For anyone who has struggled with getting to sleep or staying asleep, you have undoubtedly tried everything and possibly not have found anything that really works.

Melatonin seems harmless, but is it?

Because melatonin is a natural substance produced by the body to regulate sleep, most people think it has no downside. Melatonin is a hormone produced by the pineal gland to help bring on sleep.  Melatonin is the most widely-used sleep aid. It is used by 86% of adults who use over the counter products to help them sleep.

Long-term use is not recommended

Melatonin can be helpful for occasional problems with sleep. However, the American Academy of Sleep Medicine finds there is no strong evidence for “the effectiveness or safety of melatonin for chronic insomnia.” Metanalyses of melatonin vs a placebo shows an almost insignificant benefit of 4-12 minutes improvement in the onset of sleep. Long term usage can alter hormone levels and sabotage sleep with potential side effects for children that could be even worse.

What you see is not always what you get

Melatonin supplements are not regulated by the FDA for effectiveness, safety or ingredients.  Over-the-counter melatonin has been banned in the UK, EU, Japan, Australia and Canada. Only the US has melatonin readily available over the counter. A review of 31 OTC melatonin supplements in Journal of Clinical Sleep Medicine revealed that the melatonin content was between -83% to +478% compared to the label. High doses of melatonin can cause side effects, especially in those who take medications that interact with it and those with diabetes. In addition, the hormone serotonin was found in 26% of the samples. This can be potentially dangerous for people who are taking SSRIs which increase serotonin in the brain.  Too much serotonin can lead to serotonin syndrome which can cause shivering, diarrhea, fever and seizures.

There can be unwanted side effects and interactions

The most common side effects are headaches, dizziness, nausea and drowsiness during the day. Less common side effects could include mild depression and anxiety, confusion and disorientation and hypotension.

Melatonin can interfere with some important drugs for: diabetes, seizures, immune suppression and even some contraceptives.  It is also not considered safe to take melatonin with alcohol.

People with auto-immune conditions like rheumatoid arthritis, asthma, dementia or restless leg syndrome should avoid melatonin. No studies have been conducted to determine if melatonin is safe if you’re pregnant or breastfeeding.