Melatonin for Sleep: What You Should Know

It’s not fun to struggle with sleep. Not being able to get a good night’s sleep can have a serious impact on your quality of life. Melatonin is a popular sleep aid that many turn to as a solution to their sleep woes. Melatonin is a hormone that is produced in your pineal gland (part of your brain). The production of melatonin is controlled by the level of light and darkness in the environment. Typically, melatonin release starts shortly after the sun sets. It tends to peak in the very early hours of the morning (e.g. 2-4 am) and then starts to decline. Light (especially blue light) blocks the production of melatonin. In addition to regulating sleep, melatonin plays a role in many other functions in the body. It’s a potent antioxidant and it regulates functions like immunity, energy, metabolism, mood and the activity of hormones. Below are some important facts about melatonin.

Effectiveness

Most of the evidence around melatonin shows that it can be helpful for those who have a biological clock that is thrown off. This includes people dealing with jet lag and night shift workers. There is also some evidence that it can help people who have insomnia for no particular reason (primary insomnia) by slightly decreasing the time it takes to fall asleep, improving sleep quality and increasing morning wakefulness. The effectiveness of melatonin can increase over time and then may eventually hit a plateau after several weeks.

Melatonin and Age

As we age, we start producing melatonin later and later after sunset. The peak levels of melatonin in the body also decreases with age. For this reason, scientists believe that melatonin may work better in people over 50 years of age compared to younger people.

Prolonged Release Forms

Melatonin can often be found in two different forms: regular and prolonged release. When you take regular melatonin orally, it tends to peak pretty soon after you take it (e.g. an hour). The levels spike higher than what your body would naturally have produced and then they quickly start to decrease. Experts have found melatonin levels can drop back to baseline anywhere between 2-8 hours of taking it. With prolonged released forms, the melatonin levels in your body rise more slowly, don’t go as high and drop back down more slowly. Some patients experience better results with prolonged release forms although more studies are needed to verify this difference in effectiveness.

Dosing

Typically, 1-5 mg doses are used (more is not better when it comes to melatonin supplements for sleep). People often take melatonin at the wrong time. In most research studies, melatonin is taken 30-60 minutes before bed.  

Side Effects and Safety

Many people tolerate melatonin well without any side effects, but side effects are still possible for some people. Melatonin can cause vivid dreams and nightmares in some individuals. It can also cause grogginess the next day as well as headaches. I tend to avoid melatonin in patients with depression as it has been associated with transient depression and worsening current depression. Melatonin also interacts with a number of different medications, supplements and health conditions so it’s important to speak to your naturopathic doctor and medical doctor prior to taking melatonin. The safety of taking melatonin continuously long term has not been well studied. This is why I always discuss with my patients about how long and how often we will incorporate melatonin into their plan.

Managing Your Sleep Beyond Supplements

Treating sleep difficulties involves more than just a sleep supplement. A well-rounded approach is required. Underlying conditions like anxiety, depression, thyroid disorders and sleep apnea need to be ruled out or treated. We also need to focus on other factors that can enhance sleep like specific behaviour changes and certain nutrition and lifestyle recommendations. I often find it helpful to incorporate other treatments like acupuncture for my patients with insomnia.

Good sleep affects every aspect of your health. Getting your sleep corrected can be a gateway to vastly improving the quality of your life.