Do you find yourself struggling to get a good night’s sleep? You’re far from alone. One out of every three American adults falls short of the seven recommended hours of sleep, reports the U.S. Centers for Disease Control and Prevention (CDC).
Lack of sleep affects many of us — and it impacts more than just our energy levels. A consistently sleep-shy schedule has been shown to affect mood as well as increase risk for heart disease, kidney disease, cognitive decline, injuries, type 2 diabetes, and more, according to the National Institutes of Health (NIH).
To cope with the deficit in shut-eye — and to try to convince our bodies and brains to chill out — a growing number of us have been turning to melatonin pills, gummies, or liquid supplements. In less than 20 years (from 1999 to 2018), over-the-counter melatonin supplement sales doubled, according to a research letter published in February 2022 in the Journal of the American Medical Association. Melatonin sales have continued to climb since then, growing from $436 million in 2018 to $821 million in 2020.
But melatonin isn’t for everyone. DailyOM asked sleep experts to share safer alternatives to melatonin, as well as how you can harness the powers of melatonin naturally to conquer sleep problems.
What Is Melatonin?
In its original form, melatonin is not a supplement. It’s actually a hormone produced by the pineal gland in the brain, as well as in the gut and in other tissues, explains Akil Palanisamy, MD, an integrative medicine physician in San Francisco and author of The T.I.G.E.R. Protocol: An Integrative, 5-Step Program to Treat and Heal Your Autoimmunity.
“Melatonin is the key that starts the ‘engine’ for sleep,” adds Michael Breus, PhD, a Manhattan Beach, California–based clinical psychologist, sleep medicine expert, and founder of The Sleep Doctor. “It’s really the initial step in the biochemical process of sleep.”
Taking too much melatonin can have adverse effects, including headaches, blood pressure fluctuations, digestive problems, and even changes in other hormone levels.
Melatonin levels typically pick up in the presence of less light exposure and once your core body temperature goes down, which is around 10:30 p.m., and peaks around 2 a.m., gradually decreasing in the early hours of the morning as your body prepares to wake up.
Melatonin regulates our internal clocks involved in the sleep-wake cycle (aka circadian rhythm) and helps our bodies feel sleepy or alert, says Muhammad A. Rishi, MD, MBBS, a pulmonary, critical care, and sleep medicine physician with Indiana University Health in Indianapolis and the vice chair of the public safety committee for the American Academy of Sleep Medicine.
Interested in learning more? Check out The Binaural Beat Method for Better Sleep
Who Should Take Melatonin — and Who Should Avoid It?
Melatonin is best for people living with circadian rhythm disorders or in short-term circumstances, such as in cases of insomnia, jet lag, or shift work, explains Diana M. Plata, MD, an internal medicine and sleep medicine physician at Northwest Community Healthcare in Arlington Heights, Illinois. Your doctor may also suggest it if you have a diagnosed melatonin deficiency.
“Everyone else should have enough in the system,” Dr. Breus says.
Because supplemental melatonin is so new, it’s tough to say what the long-term effects might be. Prolonged, continuous use of melatonin without medical supervision is not recommended, at least not until we know more.
“There is just not enough research available to know for sure how often it is safe to take melatonin,” Dr. Rishi tells DailyOM. “However, it’s likely that a short course for a few days is safe.”
Don’t go it on your own, though, Rishi cautions: “Melatonin should not be taken without speaking to a physician with expertise in circadian biology and sleep medicine.”
Plus, unlike prescription and over-the-counter medications, which need to be reviewed by the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research for their safety and effectiveness, dietary supplements, such as melatonin, aren’t regulated by the FDA.
When you’re purchasing melatonin or any other supplement, look for seals from BSCG, NSF, USP, and Informed Sport. These organizations offer supplement safety verification that the DU.S. Department of Defense's Operation Supplement Safety program stands behind.
If your doctor does suggest supplemental melatonin, the appropriate dose may vary. For adults, it’s typically 0.3 to 5 milligrams taken about one to two hours before bedtime, Dr. Palanisamy says. It's generally best to start with the lowest effective dose and adjust gradually if necessary, and stick to about four weeks or less of use. Avoid alcohol, which can interfere with the hormone’s effectiveness and lead to increased drowsiness.
“While you may think taking a higher dose will lead to better sleep, that’s not exactly the case. Taking too much can make it more difficult to sleep, because your circadian rhythms will be disrupted,” says Rosie Osmun, a Miami-based certified sleep science coach and contributing writer for Sleep Junkie. “An overdose can leave you groggy and sleepy during the day and give you vivid dreams or even nightmares at night.”
