As Melatonin Use Rises, So Do Safety Concerns

As Melatonin Use Rises, So Do Safety Concerns

As Melatonin Use Rises, So Do Safety Concerns

A lifelong night owl whose sleeplessness worsened as she aged, she sipped chamomile tea, popped antihistamines, and listened to relaxation tapes before bed -- all to no avail. Some days she’d call in sick to work, afraid she couldn’t drive safely. After she retired, she started staying up all night.

What to do Today to Sleep Better Tonight

Repay Your Debt

The lack of enough sleep over time can result in a sleep debt. This is the difference between the amount of sleep you need and the amount you actually get. This debt can be repaid by tacking on extra snooze time each night until you feel caught up.   

Exercise by Day to Sleep at Night

Regular exercise can help you sleep better. For best results, exercise outside before dinner. But don't rev up with exercise near bedtime. In the evening, light yoga or stretches can help you wind down. If you have a medical problem or are over 50 check with your doctor before starting an exercise routine.

Choose Evening Snacks Wisely

An oatmeal raisin cookie and a glass of milk can help you fall asleep. That's because this snack includes complex carbs that likely increase levels of sleep-inducing amino acid tryptophan. Other sleep-boosting choices: a piece of whole grain toast or a small bowl of cereal.

Get on a Sleep Schedule

The average person needs 7-9 hours of sleep per night. Most experts recommend maintaining a consistent sleep schedule even on days when you are able to sleep in. This balances a person's internal clock, allowing them to stay awake when needed and fall asleep when ready. It helps if your bedroom is conducive to sleep: dark, cool, and quiet. 

Wind Down Your Brain

Try blocking out a daily "worry time" to get anxiety out of your system before bed. Make time just after dinner to plan your next day, catch up on email, and tie up loose ends. Then you can have time before bed to let go of anxieties and relax.

If You Nap, Keep it Short

Whether you should nap during the day depends on how you normally sleep at night. If you typically sleep well, then an occasional short nap is OK. Naps can make you function better, lower blood pressure, and maybe even help you live longer. Avoid napping too late in the day, as it might affect your nighttime sleep. But if you have sleep problems, naps may mess up your sleep schedule even more.

Avoid Hidden Sleep Wreckers

Caffeine can perk you up so avoid it after lunch if you have trouble sleeping at night. It can stay in your system for an average of three to five hours, but some people are affected as long as 12 hours. Watch your afternoon food and drink choices. Caffeine may hide in soft drinks, tea, and chocolate. Also be wary of certain medications, such as decongestants, which can aggravate sleep problems.

Natural Ways to Help You Sleep

Some people try natural methods to wind down their day. Used medicinally for thousands of years, chamomile brewed in tea is non-caffeinated and may help relax you for sleep. Or try aromatherapy. Studies have found that lavender produces slight relaxing and calming effects when inhaled. For some people, melatonin seems to improve sleep. If you take medications, talk with your doctor before taking any supplement.

Try Relaxation Exercises

In the late evening, visualize something calming, using all your senses to make the image as vivid as possible. Or try progressive muscle relaxation. Tighten up the muscles in your toes for several seconds. Then relax them for 30 seconds. Focus on how relaxed they feel. Repeat this all the way up your body, ending at your neck and face.

When You're in Pain

Are aches and pains keeping you up at night? You’re not alone: According to one survey, three-quarters of people with low back pain experienced poor sleep. And if you can’t sleep well, you may feel even worse during the day. First, make sure you practice good sleep hygiene. You may want to consider taking a nighttime pain reliever to help you doze off, but consult your doctor if pain commonly keeps you up at night.

See a Doctor About Sleep Problems

If you have sleep problems and none of these strategies helps, you may have a sleep disorder. Medications and some medical conditions can cause sleep problems. Your doctor or a sleep specialist can help you find the problem and learn ways to improve sleep.

 

“There’s no one to talk to at 3 a.m., and when you sleep all day, it’s hard on your social life. I was getting really depressed,” says Wazny, 63, who lives in British Columbia. When she asked her doctor for sleeping pills, she recommended melatonin instead. Today, her life has turned around.

“I have never had such a regular pattern of sleep in all my adult life,” she says. “I wish I had known about this 30 years ago.”

Wazny is among a growing number of sleep-deprived consumers turning to a once-little-known hormone, often referred to as the “sleep hormone,” for relief for themselves and their families.

In all, U.S. consumers are expected to spend more than $425 million on melatonin supplements in 2018, up from $259 million in 2012, according to Nutrition Business Journal. More than 3 million adults and close to a half-million children take it, and that number is expected to grow as more sleep-deprived families clamor for cheap “natural” remedies and companies roll out everything from melatonin teas to mouth sprays to animal-shaped gummies.

But with such growth have come concerns that consumers have a view of the potent, complex hormone that’s too simple. In March, three workers at a day care in Illinois were arrested for slipping melatonin gummies to 2-year-olds to hasten their naps. When questioned by police, they said they assumed it was safe since it was sold over the counter.

