Melatonin is a naturally occurring hormone produced by the pineal gland, playing a pivotal role in regulating the human sleep-wake cycle. As a dietary supplement, synthetic or animal-derived melatonin is widely utilized to address sleep disorders, particularly those related to circadian rhythm disruptions. Its primary function is to signal the body that it is time to prepare for sleep, making it a cornerstone of chronobiological therapy for individuals with delayed sleep phase syndrome, jet lag, and shift work sleep disorder. Expert consensus supports its use under guidance for short-term sleep initiation challenges.

Features

• Synthetic or phytomelatonin formulation in controlled-release or immediate-release tablets, capsules, liquid, or sublingual forms.
• Standardized dosage strengths, typically ranging from 0.5 mg to 10 mg per serving.
• Often supplemented with additional supportive ingredients like magnesium, vitamin B6, or herbal extracts such as valerian root.
• Produced under cGMP (Current Good Manufacturing Practices) to ensure purity, potency, and consistency.
• Non-habit forming, unlike many prescription sleep aids.

Benefits

• Facilitates Faster Sleep Onset: Reduces the time taken to fall asleep by signaling the body’s internal clock that it is time for rest.
• Helps Realign Circadian Rhythms: Effective for managing the symptoms of jet lag and adjusting sleep schedules for shift workers.
• Provides a Non-Prescription Alternative: Offers a widely accessible option for individuals seeking support for transient sleep disturbances without a prescription.
• May Support Overall Sleep Quality: By promoting a more regular sleep pattern, can contribute to more restorative sleep cycles.
• Antioxidant Properties: Exhibits free radical scavenging abilities, contributing to cellular protection, though this is not its primary indicated use.

Common use

Melatonin supplements are predominantly used for the short-term management of sleep disorders. This includes insomnia characterized by difficulty with sleep onset, circadian rhythm sleep-wake disorders (such as Delayed Sleep-Wake Phase Disorder), jet lag disorder, and shift work disorder. It is also frequently employed to mitigate sleep problems in certain neurodevelopmental disorders in children, though this should only be done under strict pediatric supervision. Off-label, it is sometimes explored for its potential antioxidant effects and in managing certain headache disorders.

Dosage and direction

Dosage is highly individualized and should be initiated at the lowest effective dose. For sleep onset insomnia, a dose of 0.5 mg to 3 mg taken 30 to 60 minutes before the desired bedtime is typical. For circadian rhythm adjustment (e.g., jet lag), doses of 0.5 mg to 5 mg are commonly used, starting before travel and continuing for a few days after arrival at the destination. It is crucial to take melatonin in a low-light environment to support its physiological action. The duration of use should be discussed with a healthcare provider, as long-term safety data is still evolving. Do not crush, chew, or break extended-release formulations.

Precautions

Consult a healthcare professional before use, especially if you have an autoimmune disease, a seizure disorder, or are taking other medications. Use with caution in individuals with depression, as effects can be variable. May cause drowsiness; avoid driving, operating machinery, or engaging in hazardous activities within 4-5 hours after ingestion. Not recommended for long-term use without medical supervision. Keep out of reach of children. If you are scheduled for surgery, inform your surgeon and anesthesiologist of your melatonin use, as it can interact with anesthetic and sedative agents.

Contraindications

Melatonin is contraindicated in individuals with a known hypersensitivity to melatonin or any component of the formulation. Its use is not advised for women who are pregnant or breastfeeding due to insufficient safety data and potential hormonal effects. It is generally contraindicated in people with autoimmune diseases (e.g., rheumatoid arthritis, lupus, multiple sclerosis) unless explicitly approved by a treating physician, as it may stimulate immune response.

Possible side effect

While generally well-tolerated at low doses, melatonin can cause adverse effects. Common side effects include:

• Headache
• Dizziness
• Nausea
• Daytime drowsiness or sleepiness
• Vivid dreams or nightmares Less common side effects may include:
• Short-lived feelings of depression
• Irritability
• Mild anxiety
• Abdominal cramps
• Reduced alertness the following morning

Drug interaction

Melatonin can interact with several classes of medication. Key interactions include:

• Sedatives: (e.g., benzodiazepines, zolpidem, barbiturates) - May enhance sedative effects, leading to excessive drowsiness.
• Anticoagulants and Antiplatelet Drugs: (e.g., warfarin, aspirin, clopidogrel) - May increase the risk of bleeding.
• Immunosuppressants: - May counteract the intended effects of these drugs.
• Blood Pressure Medications: - May affect the efficacy of drugs used to manage hypertension.
• Diabetes Medications: - May influence insulin sensitivity and blood sugar levels.
• Fluvoxamine (Luvox): - This SSRI can significantly increase melatonin levels, amplifying its effects and side effects.
• Contraceptives: - Hormonal birth control can increase endogenous melatonin production, potentially leading to additive effects.

Missed dose

If you miss a dose of melatonin, skip the missed dose and take your next dose at the regular time. Do not take a double dose to make up for a missed one. Since melatonin is taken on an as-needed basis for sleep, there is typically no regular dosing schedule to miss.

Overdose

Symptoms of melatonin overdose may include severe drowsiness, confusion, disorientation, and headache. In significant overdoses, seizures and hypotension (low blood pressure) have been reported. There is no specific antidote for melatonin overdose. Treatment is supportive and symptomatic. If an overdose is suspected, seek immediate medical attention or contact a Poison Control center.

Storage

Store melatonin in its original container at room temperature (59°F to 86°F or 15°C to 30°C), away from direct light, heat, and moisture. Ensure the cap is tightly closed. Do not store in the bathroom. Keep all dietary supplements out of the reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new dietary supplement regimen. Do not disregard professional medical advice or delay in seeking it because of something you have read here. The efficacy of these products has not been confirmed by FDA-approved research.

Reviews

• “As a nurse working night shifts for 15 years, this is the only thing that reliably helps me sleep during the day. I started with 1mg and it made a significant difference in my sleep quality without any grogginess.” - Sarah K., RN
• “I used a 3mg timed-release formula for jet lag after a trip from the US to Japan. It didn’t knock me out, but it gently eased me into the new time zone. I experienced no side effects.” - Mark T.
• “After discussing with my neurologist for sleep maintenance insomnia, I found a low-dose (0.5mg) sublingual tablet effective for falling back asleep. It’s a valuable tool in my sleep hygiene routine.” - Jennifer L.
• “I experienced very vivid, almost stressful dreams and morning grogginess on a 5mg dose. I’ve since learned that a much lower dose is more effective for me with fewer side effects.” - David R.