Trouble sleeping? If insomnia has become part of your nighttime routine, chances are you have stumbled upon melatonin for sleep and using it as a potential "cure" for your sleepless nights. It is readily available in almost all pharmacies in the US and is frequently recommended by physicians. Yet, the science behind what dosage of melatonin to use and how to use it is often poorly understood, and the long-term side effects of melatonin are unclear. Let’s explore this supplement to better understand its use and misuse.

Using Melatonin as a Sleep Aid

What is melatonin?

Melatonin is a naturally occurring hormone that is secreted from a small gland in the center of the brain known as the pineal gland. The brain secretes this hormone in the evening time and at night. The rise of melatonin typically correlates with onset of outdoor darkness. It is essentially a signal to your brain that it is now nighttime. By linking the timing of secretion with the decrease in light, melatonin helps keep your body's clock (circadian rhythm) synchronized with the day/night schedule.

Interestingly, nocturnal animals also secrete melatonin at night. However, for their brains, melatonin is a signal to stay awake and become active.

What is melatonin good for?

It depends. It is important to understand the reason behind why someone may have difficulty sleeping in order to tailor the treatment approach when using melatonin as a sleep aid. Melatonin is not a treatment for all causes of insomnia. For example, those that suffer from insomnia due to frequent intrusive thoughts and worries when they lay in bed would benefit from an alternative treatment, such as cognitive behavioral therapy with a sleep specialist.

Similarly, young children that have difficulty sleeping at nighttime almost always have a behavioral cause and therefore need a behavioral solution. Melatonin may not help in this situation either. Despite that, melatonin is one of the most commonly used supplements among children (second only to fish oil). However, the long-term effects of chronic melatonin use is not known, so as with any supplement, it should be used with caution.

Most of the data that supports the use of melatonin is for sleep difficulties that arise from circadian rhythm misalignment. This occurs during travel over time zones (jet lag), during shift work or during adolescence and young adulthood when the body clock becomes delayed. In each of these situations, melatonin can help realign the body clock in order to get more sleep.

What’s in the bottle?

In the United States, melatonin is considered a supplement. Therefore, it does not have direct oversight from the U.S. Food and Drug Administration. So, it is hard to know for certain what is actually in a bottle that is labeled "melatonin". In fact, a study published in 2017 in the Journal of Clinical Sleep Medicine showed that 71% of bottles labeled melatonin had differences in dose by more than 10% of what was labeled. Compounds not identified on the ingredient list were also found in 26% of bottles. It is important to use trusted sources for melatonin, such as generic versions from well-known pharmacies and retailers.

Optimizing Your Own Melatonin

The most important melatonin sleep aid fact is that there are ways to ensure your brain is producing a healthy amount. While the amount of melatonin we secrete does decrease with age, there are also environmental and medication effects that can change melatonin secretion. The most easily modifiable behavior is reducing light exposure at night. Blue light, the light from phones and other screens, tends to decrease melatonin more than other colors. To get your best rest, try to avoid screen exposure for at least 30 minutes prior to bedtime to ensure your brain’s melatonin is secreted properly. Medications such as beta-blockers can also decrease melatonin secretion, so it is important to consult your doctor if you experience issues sleeping.

While melatonin is easily accessible, the science behind its use is not as straightforward. Always discuss your sleep issues with your physician prior to self-medicating with melatonin. There may be more effective treatment options available for your sleep needs.