Melatonin: Am I Doing This Right?

It is not a secret that melatonin plays a very important role in our sleep wake cycles. In fact, most species have and use this hormone for this purpose. However, in recent years, the United States has seen an increase in over the counter (OTC) melatonin-use. According to the CDC (2022), within the United States, an increase from $285 million to $821 million occurred between 2016 and 2022. Currently, the United States is one of the few remaining countries that classifies OTC melatonin as a dietary supplement, whereas countries such as the United Kingdom, European Union, Japan, Australia, and Canada have banned the sale of melatonin over the counter (Grigg-Deamberger & Ianakieva, 2017). Due to this classification, there is a lot of information about the dietary supplement that remains unknown by the general population. Advertisements created are often geared towards the use of the general public and misrepresent the appropriate consumption of melatonin as a supplement for both children and adults.

HOW DO WE VIEW MELATONIN IN THE MEDIA?

This is an ad you could see watching TV, streaming, or surfing the web. And the message is clear: if you’re feeling like you can’t fall asleep right away, feel restless throughout the night, or wake frequently, then OTC melatonin is right for you. But how do we know if advertisements like this are correct? How do we know the appropriate dosage? How do we know what is in the supplements we are buying?

For parents with children that struggle with bedtime advertisements like this sound like a dream:

 “Can this help me get more hours of rest each night?” “Will that help me with my productivity tomorrow? If I’m more productive, I will be a better parent.”

WHERE DO THE DANGERS IN MELATONIN LIE?

Melatonin is a naturally occurring hormone, so how could it be harmful? It isn’t the use of melatonin as a dietary supplement that is the issue. It is the danger of knowing WHAT is within your supplements, what the appropriate dosages are, and how they should be utilized. Because OTC melatonin is considered a dietary supplement, the Food and Drug Administration (FDA) is not required to regulate what is being used within the medication. Often, companies supplement or misrepresent dosing, which can be extremely dangerous (NCCIH, 2022). According to a study conducted by Li et al (2022) attached here, prior to 2006 reported use of melatonin over 5 m/g was not found, however in recent years the use of more than 5 m/g has increased by 95% across all demographic groups.

Another area where we must tread with caution is how the melatonin is stored. Because it is considered a dietary supplement, most people assume it is not dangerous which has led to an exceptional number of accidental ingestions, primarily by children. In a study conducted by the CDC attached here. It was found that the number of ingestions that have led to adverse complications, hospitalizations, and even death has increased by 530%, during the ten-year study period (CDC 2022). This is likely attributed to the overall increase of homes that now contain OTC melatonin, and the “fun” gummy presentation of the medication which appeals to children.

SO, WHAT IS THE SAFE WAY TO USE MELATONIN?

Recent research suggests melatonin is safe and effective for short-term use (Montague, 2022), such as:

• Jet lag
• Some short-term sleep conditions
• Shift changes at work
• Some cases of insomnia

However, the current research does not contain information about the effects of long-term use on child or adult populations.

So, the takeaway is this: Can OTC melatonin help you in correcting or re-correcting your sleep-wake cycles day-to-day? Yes. But it shouldn’t be relied on as the sole provider for this process. There is a lot you can try:

Change your sleep environment (darkening curtains, limited background lighting, etc.)

Limit your caffeine intake during the afternoon

  Incorporate exercise into your daily living

Limit electronic use before bed

But most of all: TALK TO YOUR DOCTOR!

            Before choosing to take OTC melatonin daily, communicate with your primary care physician. Ask about interactions with other medications, ask about the appropriate dosing, and ask for a recommended brand because they are NOT all the same. 

Resources:

Grigg-Damberger MM, Ianakieva D. Poor Quality Control of Over-the-Counter Melatonin: What They Say Is Often Not What You Get. J Clin Sleep Med. 2017 Feb 15;13(2):163-165. doi: 10.5664/jcsm.6434. PMID: 28095978; PMCID: PMC5263069.

Lelak, K., Vohra, V., Neuman, M., Toce, M., & Sethuraman, U. (2022, June2). Pediatric      melatonin ingestions – United States, 2012–2021. Centers for Disease Control and           Prevention. Retrieved April 25, 2023, from            https://www.cdc.gov/mmwr/volumes/71/wr/mm7122a1.htm?s_cid=mm7122a1_w#sugg     stedcitation

Li J, Somers VK, Xu H, Lopez-Jimenez F, Covassin N. Trends in Use of Melatonin Supplements Among US Adults, 1999-2018. JAMA. 2022;327(5):483–485. doi:10.1001/jama.2021.23652

Montague, J. (2022). Melatonin mystery. New Scientist, 256(3419), 41–45. https://doi        org.ezproxy.neit.edu/10.1016/s0262-4079(22)02322-3

U.S. Department of Health and Human Services. (2022, July). Melatonin: What you need to know. National Center for Complementary and Integrative Health. Retrieved April 22, 2023, from https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know

YouTube. (2018, September 5). Natrol melatonin TV commercial (:30 – captioned). YouTube. https://www.youtube.com/watch?v=zTnUT7SZioM