Is Melatonin Safe?

Melatonin supplements designed to help people fall asleep may be more popular than ever but these over the counter sleep aids may actually do more harm than good. Overuse, underlying medical conditions and interactions with medications may cause unintended side effects. Here’s what you need to know before taking a melatonin supplement.

How does melatonin work?

Melatonin is a hormone that occurs naturally in the body when it gets dark, signally that it is time to go to sleep. The melatonin available online and most pharmacies is typically a synthetic version. The FDA does not regulate it because it is a supplement and not a medication.

Northeast Medical Group Sleep Center Medical Director Stasia Wieber, MD, said she typically does not recommend melatonin to her patients and finds it is only helpful for specific sleep conditions such as jet lag, shift work sleep disorders and circadian rhythm disturbances.

“It is useful in certain sleep disorders but if you’re having chronic problems sleeping you probably should speak to your healthcare provider because maybe there’s something underlying that’s causing you not to sleep well,” Dr. Wieber said.

Common reasons why patients have trouble sleeping include insomnia, sleep apnea, restless legs and anxiety. To treat those conditions, Dr. Wieber said patients usually benefit from a multi-pronged approach that can include a mix of prescription medication and cognitive behavioral therapy.

Melatonin side effects

Melatonin supplements can also interact with common drugs such as some seizure medications, beta-blockers, calcium channel blockers and Coumadin, a common blood thinner. In addition, pregnant people and those who are lactating should not take melatonin.

Even for those who may benefit from melatonin, Dr. Wieber says be careful about taking too much. The appropriate dose should be only be between 0.3-1 milligrams for adults and it’s not intended for long-term use.

“I often see people who say they’re taking 10 milligrams. That’s a huge dose of melatonin and they’re wondering why they’re groggy the next day or they’ve had severe nightmares,” Dr. Wieber said.

Other common side effects include headaches, dizziness, and anxiety, agitation or depression can worsen.

How to fall asleep

For the average person having trouble sleeping, there are few things to try first before turning to an over the counter sleep aid. First, go to bed and wake up at the same time most days. Avoid caffeine in the afternoon, electronics right before bedtime and try to exercise throughout the week.

If you are not falling asleep after 20 minutes, go in a dimly lit room and write down the things that are bothering you and how you plan to deal with it the next day. Breathing exercises or meditation techniques are important tools that can also help troubled sleepers. If you want to try a sleep aid like a melatonin supplement, always talk with your doctor first.