Melatonin and sleep: 6 things to know

Wish you had a few more hours in bed this morning? You’re not alone. More than a third of adults say they don’t get enough sleep.¹ And sleep problems, or so-called "coronasomnia," are one of the lasting effects of the pandemic.²

In a quest for shut-eye, more people are turning to melatonin. Between 1999 and 2018, the use of melatonin supplements by adults in the United States quintupled.³

Whether you’re curious about melatonin or have already added it to your routine, there are important things to know. Anupamjeet K. Sekhon, MD, a sleep medicine doctor at Kaiser Permanente’s Sleep Center in Fontana, California, answers 6 common questions about melatonin.

What is melatonin and how does it work?

Melatonin is a hormone made by our brains. It regulates a person’s circadian rhythm, the internal clock that tells the body when to sleep and wake.

Melatonin isn’t produced during daylight hours. But as the sun sets and a person’s usual bedtime nears, their brain begins to make melatonin. As melatonin levels rise, levels of the stress hormone cortisol fall, and breathing slows. This tells the body that it’s time to wind down and prepare for sleep.

Synthetic melatonin is available without a prescription in gummies, pills, liquids, or patches.

Are melatonin supplements sleeping pills?

While melatonin may make you feel drowsy, it doesn’t have the same effect as prescription sleep medication. For example, it doesn’t force you into slumber soon after you take it.

"Melatonin supplements tell our body that it’s time to sleep, but they can’t put us to sleep," says Dr. Sekhon.

And because the production of melatonin depends on the time of day and your internal clock, its effect depends on when you take it. So a dose of melatonin in the middle of the day isn’t a fast track to an afternoon nap.

When should people consider using melatonin?

According to Dr. Sekhon, melatonin works best for 2 sleep problems:

• Jet lag: When a person travels, they can have trouble falling asleep because their internal clock is out of sync with the local time zone.
• Delayed sleep phase disorder: People with this sleep problem fall asleep 2 hours after conventional bedtimes, usually after midnight. This makes it hard for them to wake up early.

"In both of these cases, melatonin taken 2 hours before a desired bedtime can help people adjust their sleep cycles," says Dr. Sekhon.

Is melatonin safe?

More research is needed to know the effects of long-term melatonin use. But short-term use seems to be safe.⁴ Melatonin isn’t addictive, but it may interact with certain medications. So, talk to your doctor to learn if melatonin is right for you, especially if you’re pregnant or breastfeeding.

Although melatonin has fewer side effects than prescription sleep aids, people who take it may have:

• Headaches
• Nausea
• Daytime drowsiness
• Nightmares
• Vivid dreams

In addition to those side effects, Dr. Sekhon says children may also experience agitation and bedwetting.

Keep in mind that because melatonin is a supplement, it’s not as strictly regulated by the Food and Drug Administration as other medications. To choose the right brand of melatonin, Dr. Sekhon recommends looking for the Good Manufacturing Practice (GMP) or Good Laboratory Practice (GLP) logos on labels. You can also look for the United States Pharmacopeia (USP) verified mark.

What’s the right dose for melatonin?

To learn how much melatonin to take, Dr. Sekhon says it’s best to ask your doctor. But in general, she recommends a less-is-more approach. She suggests that adults start with a dose of 1 to 3 milligrams. For children, she recommends starting at 1 milligram and never using more than 3 milligrams.

Are there alternatives to melatonin?

Creating an evening self-care ritual can help your body wind down and transition to sleep. You can include things like:

• A warm bath or shower
• Meditation
• Yoga
• Journaling
• Breathing exercises
• Limiting screen time

Melatonin can’t fix underlying conditions that affect your sleep, such as insomnia or anxiety. Those conditions may need treatments like therapy rather than melatonin or another sleep aid. That’s another reason to see your doctor if you’re having sleep problems regularly, even if you’re seeing some benefit with melatonin.

"If the behavior surrounding melatonin use is not improved, it will eventually stop working," says Dr. Sekhon.