What you should know before taking melatonin to help you sleep

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Whether you’re struggling with jet lag, are a shift worker who sleeps during the day, or someone with more severe insomnia, you might have wondered if melatonin can help you get a better sleep.

Melatonin is a hormone made in the brain to regulate your daily sleep-wake cycle. It tells your internal body clock to get sleepy when it’s dark.

Melatonin supplements are a synthetic version of this hormone that people can take to help them sleep.

But they won’t work for all sleep conditions. So what can you take it for?

Melatonin works by slowing or stopping neuron firing in the area of the brain called the hypothalamus. This is the brain’s master biological clock.

Your eyes detect when darkness falls, triggering the brain to produce melatonin.

Because you need lower light levels, or darkness, to trigger melatonin release, sleep can be a problem for people living at very high or low latitudes. In summer the sun may not set, or it is only dark for a few hours per day, and that affects melatonin production. And in winter the sun may never come up, or you get only a few hours of sunlight.

For those in the rest of the world, if you suffer from low levels of melatonin – which can happen as you age – it can make it harder to sleep.

There are several diseases and conditions that affect sleep, but only two have evidence that they are treatable with melatonin supplements.

Melatonin has been shown to be effective in reducing and preventing jet lag. It’s of most benefit if you fly across more than five time zones. This includes from Europe back to Australia and flying to the Americas from Australia. To be most effective, the melatonin should be taken as close to when you want to go to sleep as possible.

There appears to be some benefit to taking melatonin for those who have difficulty sleeping during the day due to shift work. It has been shown to improve the duration of your sleep after a night shift, but it doesn’t appear to improve other aspects of quality sleep, such as alertness, sleepiness, or fatigue at work.

General, or chronic, insomnia is when you regularly struggle to fall asleep, stay asleep, or when you often wake too early. Unfortunately, if you suffer from chronic insomnia, the evidence indicates melatonin supplements are unlikely to work.

The pain and discomfort of chronic kidney disease and cancer, and its treatment, can make it more difficult to sleep. But the science is unclear whether melatonin can help with sleep due to those conditions. So for either, it is best for you to speak with your doctor before trying a supplement.

People with dementia can have difficulty sleeping due to the disease’s ability to damage the brain’s internal clock. However, the science indicates that melatonin is not effective for this condition.

Melatonin is available in different doses and formulations in Australia.

While homeopathic products are available in Australia, they either do not contain melatonin or have a dose so low that they are ineffective. Any benefit will be from a placebo effect.

Pharmacists can supply controlled-release tablets that contain 2mg or less of melatonin for the short-term treatment of sleep problems for people aged 55 or over. These are available over the counter as a pharmacist-only medicine.

Nial Wheate is a Professor of Pharmaceutical Chemistry, Macquarie University.

Wai-Jo Jocelin Chan is a Pharmacist and Lecturer, UNSW ; University of Sydney.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Controlled-release melatonin formulations release melatonin slowly and steadily in the body throughout the eight-hour sleep period. This is more suited for managing age-related sleep issues caused by reduced natural melatonin production as we get older.

Immediate-release products that contain 5mg or less of melatonin are also available. The short-lived peak of melatonin that comes from this formulation is more suitable for managing jet lag. Pharmacists can supply these to adults 18 years and older for jet lag.

All other formulations above these dosages are prescription-only. They are used for the short-term management of other types of sleep problems, including those that occur alongside neurodevelopmental disorders such as autism.

Melatonin is generally well-tolerated. The side effects are generally minor and short-lived and include daytime sleepiness, headaches, nausea and dizziness.

Avoid taking melatonin before driving, as it may affect your attention and reaction time.

A study has found that daily 1,000 to 6,600mg doses of melatonin may cause a loss of sleep and weight loss in people with depression and Huntington’s disease.

There is little research, and inconsistent results, about the side effects of longer-term melatonin use (greater than six months).

Other than taking melatonin, there are a few techniques that can be used to help with sleep. The first is to keep a regular bed and wake-up time, including on weekends. This can help to regulate your body clock.

If you’re unable to fall asleep after 20 minutes, get up and do something relaxing, then return to bed when you feel sleepy.

Avoid exposure to bright light from computers, televisions and phone screens one to two hours before bed, as this can prevent your body from releasing natural melatonin.

It’s also important to create a good sleeping environment. Make sure your bedroom temperature is cool, and the room is comfortable, quiet and dark enough.

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