Does Melatonin Work?

By Jane Farrell

could get to sleep. Millions of people suffer from the same condition, and melatonin, a popular dietary supplement, is said to help.

The melatonin sold in stores is a concentrated form of a natural hormone that plays a role in sleep. The hormone’s levels in the body rise in the a.m. and fall in the p.m. It’s been studied in connection with sleep disorders such as jet lag and insomnia, as well as dementia symptoms.

But how well does it work, and are there any side effects? The experts at the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health, have assessed the claims made for melatonin. Here are their findings:

*Overall, melatonin appears to be safe when used short-term, but the lack of long-term studies means we don’t know if it’s safe for extended use. Side effects of melatonin are uncommon but can include drowsiness, headache, dizziness, or nausea. There have been no reports of significant side effects of melatonin in children.

*In one study, researchers noted that melatonin supplements may worsen mood in people with dementia.

*In 2011, the U.S Food and Drug Administration issued a warning to a company that makes and sells “relaxation brownies,” saying that the melatonin in them has not been deemed a safe food additive.

Studies suggest that melatonin may help with certain sleep disorders, such as jet lag and sleep problems related to shift work, according to the NCCAM. It also appears to help treat a sleep disorder that leads to changes in blind peoples’ waking and sleeping patterns. As for general insomnia, it may help reduce the time it takes to fall asleep.

It may also help with a condition known as delayed sleep phase disorder; people with this condition have trouble falling asleep before 2 a.m. and have difficulty waking in the morning.

When it comes to shift work disorder, the results are mixed. About 2 million Americans who work from the afternoon to night or from night to early morning are affected by the disruption in their natural sleeping patterns. A systematic review of the evidence has found that melatonin can help improve sleep in the daytime, but not nighttime alertness.

Insomnia is a general term for a group of problems characterized by an inability to fall asleep and stay asleep. A 2013 analysis of 19 randomized placebo-controlled trials included 1,683 people found that melatonin slightly shortened the time to fall asleep, the total sleep time, and the overall quality of sleep. The NCCAM also reports that a 2007 study of 170 participants with insomnia, aged 55 years or older, s found that prolonged-release melatonin significantly improved quality of sleep and morning alertness.

If you are considering taking melatonin, the NCCAM suggests that you talk to your doctor. The regulations for dietary supplements are much less stringent than those for over the counter or prescription drugs. Remember that “natural” doesn’t always mean “safe.”

Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure safe and coordinated care. For tips about talking with your providers about complementary approaches, see NCCAM’s Time to Talk campaign.

For more information on alternative health, visit nccam.nih.gov.