One of the symptoms that many people with a mental illness struggle with is an inability to fall asleep or stay asleep. My recent treatment included, several times, the suggestion that using melatonin may prove beneficial in reducing or eliminating the symptom. Some in the group had tried it with beneficial effects while other had tried it with little or no effect.
What does the current research say about melatonin? I am going to try to provide some information so that your choice to use or not use is as informed as possible. Melatonin is not entirely benign and there are risks, as with any supplement or medicine.
What is melatonin?
The National Center for Complementary and Integrative Health explains melatonin like this: [1]
Melatonin is a natural hormone that plays a role in sleep. Melatonin production and release in the brain is related to time of day, rising in the evening and falling in the morning. Light at night blocks its production. Melatonin dietary supplements have been studied for sleep disorders, such as jet lag, disruptions of the body’s internal “clock,” insomnia, and problems with sleep among people who work night shifts. It has also been studied for dementia symptoms.
A 2017 study titled “A review of sleep disorders and melatonin” defines it this way: [7]
Melatonin (N-acetyl-5-methoxytryptamine) is an endogenous hormone produced by the pineal gland and released exclusively at night.
What does melatonin do?
Melatonin has been found, with appropriate dosing, to have a benefit in:
- Jet lag [1]
- delayed sleep phase disorder [1]
- shift work disorder [1]
- insomnia [1]
- “Melatonin offers an alternative treatment to the currently available pharmaceutical therapies for sleep disorders with significantly less side effects.” [7]
- “with the correct dosage, melatonin can help an older person experience a restful and uninterrupted night of sleep” [4]
The usual cautions about medication apply. Melatonin should only be taken with the guidance of a physician. Never drink alcohol while taking melatonin. The hormone may interact with other prescribed or over-the-counter medications and supplements that you are taking. It should never be used in children or with other sleep-inducing medications.
How to use melatonin.
“it is very unlikely that someone has a melatonin deficiency” [6]
“According to research conducted at MIT, the correct dosage of melatonin for it to be effective is 0.3-1.0 mg.” [4] [6]
Cautions and risks for melatonin use
- “In one study, researchers noted that melatonin supplements may worsen mood in people with dementia.” [1]
- “Side effects of melatonin are uncommon but can include drowsiness, headache, dizziness, or nausea. There have been no reports of significant side effects of melatonin in children.” [1]
- “serious side effects related to high doses such as hypothermia” [5]
- “When the melatonin receptors in the brain are exposed to too much of the hormone, they become unresponsive.” [5]
- “the higher dosage elevated plasma melatonin levels during the day, which can cause a “hangover” effect in some of the subjects.” [4]
- “In Europe, melatonin at very high doses has been used as a contraceptive.” [6]
- “Melatonin (2-3mg or higher) has reported side effects of headaches, nausea, next-day grogginess, hormone fluctuations, and vivid dreams and nightmares.” [6]
Resources
- Melatonin: In Depth - National Center for Complementary and Integrative Health
- Brain Basics: Understanding Sleep - National Institute of Neurological Disorders and Stroke
- Mayo Clinic Minute: Is melatonin the right sleep aid for me?
- Scientists pinpoint dosage of melatonin for insomnia - MIT
- Rest easy: MIT study confirms melatonin’s value as sleep aid - MIT
- Melatonin: Not a Magic Bullet for Sleep - Psychology Today
- A review of sleep disorders and melatonin - Neurol Res. 2017 Jun;39(6):559-565. doi: 10.1080/01616412.2017.1315864. Epub 2017 May 1.