Melatonin is not addictive. As a naturally produced hormone, it does not cause a physical dependence. Regardless, that doesn't mean self-prescribing melatonin is a great solution for troubled sleep.
Melatonin helps with sleep timing and circadian rhythms, which are the natural rhythms your body uses to track day and night cycles and act like an internal clock. When light decreases, melatonin production increases. Likewise, when you're exposed to more light, melatonin production can drop.
Melatonin is not addictive but can cause a psychological dependence
Since our bodies produce melatonin to fall asleep, it does not cause physical dependence. No evidence supports that taking melatonin diminishes how well our bodies produce it either.
But those who rely on melatonin can nonetheless feel anxious about trying to fall asleep without it. If this resonates, it may be the stress or anxiety that's keeping you up, or at least compounding your sleep issue.
Although non-addictive, taking melatonin repeatedly can lead to indirect psychological reliance on the substance to get sleep, causing you to reach for more melatonin each night.
If once you take it, you finally fall asleep, it can easily mislead you to believe it was the melatonin doing the job. But this isn't true. Rather, your anxiety was lifted once you took it, allowing your body to relax and eventually fall asleep.
Melatonin is regulated as a dietary supplement
While several countries have melatonin available by prescription, it's considered a dietary supplement in the US and not approved as medication by the Food and Drug Administration (FDA). This means melatonin is less regulated than prescription or over-the-counter drugs, with no specific dosage guidelines.
Because of this, it can be easy to take the wrong amount at the wrong time. When this happens, the supplement can be less effective and keep you awake longer. This might cause you to needlessly increase your dosage, which can cause or worsen side effects.
Findings from a study of various melatonin supplements supports this. It found that melatonin content in over 71% of supplements did not come within a 10% margin of the label claim. Another 26% contained serotonin, a hormone that can be harmful, even in low amounts.
The results of melatonin efficacy studies have varied
Several studies exist on the efficacy of taking melatonin to treat insomnia. While the results vary, general outcomes show it's misused by many and has little to no impact.
For example, one study showed those who took melatonin compared to those who didn't, on average, fell asleep only 7 minutes faster and stayed asleep just 8 minutes longer. That said, many felt they had better quality sleep.
Typically, a melatonin dose is about 1-3 mg taken about 1-2 hours before going to bed. But, some forms of the supplement come in single, larger doses. It can be easy and understandable to assume that something closer to 10 mg is the right amount to take. Don't be fooled.
When taking melatonin, always follow the directions on the package. If there's a dosage range, it's best to start low and go slow. Some experts believe that dosage timing matters even more than quantity, so pay attention to that too.
How melatonin differs from other sleep medication
“Melatonin is a sleep manipulator, not a sleep initiator. It pushes your circadian rhythm in one direction or another,” says Michael Breus, diplomat of the American Board of Sleep Medicine and author of Energize!. Breus feels that melatonin gets too much credit and that, " … melatonin for insomnia is more placebo than anything else.”
Generally, sleep medication forces your body to sleep, but melatonin doesn’t work this way. Rather, it works with the body's circadian rhythm, reduces dopamine, and binds to receptors. The pineal gland creates and releases melatonin, as does the retina after a circadian rhythm. Then, the melatonin impacts several parts of the brain, including the hypothalamus and pars tuberalis. It also binds with the kidneys, gonads, cardiovascular system, and immune system cells.
The high-affinity G protein–paired brain receptors, MT1 and MT2, work with melatonin to lower nerve activity. This helps us relax and wind down. But if your body doesn't produce enough melatonin to help you sleep, supplements can fool your brain into believing it's dark and, after sunset. This is when your melatonin levels rise and tell your body it's time to rest.
For this reason, it can take up to a few hours for melatonin to take effect. During this time, it's important to do things that encourage a calm, relaxing state. For example, limit heavy food and stimulants such as caffeine, noise, screen time, and bright lighting. Otherwise, you could be encouraging your body to do the opposite and stay alert. Quality sleep hygiene matters.
Medication alone won’t solve insomnia
If you're dealing with insomnia or other sleep issues, you might be tempted to reach for a sleep aid like melatonin. But taking melatonin or sleeping pills isn't sustainable as a long-term solution.
Melatonin or sleeping pills are often best used for a short time with other remedies, like cognitive behavioral therapy ( CBT-i). This combination helps to improve your sleep-related behavior and create a healthy circadian rhythm. It's why our sleep experts always combine CBT-i and medication for a healthy long-term outcome.
Common side effects of melatonin
Like many other supplements and drugs, melatonin comes with some side effects that can impact people, but they seem to be infrequent. "Most people do not have side effects, but some can experience increased sleepiness when waking up, headaches, or dizziness,” says sleep specialist Dr. Marri Horvat, MD.
Other common side effects include sleepiness or drowsiness during the day, nausea, and vivid dreams or nightmares.
Melatonin can interact with medicine that:
- Prevents seizures
- Slows blood clotting
- Prevents pregnancy (birth control)
- Suppresses the immune system (immunosuppressants)
- Lowers or manages high blood pressure
- The liver breaks down
- Helps with diabetes
If you're taking any medications that you’re worried may interact with melatonin, speak with your health care provider or pharmacist first.
Long-term side effects are unknown
Since most melatonin studies span 1-7 days, it's tough to be certain about the impacts of long-term usage. Doctors and other experts warn against using the supplement long-term since we simply don't know if and how it can adversely affect people.
The practice guidelines of the American Academy of Sleep Medicine and the American College of Physicians state that, "There's not enough information yet about possible side effects to have a clear picture of overall safety.”
Findings from a study of various melatonin supplements supports this. It found that melatonin content in over 71% of supplements did not come within a 10% margin of the label claim. Another 26% contained serotonin, a hormone that can be harmful, even in low amounts.
If you're unsure or decide against melatonin, the good news is there are other safe, effective options out there.
Effective alternatives to melatonin
If melatonin isn't a great fit for you, it's easy to explore options through Kick. Here's how it works.
Once you go through a simple and quick online consultation, our sleep experts can offer you trials of prescription alternatives to melatonin. These solutions provide you with the right medical guidance to fall asleep sooner, stay asleep longer, and wake up feeling alert and better rested.
Our sleep experts use a combination of CBT-i and medication that best suits your circumstances. We currently use gabapentin, hydroxyzine, trazodone, or cyclobenzaprine. We don’t prescribe ‘heavy’ z-drugs like Ambien.
From there, you'll get continuous sleep coaching and ongoing support from our professional, supportive team of experts. Best of all, everything is done online:
- Visits and check-ins with expert doctors
- Prescription insomnia medications sent to your door
- Proven CBT-i sleep coaching
Read more about our Insomnia Treatments and schedule your online consultation today.
