• Melatonin Is Not The Sleep Solution

    by Lauren King, PsyD
    on May 23rd, 2017

Melatonin is Not the Sleep Solution
By Lauren King, PsyD


You have probably heard of melatonin, the sleep hormone. It is found naturally in our bodies. However, it is also sold as a supplement over the counter. The use of over the counter melatonin has significantly increased over the past few years. People taking melatonin may not fully understand what it is and how it works.

It is well known that sleep and wakefulness are regulated by light and darkness. Darkness or lack of light causes the body to produce and release melatonin, which signals the body to prepare for sleep. On the other hand, light exposure in the morning decreases melatonin production. Light then signals the body to prepare for being awake by releasing wakefulness brain chemicals.
Melatonin is indicated in treatment of jet lag, shift-work issues, or something called delayed phase circadian rhythm disorder. However, melatonin is not intended for use to treat insomnia. Even so, many physicians suggest melatonin as it is relatively safe to use with few side effects. Even though melatonin is relatively harmless and often touted by physicians, it is frequently overused by individuals. Melatonin should not be used as a sleep aid. It is actually not supposed to be taken for many consecutive nights, either. However, many people with insomnia take it every night, in high does, and for long periods of time.

Purpose
The purpose of melatonin is to set the body’s internal sleep/wake rhythm. That is why it is so useful for jet lag. Say you are coming back to the east coast of the United States from a two week trip on the west coast and were used to the 3 hour later time difference. In this situation, melatonin could be used (in addition to natural changes in light and dark) to trigger your body to go to bed at an earlier time, consistent with the eastern time zone. When not traveling across different time zones, taking melatonin at your usual bedtime to reduce the time it takes you to fall asleep or to try to keep you asleep is not likely going to be effective.

Dosage
Many people are taking very high doses of melatonin, as much as 10 to 20 mg per night. Most research studies suggest taking less than 1 mg of melatonin is more effective. Melatonin is not FDA-regulated so you never quite know what you are getting since it is not regulated. A recent study looking at different brands of melatonin revealed advertised dosages were not consistent with what was found in the pill in the lab (Erland & Saxena, 2017). Often, melatonin doses were much higher than advertised (as much as 478% more than on the label). The study also found that the chewable forms of melatonin varied the most in how much melatonin was actually in the tablet. This is alarming as consumers do not always know what they are getting when buying melatonin supplements.

Risks of taking too much melatonin include headaches, nausea, dizziness, and/or grogginess the next day. Depressed mood is associated with higher levels of melatonin. When melatonin receptors in our brains are exposed to too much melatonin, they become unresponsive to it.

Timing
Taking melatonin at the incorrect time of day can disrupt your sleep schedule. Taking melatonin too early or too late can throw off your natural sleep/wake cycle (circadian rhythm).

Before taking melatonin, talk to your sleep doctor at Bluepoint Medical Associates. Our sleep specialists can individualize treatment. With treatments such as Cognitive Behavioral Therapy for Insomnia (CBT-I), you may not even need sleep medications to improve your sleep.





References:
Erland LA, Saxena PK. Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content. J Clin Sleep Med. 2017;13(2):275–281.

Author Lauren King, PsyD Licensed Clinical Psychologist, CBT-I Provider

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