Should You Try Melatonin to Help You Sleep?

Nearly 15% of adults reported having trouble falling asleep most or every day in the past 30 days, according to a national survey. Meanwhile, research shows that more people are turning to a popular and readily available over-the-counter (OTC) sleep aid: melatonin supplements.

That doesn’t surprise Brienne Miner, MD, MHS, a Yale Medicine geriatric and sleep medicine specialist. She explains that it's generally safe to take a melatonin supplement—a synthetic version of the hormone produced in the brain that helps regulate the sleep-wake cycle.

“I think that's why we see it being used more and more, especially in older people, and especially as people become—appropriately—less comfortable with prescription sleep aids, which can have many side effects,” Dr. Miner says. For older adults, in particular, these side effects can include cognitive problems, falls, driving impairment, and more.

Yet, while melatonin supplements appear to be safe, the Food and Drug Administration (FDA) does not regulate dietary supplements as it does medications. For example, the agency does not approve supplements for safety or efficacy before they are sold, but can take action against misbranded or adulterated products after they are on the market.

In addition, a 2023 study published in the Journal of the American Medical Association found that the actual amount of melatonin in tested products ranged from 74% to 347% of the amount on the label, and 22 of the 25 products tested were inaccurately labeled. Some independent, “third-party” groups, such as NSF or the United States Pharmacopeia, test supplements for their ingredients and the presence of contaminants, but the FDA does not have oversight over these organizations.

Below, Dr. Miner talks more about melatonin supplements.

"Melatonin is involved mostly with sleep initiation,” explains Dr. Miner. Levels of melatonin produced by the body naturally rise before bedtime, peak in the middle of the night, and are depleted by morning. The hormone, created in the brain by a tiny gland called the pineal gland, helps regulate the body’s circadian rhythm and is generally released as the sun begins to set and the body senses darkness.

In this way, melatonin has two benefits, Dr. Miner says. First, it has a hypnotic, sleep-inducing effect. As a result, doctors believe melatonin supplements can be beneficial for people who have difficulty falling asleep at the beginning of the night. However, the hypnotic effect of melatonin is weak, and the supplement is not recommended for people with insomnia disorder, which is associated with trouble falling asleep, staying asleep, and waking up too early.

Melatonin also has a chronotropic effect, meaning that it affects the timing of our circadian clock, Dr. Miner explains. “It can be helpful if you have a delayed sleep phase—for example, if you don’t feel tired until 3 a.m. We might use melatonin supplements in those cases to help someone initiate the sleep process earlier in the night,” she says.

Generally, Dr. Miner recommends taking melatonin an hour before going to bed—or an hour before a desired bedtime—to let the drowsy feeling sink in.

However, she notes that proper dosing of a melatonin supplement is essential. The brain releases about 0.3 milligrams of melatonin every 24 hours. On the other hand, over-the-counter melatonin supplements can range from 1 milligram to more than 10 milligrams of melatonin per dose, delivering “supraphysiologic doses” of melatonin—or far more than the body produces, Dr. Miner explains

She emphasizes that more melatonin is not better. One exception is for those with rapid eye movement (REM) sleep behavior disorder, which causes people to act out their dreams while sleeping. “Generally, no one should need a melatonin dose of more than 5 to 10 milligrams, unless they have REM sleep behavior disorder,” Dr. Miner says.

While experts generally view melatonin as a safe supplement, and research suggests that negative interactions with drugs are rare, it can have side effects, including daytime sleepiness, headaches, dizziness, or mood changes.

Dr. Miner mostly worries about side effects with melatonin supplement doses that exceed 10 milligrams, except when treating REM sleep behavior disorder, which may require a higher dose, as noted above. Research on long-term effects of melatonin supplementation is limited.

Dr. Miner also cautions against using melatonin doses higher than 10 milligrams if someone has liver problems because the liver is responsible for removing melatonin from the blood, she explains.

When used in small doses, melatonin supplements can serve as a safe short-term or even long-term fix to some sleep problems, says Dr. Miner. Melatonin is most beneficial for those who have trouble falling asleep.

However, Dr. Miner urges people with ongoing sleep problems to speak with a medical provider rather than relying on the supplement.

“If you find yourself having to take melatonin every night to help you sleep, you may want to be evaluated to make sure there is not an underlying sleep disorder,” she says.