Plenty of people are taking melatonin as a sleep aid. What you should know before you do.
it’s the one I get asked about the most. Melatonin is easily the subject of more myths and questions than perhaps any other supplement.
Melatonin is a hormone naturally secreted by the pineal gland in our brains to help us fall asleep, and supplementation with melatonin is seen as a “natural” way to help regulate or improve sleep. Melatonin is the remedy of choice for a significant portion of the 70 million Americans who experience sleep disorders. We spent $826 million on melatonin supplements in 2020, a 43% increase from the year before, likely fueled by multiple COVID-19 pandemic-related stressors.
Despite this surge in use, there is a general lack of oversight by the FDA surrounding melatonin and the supplement industry in general. Compared to more regulated doctor-prescribed medications, there is decidedly less evidence-based research on melatonin. Four of the most common questions I encounter are: “Will taking melatonin cause my brain to stop making it?” “Is it safe to give to kids?” “Does it cancel out birth control?” “Is melatonin a sedative?”
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By far the most common myth around melatonin is that supplementing with it will cause your brain to make less of it. Taking a melatonin supplement before bed will not affect the pineal gland’s natural secretion of it. However, there are many factors that can decrease its production over time. Aging plays the biggest role in natural reduction of melatonin production. Stress, smoking, and disrupted light-dark cycles all decrease melatonin production. Exposure to too much light after dark (especially blue light), not getting enough natural sunlight during the day, and shift-work all interrupt the critical light-dark schedule.
We know that children with certain medical conditions such as ADHD, autism spectrum disorder and asthma are more susceptible to sleep problems. A 2019 meta-analysis of 18 studies of over 1,000 children with such conditions showed that melatonin was better than placebo for improving time to fall asleep and total sleep. However, these studies were inconsistent in their recommendations for dosage and duration. They only tracked the children over a brief time, and because melatonin is a hormone, we don’t know the effects it can have on development. A safer long-term strategy is developing and maintaining good bedtime habits.
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Even less is known about the interaction between melatonin and birth control. Since both are hormones, there is likely an interaction, but studies have been inconsistent in their results. Research showed an increase in the naturally occurring level of melatonin in those taking birth control, particularly in those with progestin. Yet other studies showed no difference in melatonin in those who took birth control compared to those that didn’t. It is unlikely that taking melatonin will cancel out the contraception from birth control. But since there’s no conclusive evidence to say for sure, and a risk that using both together might cause increased sedation from melatonin, those on birth control should discuss other sleep-promoting options with their doctor.
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Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault