your sleep naturally.
Optimize your exposure to light: During the day, spend time outdoors in natural sunlight, especially in the morning. In the evening, reduce your exposure to screens (phones, televisions, and computers). This will help to regulate your circadian rhythm.
Create a sleep-conducive environment: Use blackout curtains or shades to block out light during sleep time. Similarly, use dim lights in the evening to signal to your body that it's time to wind down. You should also keep your bedroom cool, as a lower body temperature can signal to your body that it's time to sleep and promote melatonin production.
Maintain a consistent sleep schedule: Go to bed and wake up at the same time every day, even on weekends, to reinforce your body's natural sleep-wake cycle.
Diet and nutrition: Among animal foods, eggs and fish have higher melatonin than meat. Melatonin is also found in vegetables with relatively high concentrations in tomatoes and peppers. Fruits like grapes, cherries and strawberries also have higher melatonin concentrations compared to other fruits. Melatonin is equally present in nuts, seeds and edible oil among other food types [14].
Exercise Regularly: Regular exercise, particularly aerobic exercise, can help improve sleep quality and increase melatonin levels. Try to exercise earlier in the day, as exercising too close to bedtime can be stimulating.
Although sleep medicine does not have so much popularity yet in Africa, many Africans suffer from different forms of sleep disorders that are both long-term and short-term. Among young people, most sleep problems are caused by behavioural factors. Therefore, while melatonin supplements are good for attaining healthy sleep, you should consider behavioural changes first. If you do not notice any improvement, talk to your healthcare provider for advice on the right melatonin supplement and appropriate dosage.
1. Tordjman S, Chokron S, Delorme R, Charrier A, Bellissant E, Jaafari N, & Fougerou C. Melatonin: Pharmacology, functions and therapeutic benefits. Current Neuropharmacology. 2017;15(3):434–443. DOI: 10.2174/1570159X14666161228122115 Available from here.
2. Xie Z, Chen F, Li WA, Geng X, Li C, Meng X, Feng Y, et al. A review of sleep disorders and melatonin. Neurological Research. 2017;39(6):559–565. Doi: 10.1080/01616412.2017.1315864. Available from here.
3. Chidi IR. The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting. University of Cape Town, Faculty of Health Sciences, Division of Neurology. 2018. OpenUCT. Cited: 12 July 2024. Abstract. Available from here.
4. Poza JJ, Pujol M, Ortega-Albás JJ, Romero O. Melatonin in sleep disorders. Neurología (English Edition). 2022;37(7):575-585. doi: 10.1016/j.nrleng.2018.08.004. Available from here.
5. Auld F, Maschauer E, Morrison I, Skene D, Riha R, Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders, Sleep Medicine Reviews. 2016. Doi: 10.1016/j.smrv.2016.06.005. Available from here.
6. Kunz D & Mahlberg R. A two-part, double-blind, placebo-controlled trial of exogenous melatonin in REM sleep behaviour disorder. Journal of Sleep Research. 2010;19(4):591–596. Doi: 10.1111/j.1365-2869.2010.00848.x. Available from here.
7. Reid KJ & Abbott SM. Jet lag and shift work disorder. Sleep Medicine Clinics. 2015;10(4):523-35. Doi: 10.1016/j.jsmc.2015.08.006. Abstract. Available from here.
8. Liampas I, Siokas V, Brotis A, Vikelis M & Dardiotis E. Endogenous melatonin levels and therapeutic use of exogenous melatonin in migraine: Systematic review and meta-analysis. Headache. 2020;60(7):1273–1299. Doi: 10.1111/head.13828. Available from here.
9. Tseng PT, Yang CP, Su KP, Chen TY, Wu YC, Tu YK, Lin PY, et al. The association between melatonin and episodic migraine: A pilot network meta-analysis of randomized controlled trials to compare the prophylactic effects with exogenous melatonin supplementation and pharmacotherapy. Journal of Pineal Research. 2020;69(2):e12663. Doi: 10.1111/jpi.12663. Available from here.
10. Erland LA, & Saxena PK. Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content. Journal of Clinical Sleep Medicine. 2017;13(2):275–281. Doi: 10.5664/jcsm.6462. Available from here.
11. Savage RA, Zafar N, Yohannan S, et al. Melatonin. [Internet. Updated 9 Feb 2024]. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024 Available from here.
12. Foley HM, & Steel AE. Adverse events associated with oral administration of melatonin: A critical systematic review of clinical evidence. Complementary Therapies in Medicine. 2019;42:65–81. Doi: 10.1016/j.ctim.2018.11.003. Available from here.
13. NHS. Who can and cannot take melatonin. [Reviewed 13 Feb. 2023]. Cited: 14 July 2024. Available from here.
14. Meng X, Li Y, Li S, Zhou Y, Gan R-Y, Xu D-P, Li H-B. Dietary sources and bioactivities of melatonin. Nutrients. 2017;9(4):367. Doi: 10.3390/nu9040367. Available from here.
Published: August 6, 2024
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