Does Melatonin Work for Insomnia? A Doctor Answers «

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Does Melatonin Work for Insomnia? A Doctor Answers

[Editor's note: This article was originally hosted on MyFamilyDoctorMag.com, our sister site.
It's now featured here as part of our new general-health section.]

by Edward R. Rosick, D.O., M.P.H.

Melatonin for Sleep

 

Did you get a good night’s sleep last night?

Most of us have insomnia every now and then. About 60 million Americans have trouble sleeping frequently or for extended amounts of time, according to the National Institute of Neurological Disorders and Stroke. And drug cures are plentiful. They’re also mostly short-lived and sometimes a little too good to be true.

But there may be an alternative.

Sleeping Pills and Side Effects

For short-term sleep problems, doctors often prescribe benzodiazepines (such as Ativan, Valium and Xanax) and other similar medications. While these do help people sleep, they’re not a cure for insomnia. Many prescription and over-the-counter pills tend to lose their effectiveness after a couple of weeks, can be habit-forming and can actually interfere with a good night’s sleep by reducing the time you spend in deep sleep. For people who want to try an alternative, the answer may be the supplement melatonin.

How the Melatonin Hormone Works

Melatonin is a hormone produced in a structure called the pineal gland, which is deep within our brain. While there’s still a lot to learn about it, researchers have shown that it’s intimately connected with sleep.

During the day, melatonin levels are low; when darkness falls, they increase significantly. Since we know that melatonin is part of the sleep/wake cycle, many integrative-medicine doctors recommend it as a sleep aid, touting it as a more “natural” way to help people beat insomnia.

Melatonin Safety and Interactions

The Therapeutic Research Center, an organization that makes recommendations about drugs and other therapies, has published some advice about melatonin. It includes:

  • Children, women who are pregnant or breastfeeding, and people on certain blood-pressure medications shouldn’t take melatonin.
  • Melatonin may worsen symptoms of diabetes, depression and seizure disorders.
  • Don’t take melatonin with sedatives.
Other medications melatonin may interact with include:
  • Birth-control pills
  • Fluvoxamine (Luvox)
  • Immunosuppresants
  • Medicines or supplements that slow blood clotting.

For more precautions and further details on any of these warnings, see MedlinePlus.

Does the Melatonin Supplement Work for Insomnia?

Melatonin does have a few studies backing its effectiveness, though they’re not particularly large or conclusive. In 2005, researchers analyzed data from 17 small studies. Their findings, published in Sleep Medicine Reviews, concluded that melatonin can make you fall asleep about four minutes faster, increase your sleep efficiency by about 2 to 3 percent and add around 13 minutes to your sleep duration.

Melatonin use may be especially relevant to elderly people. As people grow older, sleep problems become more common. Since melatonin levels decline as we age, it makes sense to think that supplements could help seniors get a good night’s sleep.

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Melatonin Side Effects and Dosage

Melatonin doesn’t appear to be habit-forming, lose its effectiveness or interfere with normal sleep. It’s apparently safe for most people in the short-term but hasn’t been studied in the long-term. Dosages vary widely. A good starting point seems to be 0.3 milligrams. (You can cut a 1-milligram tablet into thirds).

As a physician specializing in holistic medicine, I try to educate my patients on what supplements are safe and effective, as well as which ones are worthless and possibly dangerous. For people looking for a natural alternative for insomnia, melatonin appears to be a good choice to help them get a good night’s rest.


Board certified in preventive medicine and specializing in integrative medicine, 
EDWARD R. ROSICK, D.O., M.P.H., is an assistant professor at the Michigan State University College of Osteopathic Medicine.

  • Mich

    How long does it last? I tend to wake up between 2:30-4 & then I am awake for a few hours then sleep on & off until 11. I have a TBI. My question is can I take it when I wait up to be able to sleep until 8 or to 11?

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  • Bree Utsman

    I have had long-term insomnia for about four years now (since I was eleven) and my neurological doctor prescribed to me a 5mg tablet every night. I am very excited, because my last doctor put me on hydroxyzine (an antihistamine, also known as atarax) as he believed it was from anxiety. It never worked for me, and it was slightly addictive. Wish me luck! I really hope that, for once, I have finally found something that works!

