Melatonin Side Effects – Is Melatonin Safe? – Runner’s World
Melatonin Side Effects – Is Melatonin Safe? Runner’s World
Chances are you’ve heard of melatonin by now—the “natural” supplement manufacturers claim will help you sleep better. It’s a supplement many runners turn to before bed in hopes they’ll get more quality shut-eye and therefore, sidestep major health concerns, like chronic disease, as recent research shows, as well as recover from long runs.
In fact, usage of melatonin supplements among Americans has increased by more than 400% over the past two decades, according to recent research published in JAMA. That could be because, according to the Sleep Foundation, more than one third of working adults sleep fewer than six hours a night, and between 10% and 30% of adults struggle with chronic insomnia.
Here’s the catch: Despite these struggles and the (smart!) goal to get more sleep, melatonin probably doesn’t help as much as you think—or hope. Runner’s World spoke with three sleep specialists to clue us into the effectiveness of these supplements, and the potential side effects of melatonin. The answers may surprise you.
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What is melatonin?
Melatonin is a hormone that your brain naturally produces, and it’s responsible for giving you that sleepy feeling. Your body should typically produce melatonin about two to three hours before bedtime.
Melatonin release is often triggered by darkness, , M.D., medical director and the Center for Sleep Medicine and assistant professor at Tufts University School of Medicine tells Runner’s World. So if you’re surrounding yourself with artificial light (translation: looking at your phone, computer, or TV) in the hours before bed, you may delay your body’s ability to produce melatonin, and thus feel tired.
Avoiding a regular sleep schedule (meaning going to bed and waking the same time each day) can also affect the release of the hormone, as a more consistent routine also help with the release of melatonin.
A melatonin supplement—found in a pill, gummy, or liquid form—is usually made in a lab with a synthetic form of melatonin and it carries the claim to trigger sleepiness. But what exactly is in these supplements, and the side effects aren’t always clear.
Do melatonin supplements actually help you sleep better?
The answer is that it depends—in this case, it depends on what’s happening in your body that’s keeping you from getting tired and falling or staying asleep.
If you’re not producing enough melatonin, like those with it can be effective. A circadian rhythm disorder, according to the National Institutes of Health, are problems that occur when your body’s internal clock, which tells you when it’s time to sleep or wake, is out of sync with your environment.
, Psy.D., a psychologist with the Sleep Disorders Center at the Cleveland Clinic, who treats patients suffering from sleep issues, says melatonin supplements can be helpful for addressing sleep concerns when you need to shift the timing of your sleep cycle. For example, if you’re experiencing jet lag from travel, melatonin may offer an effective strategy for getting you back on a particular time zone, Drerup says. Dreup also says melatonin may help align the natural circadian rhythm for those who work a night shift.
However, while melatonin can help you fall asleep in these cases, it doesn’t mean it’ll help you stay asleep, she says.
Research supports the idea that melatonin may be effective for shift workers—those who don’t have a normal or routine bedtime. In a published in 2008 in the Journal of Circadian Rhythms, 86 shift-worker nurses were either given a placebo or 5 milligrams of melatonin 30 minutes before bed. Researchers found that sleep onset latency (or how long it takes to fall asleep) was significantly reduced in subjects who took melatonin, compared with both placebo and baseline. However, there was no evidence that melatonin altered total sleep time.
While melatonin may help you shift your sleep cycle—if that’s your goal—these supplements are not recommended for the treatment of chronic insomnia (when sleep problems last a month or longer), says , Ph.D., assistant professor of psychiatry and behavioral sciences at The Johns Hopkins School of Medicine. The states that there isn’t enough supporting evidence on the effectiveness or safety of melatonin for treating chronic insomnia.
Can melatonin supplements be overused and if so, what are the side effects of melatonin?
A lot of times people think a higher dosage of melatonin will have a better effect, but that’s not the case, says Drerup. With an increased dosage you might experience excessive sleepiness in the morning, as well as confusion, dizziness, headaches, or GI issues. “Higher doses don’t lead to improvement in sleep, just more potential side effects in the morning,” she says.
Even if you’re taking a smaller dose, you may want to still watch out for these side effects of melatonin, especially if you’re already prone to things like headaches and nausea. But the higher your dose, the more likely you are to feel side effects.
“It also tends to increase the vividness of dreams for some people, so someone who has nightmares related to PTSD, should be mindful of that,” Drerup says.
Grover cautions that melatonin can also interact with other medications, including immunosuppressants, blood thinners, and some diabetes medications, so it’s important to discuss with your doctor before starting melatonin. Long-term usage in children also hasn’t been studied, so it’s best for them to avoid it. The American Academy of Sleep Medicine also does not recommend melatonin usage among people with dementia.