The growing use, or misuse, is showing up in other ways. Calls to poison control centers about melatonin have skyrocketed. There was an 86% increase in calls about children exposed to melatonin from 2014 to 2018, according to the American Association of Poison Control Centers. Just since January, there have been nearly 30,000 calls about melatonin -- 24,000 of them about children 12 and under.

“People think of it as a vitamin, but in reality melatonin is a hormone,” says Craig Canapari, MD, director of the Pediatric Sleep Center at the Yale School of Medicine. “Amid the mania for ‘natural treatments,’ that gets overlooked.”

Taken at the right time, in the right dose, melatonin can, indeed, repair a sleep schedule thrown off kilter by jet lag, a long weekend filled with late nights, or certain circadian rhythm disorders. And for some people, it can have a mild hypnotic effect.

But as a remedy for general sleeplessness, it has its limits. And when it comes to its use in children, concerns abound. Melatonin supplements appear to be safe when used short-term; less is known about long-term safety.

“A lot of people just take it right before they go to bed as if it were a sleeping pill,” says Michael Breus, PhD, a California-based clinical psychologist who specializes in sleep disorders. “It’s not that simple.”

Works for Some, Not for Others

Discovered in 1958, melatonin is a hormone that the body makes to help regulate our circadian rhythm, or natural body clock. Light is the switch that controls it: As daylight fades, levels of melatonin begin to rise about 1-3 hours before bedtime, nudging us to become sleepy. In the morning, when light hits the eyes, it signals the brain to halt melatonin production, and we grow alert.

Melatonin is a sleep regulator, not a sleep initiator.

Michael Breus, PhD, a sleep disorder specialist

“Melatonin is a sleep regulator, not a sleep initiator,” says Breus, author of The Power of When.

Since the 1980s, dietary supplement makers have billed melatonin made in a lab as a promising sleep aid. But studies show its effects on occasional insomnia for the general public are mild at best.

One review of 15 studies involving 284 otherwise healthy subjects found that those who took melatonin before bed fell asleep 3.9 minutes faster on average and slept 13 minutes longer. Another, of 19 studies involving 1,700 people, found that melatonin users fell asleep 7 minutes faster on average and slept 8 minutes longer.

“When you are already making melatonin naturally at night, taking a little bit more is kind of like spitting in the ocean. It doesn’t do much,” says Cathy Goldstein, MD, an assistant professor of neurology at the University of Michigan Sleep Medicine Clinic. 

Alfred Lewy, MD, professor emeritus at Oregon Health & Science University and a pioneer in melatonin research, says he has found that a larger dose (3 milligrams or more) can have a hypnotic effect on about one-third of people who take it, making them feel sleepy.

“It works for some people, but not for others,” he says. “You just have to try it and find out which one you are.”

Shifting the Body Clock

Experts do agree that taking melatonin supplements can have a big effect on treating circadian rhythm disorders like delayed sleep-wake phase disorder, in which the body’s natural melatonin levels fail to rise at a normal time, making it hard to fall asleep and hard to wake up in the morning.

One study, published in June in the journal PLOS Medicine, looked at 116 men with the disorder and found that those who took 0.5 milligrams of fast-release melatonin 1 hour before their desired bedtime at least 5 nights per week fell asleep 34 minutes earlier on average, slept more soundly, and saw their sleep patterns normalize after 4 weeks.

The Basics: How to Recover From Jet Lag

Is your internal clock thrown off from traveling through different time zones? Fly through these tips to help ease the drowsiness.

“Say you are an extreme night owl who only begins to feel sleepy at 4 a.m. and likes to sleep until noon. You could take low-dose melatonin (0.5 milligrams) at 11 p.m., well before your natural melatonin kicks in. Not only will it help you feel sleepy earlier, it will start to pull your internal clock earlier too,” says Goldstein.

Melatonin also works great for jet lag from eastward travel, says Breus, who personally takes 0.5 milligrams of melatonin 90 minutes before bedtime in the place he’s traveling to.

After a weekend of staying up late and sleeping in, a low (0.3-milligram) dose of melatonin late Sunday afternoon can also help you get to sleep at a regular hour and avoid the “Monday morning blues” that often happen when your days off disrupt your body clock, says Lewy. (Caution: If you are one of those people melatonin makes sleepy, don’t drive after taking it).

His research also suggests that for some people, as little as 0.3 milligrams of melatonin daily in the late afternoon may ease symptoms of winter depression brought on by shorter days and shifting circadian rhythms. But because a small number of people respond better when taking the melatonin in the morning, he only recommends its use for this purpose under a doctor’s guidance.

“The challenge with melatonin is that it’s complicated. If you take it at the wrong time, it can shift your body clock in the wrong direction, and that can cause problems,” Lewy says.

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