A melatonin supplement is a natural OTC drug you can take to help you sleep better. Melatonin, not to be confused with melanin (what makes us tan or, in bigger quantities, composes a sunspot and birthmarks), is a hormone our body produces each evening when it gets dark outside to help us drift off to sleep. Exposure to light late in the evening (yes, we're referring to that smartphone-in-bed habit) interferes with the natural production of melatonin.
You'd generally take melatonin to treat jet lag, to ease temporary symptoms of insomnia, to promote an easier sleep for neurodivergent conditions (such as autism or ADHD), and for any night of insomnia. It is generally harmless and acts as a good solution for short-term sleep problems, and that's why it's sold over the counter, but can you use melatonin for prolonged periods?
Several chemicals can be tremendously beneficial in short-term use, and just as equally disastrous when consumed over long periods. We set out to find out if melatonin is one of those.
Long term use of melatonin
The problem is that currently, the longest studies about melatonin have been conducted for no longer than 6 months periods. So we still don't have clear-cut answers about the consequences of prolonged use of melatonin. What we can tell you, however, is that a recent research review discovered some very interesting findings.
The review found that over 6 months, any form of melatonin is safe and won't cause withdrawal side effects when you discontinue use. According to Mayo Clinic, "with melatonin, you are unlikely to become dependent, have a diminished response after repeated use (habituation), or experience a hangover effect."
This research review also found that people with medically diagnosed, long-term sleep disorders won't benefit much from melatonin.
Worried about dosage?
Worry not. Melatonin, being a naturally occurring hormone after all, is virtually harmless, even in extreme doses. If you took another one by mistake or by intention, the most severe side effects you can expect are headaches and mild nausea.
Before double-dosing however, make sure that you take the pill at the right time. You need to try and tune in with your natural circadian rhythm. This means taking the pill 1 to 2 hours before bedtime.
To avoid severe side effects, an overdose, or an interruption to the circadian rhythm, start with one pill, taken as instructed above, and if you feel you need more, consult with your doctor about stronger prescription medication to help you with your sleep condition, instead of piling on more and more melatonin.
Many different studies suggest many different doses, varying between 1 and 5 mg. We would like to stress that the dosage will ultimately be controlled by your doctor. A melatonin supplement isn't for pregnant and breastfeeding women, due to a lack of research regarding its safety. For children and adolescents, it can be an effective sleep aid but only under the supervision of a doctor - not as an OTC drug.
When to seek medical help
If your sleep symptoms have been interfering with your daily life, or have been lasting longer than a month, it's time to consult with the doc. They will tailor a treatment plan for your needs.
According to an article on Greatist, reviewed by Dr. Nick Villalobos, MD, people who have the following conditions should consult with a doctor before taking melatonin:
allergies to melatonin
Melatonin can also interact with certain medications, so talk to your doctor before using it if you’re taking:
natural or prescription sleep aids
blood pressure medication
hormonal birth control
central nervous system depressants
nonsteroidal anti-inflammatory drugs (NSAIDs)
You should also avoid mixing melatonin with alcohol, so skip it on nights you decide to imbibe.