More Americans Are Taking Melatonin Than Ever Before—Despite Potential Health Risks

Higher doses of melatonin—more than the safe limit of 5 milligrams per day—are on the rise, too.

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More Americans are taking melatonin to help them fall asleep—and some are using the supplement at potentially dangerous levels, suggests new research published in the Journal of the American Medical Association (JAMA).

Though the overall amount of Americans taking sleep aid remains low, the findings are still significant: Over the course of nearly two decades—comparing data from 1999–2000 through 2017–2018—researchers found the number of Americans taking a melatonin supplement increased by nearly five-fold, rising from 0.4% to 2.1%. Based on US Census estimates, this translates to about five million people in the US taking the supplement in 2017–2018.

Despite the marked increase, experts say those initial numbers aren't all that surprising. "Sleep disturbances are increasingly prevalent though they remain often underreported," Naima Covassin, Ph.D., assistant professor at the Mayo Clinic and corresponding author of the JAMA paper, tells Health. "For this reason," Covassin explains, "people are increasingly turning to over-the-counter solutions to improve their sleep."

What was surprising about the new report, Covassin says, was the increase in how many people take what she calls "high-dose melatonin," which amounts to more than 5 milligrams (mg) per day, the highest dose shown to be safe and effective. The number of people taking this high-dose melatonin increased more than three-fold, from 0.08% of American adults in 2005-2006 (the first year such numbers were available) to 0.28% in 2017-2018.

This is still a relatively small portion of the population—around 714,000 adultsbut Covassin and her study co-authors note that there are some safety concerns associated with taking a high dose of melatonin every night. This is especially concerning, Covassin says, given that "evidence supporting melatonin use for sleep disturbances is weak."

Because melatonin is a relatively popular supplement with wide availability, many people may not be aware of the risks associated with it—or when it's actually beneficial. Here, we dig into how melatonin is intended for use and the risk associated with the supplement.

How Is Melatonin Meant to Be Used?

"Backing up for a second: Melatonin isn't only found in the supplement aisle—it's technically a hormone that your brain (specifically the pineal gland) already makes," Abby Langer, RD, owner of Abby Langer Nutrition, tells Health. Melatonin helps to regulate your sleep-wake cycles, Langer says, essentially telling your body when it's time to go to sleep.

Many claims that takingmelatonin supplements can potentially make it easier for some people to fall asleep, although research is mixed on this front.

The National Center for Complementary and Integrative Health (NCCIH) says melatonin may help people reduce symptoms of jet lag and delayed sleep-wake phase disorder—a specific kind of sleep issue where you don't feel tired until two hours or more after conventional bedtimes. Additionally,people with a melatonin deficiency may benefit from taking small amounts of melatonin before bed, Brigitte Zeitlin, RD, owner of BZ Nutrition, tells Health.

However, research doesn't prove that melatonin can help with other kinds of sleep issues, such as chronic insomnia. That's a problem since many people turn to the supplement when suffering from insomnia, says Dr. Covassin says. It also doesn't seem to meaningfully improve aspects of insomnia, she adds—melatonin only decreases the amount of time it takes to fall asleep by an average of 5 to 8 minutes.

If you and your doctor decide it would beneficial to take melatonin, you'll likely be urged to start slow—as little as 0.5 to 1 mg per day, being mindful not to take more than 5 mg per day, Zeitlin says. And it's not meant to be a long-term regimen: "Think of it as a short-term approach to boost or improve [your] sleep patterns and then get into [your] own healthy sleep routine," she says. Otherwise, you run the risk of masking any underlying issues causing your sleep disturbances, adds Langer.

If you do begin a melatonin regimen, you also shouldn't expect it to be a magic bullet for your sleep routine. "Your lifestyle patterns factor in here greatly," says Zeitlin. That means if you're still drinking an afternoon coffee, or if you're glued to your phone until you close your eyes, you're not really giving your body a chance for its own melatonin to work. For the most part, melatonin is meant to supplement a sleep routine, not replace one.

Are There Any Risks to Melatonin Use?

In the short-term, melatonin is deemed safe for most people—but the NCCIH says data on the long-term safety of melatonin is incomplete. "It's generally recommended that those who supplement with melatonin stay under 5 mg per day," says Covassin. If you go above that dosage, you can up your risk of side effects like nausea, dizziness, drowsiness, or worse. "More potentially serious adverse effects includingrespiratory tract infections, worsening of seizure, changes in blood pressure and heart rate, decreased glucose tolerance has been noted with increasing melatonin doses," she says.

"More melatonin will not increase the quality of sleep, so don't try to overdo it," Langer adds. In fact, taking too much of the supplement may give you an unintended outcome: "Taking too much melatonin can cause trouble sleeping," says Langer.

The supplement may also be contraindicated for those with certain conditions or taking certain medications, like people who are pregnant or breastfeeding, the NCCIH says. It's also not recommended for those with dementia or epilepsy. People who take the following medications, too, are recommended against taking melatonin, per the Mayo Clinic:

  • Blood clotting or blood pressure drugs
  • Anticonvulsants
  • Blood pressure drugs
  • Contraceptives
  • Certain sedatives like Valium and other forms of diazepam
  • Diabetes medication
  • Immunosuppressants

Even when you're cleared to take melatonin—and you do so under a doctor's supervision—risks are still present: The 2017 study in the Journal of Clinical Sleep Medicine analyzed 31 different melatonin supplements and found that the actual amount of melatonin ranged from 83%–478% more than what was advertised on the label, meaning you could be ingesting much more melatonin than you thought.

How to Make Sure You're Taking Melatonin Safely

If you're not currently pregnant or breastfeeding, don't have any conditions that interfere with melatonin, and aren't taking any contraindicated medications, it's probably safe for you to try melatonin, says Zeitlin—but you'll want to start slow. "Start on the low [dose] range and treat it as an as-needed assist," she says. If it works for you (and you're not experiencing side effects), it can be safe to take nightly for up to a month at a time, according to Johns Hopkins.

In any other situation—if you are pregnant, breastfeeding, taking medications, or have an underlying illness—you shouldspeak to your doctor before taking the supplement, says Langer. They'll work with you to determine if the supplement is safe and provide insight on dosing and how long you should take it.

Another tip: Because supplements aren't regulated by the FDA—and thus, the quality of the product you're buying isn't guaranteed—it's best to buy products that are trusted by experts. "When it comes to all supplements, you want to make sure you are buying verified brands and products," says Zeitlin. Where possible, look for products that have been through third-party quality testing; they'll have seals from organizations like the National Sanitation Foundation (NSF) or the United States Pharmacopeial Convention (USP).

If melatonin isn't working for you and you're still struggling to sleep, Langer recommends checking in with your doctor. They can work with you to uncover any other potential issues that are affecting your ability to get a good night's rest.

And if you can't take melatonin, rest assured that there are other lifestyle-related solutions to sleep you can try. Magnesium—a muscle-relaxing electrolyte that your body uses to make melatonin—may potentially help support sleep, although there's even less research on it than melatonin. Cutting back on caffeine during the day, eliminating blue light use hours before bedtime, and other hacks might also help you reset your sleep. Again, if nothing is working and you're still dealing with insomnia, talk to your doctor ASAP.

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