What should you know before considering a melatonin supplement?
Because melatonin isn’t FDA approved, Atwood recommends looking closely at the ingredients before choosing a supplement. “If you get it in pill form, usually it’s a little less variable than if you get it in gummy form,” she says, because pills are a more concentrated form with more consistency in its ingredients.
Research also says you should check your supplements, because they might not contain what they say. A of melatonin supplements published in the Journal of Clinical Sleep Medicine in 2017 looked at the actual concentration of melatonin and other potential substances versus what was printed on the label in 31 different supplements. Researchers found that melatonin content in the supplements were not even within a 10% margin of what the label read. This held true for more than 71% of the supplements tested. The study also found that some supplements contained nearly 500% more melatonin than what was claimed on the label.
In other words, you may be getting a much larger dose of melatonin than expected, increasing the risk of negative side effects.
“We don’t know the safety of each specific melatonin brand out there. Not knowing the dosing in each pill form from different vendors and different production teams who produce melatonin is where we’re lacking in understanding the side effects,” says Grover.
What’s more: An additional 26% of supplements tested in the study were found to contain serotonin. According to the , serotonin is a chemical that carries messages between nerve cells in the brain and throughout the body and plays a key role in body functions like mood, sleep, and digestion. High levels of serotonin can lead to symptoms like heavy sweating, confusion, restlessness, and diarrhea.
Atwood says melatonin mixed with serotonin can be dangerous if you’re taking antidepressant medications that already act on serotonin, a hormone that can have harmful effects even at low levels.
In the United States, melatonin is considered a dietary supplement, which means that it’s regulated less strictly by the FDA, than prescription or over-the-counter drugs. In other countries, like the and , melatonin is available only with a prescription.
Because melatonin isn’t FDA-approved as a drug in the United States, what you’re getting in that gummy or pill will vary greatly from one brand to another, so consider discussing with your doctor what specific dosage and brands would be appropriate for you—if your doctor recommends taking them at all. The AASM recommends looking for the , which indicates that the formulation meets the requirements of the U.S. Pharmacopeial Convention, a third-party tester.
The bottom line on melatonin effectiveness and side effects
If you regularly suffer from sleep problems, like insomnia, melatonin is probably not the answer. Both Drerup and Grover agree the first line of treatment for insomnia should be cognitive behavioral therapy (CBT), as melatonin will not address sleep problems related to anxiety or stress.
“Probably the number-one thing I see in my clinic is other mental health conditions— like anxiety and depression, that can significantly impact quality and amount of sleep, and if untreated can definitely disrupt sleep,” Drerup says. Unlike melatonin, CBT focuses on addressing efforts to change thinking patterns, which in turn, may help patients who suffer from poor sleep quality.
Atwood recommends that those who suffer from insomnia talk with a sleep specialist and learn about sleep systems and how certain life events may affect the sleep cycle. “When you’re outsourcing all your confidence and sleep to medication, it’s risky because if it stops working, or if you forget it, you’re right back in the same boat,” Atwood says.
Insomnia aside, if you occasionally have issues with your sleep, melatonin may offer a short-term solution. The National Center for Complementary and Integrative Health states, “short-term use of melatonin supplements appears to be safe for most people, but information on the long-term safety of supplementing with melatonin is lacking.”
Unlike other sleep medications, you’re not likely to become dependent on it or have a decreased response if you use it for a few months, Drerup says, so that’s a pro.
For short-term use (typically nothing more than three months), Grover advises starting with small doses—about 0.5 to 3 milligrams. She also recommends behavioral modifications for better sleep hygiene as well, including those major ones like not looking at screens before bed and going to sleep and waking up at the same time every day.
Atwood also says for quality sleep it’s important to keep your room cooler, and free of noise and stress. “When we’re feeling stressed that fight or flight system is activated and it’s going to be a lot harder to sleep even if our body is ready to produce that sleep,” she says. “Even if, after implementing these things, you’re still having trouble, I think that’s when you reach out to a healthcare provider, and perhaps establish care with a sleep-specific professional.”
Editor’s Note: This article originally stated that only allows melatonin via prescription. You can get it as an over-the-counter medication there. It also stated that the requires a prescription, but that’s for certain and different countries in the EU may have different regulations. It also stated that Australia requires a prescription, but as of 2021, those over 55 can get melatonin without one.
Jennifer Acker joined the editorial staff of Runner’s World and Bicycling in January 2022. A former freelancer writer and NCAA runner, she started running as a kid and basically never stopped. She also loves outdoor adventures, like hiking, skiing, and mountain biking.
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