    • Jason

      You employ phenomenal punctuation for someone of your age on the internet. I’m impressed.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I do wish you luck, Bree.

  • Christenmariea

    I Go to a normal Dr for sleep pills
    I have Insomnia every night its part of my disability and I only stay asleep for a few hours its really annoying and
    the only thing that puts me to sleep and helps me feel a lot better in the morning is Ambien but the government will not allow me to have any more then 10 and my Dr has tried to help me with other things only thing is they aren’t sleep pills they are things for other problems and I do get sleepy but I still can not shut off my brain I am scared to talk to My Dr asking him if there is anything ells that can be filling me in but my fear is having to go to another Dr but I cant cause I don’t have anyone to help me with that and I am really tired of being up all night I fall asleep at 4 or 5 am in the morning and its hard but I have no clue what Ells normal Drs will give you that is just a sleep aid that is the only problem

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      There are many sleep aids doctor’s could prescribe depending on your specific situation, many of them not habit-forming and, yes, many are used to treat other things also. But that doesn’t mean you can’t take them specifically for your insomnia. Also, you could ask about being referred to a sleep specialist. Other than getting to and from a doctor’s office, I’m not sure what help you’d need going to another doctor.

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  • Rob

    Melatonin can produce an elevated thyroid count, (TSH), in some persons. I am one of those persons. I have never had anything other than a normal TSH. I started taking 3 to 6 mg of melatonin on a fairly regular basis. For the first time in my life I had an elevated TSH. I started eliminated every med and supplement I was ingesting. Only when I stopped the melatonin did the TSH return to normal. What I use now to sleep is 1mg of klonapin and 8mg of Seroquel together and I sleep like a baby with no grogginess the next day. This is not true with the standard 25mg of Seroquel. I see double the next day with that high a dosage.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thanks, Rob.

  • Pablo

    I am taking every night one 3mg melatonin pill. For better effect is it safe to take 2 pills?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Pablo, 0.5 mg to 5 mg seems to be the usual dose.

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  • sarah

    I just have started to notice the pattern for insomnia. I go to sleep at probably 3 4 in the morning, and then i wake up at 6 or 7 a.m. I do lead a stressful life and it doesnt help me sleep. I dont want anything habit forming really i just am not sure what to do besides that i am currently trying melatonin and it seems like it makes me tired enough and gets me through the night but i still wake up so early. Because i fall asleep so irregulary ive never been good with sleep diarys or trackers and have not been doing well with trying to set a routine. It has changed my attitude and my health im grumpier , i often feel like im on a different page and my brain is off, and i have gained weight just being up at night and not doing anything. Its driving me insane and i dont know what to do or which way to go any ideas or educational tips on dealing with a few factors?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Sarah, I do have a post on insomnia on my old blog site http://www.familydoctormag.com/sleep/1413-sleep-questions.html
      Hopefully you’ve gone through the usual insomnia-reducing recommendations, such as, go to bed at the same time every night. Train your body that the bed’s for sleep by not getting it if for other reasons (ok, other than sex.) Don’t eat a heavy meal before bed. Avoid caffeine (soda, tea, coffee, chocolate) from noon, on. Exercise is good for sleep, but don’t don’t do it in the late evening.

      Many find relaxation techniques and biofeedback very helpful. I think you need a psychologist or physician referral for that (and seeing one is a good idea anyway.)

  • Keri

    3 months ago my boyfriend of almost 7 years passed away. The investigators are still not sure if he did it him self or if it was done to him. Ever since this I have not been able to get to sleep till at least 2am. If I ever make it to sleep at a decent time I don’t sleep good till I wake at 6 and then I get like an hour of sleep before I have to get up for work. I am exhausted. I have tried everything. Do you have any suggestions.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Keri, I’m so sorry. For anyone in your situation, I’d see a counselor/therapist. If you have a regular doc, that would be a good place to start. I think some prescription medicine for a few months might help you a lot, along with grief counseling.