If you suffer from occasional sleep issues, you’re not alone. According to the American Sleep Apnea Association, 70% of U.S. adults report that they get insufficient sleep at least one night a month, with 11% reporting insufficient sleep every night. Additionally, one-third of Texans report getting fewer than seven hours of sleep every night on average. But even those numbers do not account for 2020, when pandemic-related sleep issues were on the rise throughout the year, fittingly dubbed “coronasomnia.”
If you’re one of the many people who suffer from occasional bouts of sleep issues — pandemic-related or not — you may turn to supplemental melatonin to help lull you off to sleep. But if you’ve taken a walk down the sleep supplement aisle, you may get a bit overwhelmed by the different products out there and start to question how much melatonin you need and if it’s safe to take every night.
That’s why we spoke with Rubia Sadiq, M.D., an internal medicine physician on the medical staff at Texas Health Adult Care in Benbrook, to learn more about supplemental melatonin, and get some much-needed guidance on how to navigate dosage, safety and how long you should take it.
Understanding Melatonin’s Role in Your Body
Melatonin is a hormone made naturally in your brain that plays a major role in regulating your sleep-wake cycle. It’s what tells your body “Hey, it’s getting late, time for bed,” and alternatively, “Hey, the sun is up, time to get up!”
Light exposure inhibits the production of melatonin and darkness stimulates it, so melatonin levels in your brain increase as it starts to get dark outside, reaching peak levels in the middle of the night, and then decrease as dawn nears. It’s also why you may feel drowsy during a particularly overcast day, or why you may wake up earlier in a room that faces east as the sun drenches the room.
What is the Appropriate Dosage?
Because of melatonin’s sleep-promoting effects, supplement versions of it are often used to treat a variety of sleep problems, such as:
- Jet lag
- Shift work sleep disorder
- Delayed sleep-wake phase disorder
- Sleep problems associated with autism or attention deficit hyperactivity disorder (ADHD)
Because melatonin plays such a vital role in helping regulate your sleep cycle, you may think your body needs a lot of it, but the pineal gland (the gland in our brain responsible for producing melatonin) produces a very small amount.
“Naturally, melatonin production is tightly regulated in our bodies, thus only a small amount (0.1mg to 0.5mg) is needed,” Sadiq explains. “But melatonin supplements can be found in much larger doses than that, with some doses going up to 20mg. That’s because everyone metabolizes melatonin differently. For instance, if someone took 1mg of melatonin, they may have up to 0.5mg of it in their blood, while someone else may have 0.1mg after taking the same dose. That’s why it’s great to have various strengths of melatonin available in the market to fit everyone’s needs and physiology.”
It’s important to note that melatonin supplementation is sold in the U.S. as a dietary supplement, not a drug, therefore it is not regulated by the Food & Drug Administration (FDA). Because of this, there is no guideline for quality, efficacy and dosage. That’s why Sadiq recommends reading labels, doing your research and buying from quality, trusted brands.
So with so many doses on the market, and variances with how you may metabolize melatonin, how can you know what dose will help you best? Sadiq suggests starting with a low dose, especially if you’ve never taken melatonin before. In general, a dose between .2 and 5mg is considered a safe starting dose depending on your body weight, age and sensitivity to the supplement. If you’re not seeing any changes in your sleep habits with a super low dose, you can safely move up your dosage within reason until you find the right dose that works for you.
Additionally, look for products that are “USP verified.” United States Pharmacopeia (USP) is an independent organization that works to ensure proper quality and dosing of dietary supplements.
But Is It Safe?
OK, back to the main question: is it safe, especially to use every night?
According to the National Center for Complementary and Integrative Health (NCCIH), short-term use of melatonin supplements does appear to be safe for most adults when used at the correct time and dosage. However, information on the effects of long-term usage is limited.
As with almost anything, there is such a thing as “too much of a good thing,” even with something naturally occurring like melatonin, Sadiq adds. In fact, too much melatonin could have some undesirable effects.
“Ideally, you should consult with your primary care provider to confirm the timing and dose of melatonin that may work best for you,” she says. “If you take too much melatonin, it can lead to somnolence — extreme drowsiness — fragmented or interrupted sleep, headaches, dizziness, and nausea.”
If you find yourself often waking up extremely drowsy after taking melatonin the night before, or you experience extreme drowsiness directly after taking melatonin, Sadiq says that can be a sign that you’re taking too much or taking it too earlyoo late in the evening. If you find you’re suffering from extremely vivid dreams or nightmares, that may also be a sign that you’re taking too high of a dose.
If you experience undesirable side effects from melatonin, stop taking it and speak with your provider. They may recommend using a lower dose or trying out an alternative medication or sleep aid.
We know how frustrating it can be when you just can’t get to sleep, and therefore how tempting it may be to take a second dose of melatonin if it’s been hours and you’re still tossing and turning. But remember, melatonin is a hormone, not a sleep medication, therefore it does not induce sleep. In fact, taking a second dose late into the night may promote undesirable side effects such as extreme drowsiness the next day.
Melatonin takes up to two hours to kick in, so instead of taking it in response to tossing and turning, try taking it at least an hour before you’d like to go to bed to help promote melatonin production in your body that signals it’s time to relax and drift off to sleep soon.
And if you’re worried that taking melatonin often enough will suppress your body’s natural production of it, you can breathe a sigh of relief because several studies have found that taking melatonin will not affect your body’s ability to make it on its own.
Does Melatonin Interact with Anything?
Even though melatonin is naturally occurring, it can interact with certain substances and medications, including:
- Blood-thinners — Taking melatonin with blood-thinning medication may increase your risk for bleeding.
- Epilepsy medications (anticonvulsants) — Melatonin may make these medications less effective.
- Immunosuppressants — Melatonin can potentially interfere with immunosuppressive drugs.
- Diabetes medications — Melatonin use can affect blood sugar levels.
- Blood pressure medications — High blood pressure may get worse when melatonin is taken with certain blood pressure medications.
- Contraceptive drugs — Birth control pills may increase the risk of undesirable side effects from melatonin.
Additionally, because melatonin can make you tired and drowsy, you should avoid mixing them with other substances or medications that tend to make you drowsy, such as alcohol, other central nervous system depressants (CNS) or other sleep aids.
If you are pregnant, planning to become pregnant or breastfeeding, you should consult your provider before taking melatonin.
While melatonin can be a helpful sleep aid for anyone who needs a little extra help falling asleep and/or staying asleep, there are some considerations you should keep in mind. It may not be for everyone, and you may need a larger or smaller dose than your friends or family members. Talking with your provider before adding melatonin to your medicine cabinet can help identify any individual risks and provide guidance on how much and when you should take melatonin for it to be the most effective for you.
Remember, even though melatonin is considered safe, using the lowest effective dose will give you the best outcomes while keeping any undesirable side effects at bay.
If you’re frequently having a hard time falling asleep or staying asleep, often feel drowsy or tired during the day, or have trouble performing your day-to-day tasks because you’re tired, it’s a good idea to speak with your provider. They can discuss your sleep routine and lifestyle, in addition to performing a physical exam and ordering some blood tests to rule out a medical condition that could be contributing to your sleep issues.