The NIH advises that the following populations should consult with their medical team before taking supplemental melatonin:
- Pregnant or breastfeeding people
- Anyone on birth control pills
- Individuals prescribed anticoagulants, blood pressure medications, or medicines to control diabetes
- People undergoing dialysis
- Anyone with an autoimmune condition
- Those under age 18. “There are reports of deaths in children due to melatonin overdose,” Rishi says. Children and teens should only use supplemental melatonin under a doctor’s supervision.
Why You Should Opt for a More Natural Sleep Aid
For anyone who’s not a shift worker adjusting to a new schedule, dealing with a case of jet lag or insomnia, or proven to be melatonin deficient, melatonin is not a magic pill. Your body releases melatonin on its own, and as with any hormone, balance is key.
By adding extra melatonin to the mix, you might confuse your system’s natural production, which can lead to side effects, either while you’re on or trying to get off of melatonin.
“Taking too much melatonin can have adverse effects, including headaches, blood pressure fluctuations, digestive problems, and even changes in other hormone levels, because all hormones are connected in an intricate web,” Palanisamy tells DailyOM.
The good news: Melatonin sleep supplements may have side effects, but dependency isn’t one, Osmun says. That means you can ease up any time.
“We have no evidence that melatonin causes physiologic dependence or withdrawal symptoms upon discontinuation, so it can be stopped at any time,” Dr. Plata says. “However, it’s possible to have a behavioral dependence on it. If you’re trying to stop melatonin, it’s important to focus on optimizing sleep hygiene.”
The 10 Best Melatonin Alternatives
If you’re currently taking melatonin supplements nightly and want to discontinue use, talk to your primary care doctor or a sleep physician on how to taper off safely — and discuss your best melatonin alternatives.
While melatonin use hasn’t been proven to lead to physiological dependence, the placebo effect can potentially cause “‘rebound insomnia,’ which often has a person reaching for melatonin again,” Palanisamy says. “Rather than stopping melatonin abruptly, gradually decrease the dosage over time.”
As you ease up, it can be wise to cut the dose in half for three to seven days, then in half again for three to seven days before going completely off melatonin, Breus says.
Using natural sleep aids can help improve sleep hygiene or boost natural melatonin production. “Stress is actually the biggest hidden driver of insomnia that I see in my practice,” Palanisamy says — therefore, many of the following 10 techniques focus on stress relief.
- Add stress-reducing habits to your day, such as exercise (avoid working out several hours before bedtime), deep breathing exercises, progressive muscle relaxation, gentle stretching, and therapy.
- Expose yourself to early morning light, and dim the lights and avoid screens at least one hour before bedtime. The blue light from screens may delay natural feelings of drowsiness. In fact, a research article published in February 2023 in the journal Chronobiology International found that reducing blue light from mobile phones at night helped improve sleep quality in medical students.
- Staying hydrated may help improve sleep quality. According to an article published in February 2019 in the journal Sleep, short sleep duration is associated with inadequate hydration among adults. If you find yourself waking up to use the bathroom in the middle of the night, you can limit your water intake as it gets close to bedtime.
- Avoid caffeine, large meals, and alcohol late in the day. (The role of caffeine on sleep issues is not completely clear-cut, and varies from person to person.)
- Stick to a predictable bedtime routine, including a calming bedtime meditation if that feels relaxing to you, and wake up at a consistent time.
- Try journaling for its proven stress-relieving benefits. If you’re prone to stressing about everything you have to do, write out your to-do list for the day ahead in a bullet journal. A study published in January 2018 in the Journal of Experimental Psychology: General showed that participants who wrote out their to-do lists found it easier to fall asleep.
- Try herbal remedies. “Chamomile tea, valerian root, lavender, passionflower, and lemon balm can promote relaxation and support better sleep,” Palanisamy says.
- Sleep with a weighted blanket. A small study published in October 2022 in the Journal of Sleep Research suggests that using a weighted blanket may cause a significant release of melatonin at bedtime in young adults.
- Integrate feng shui principles into your bedroom design and keep the space cool, dark, and quiet, if possible.
- Avoid bedtime procrastination. If you are a so-called “bedtime procrastinator,” meaning you delay going to sleep without a reason to do so, consider whether that’s impacting how much rest you get, and whether you need a bit more structure to wind down in the evening so you get sufficient sleep for your body’s needs. A small study published in November 2019 in the journal Sleep found that bed procrastination is negatively associated with sleep and mood. Participants who ranked high in bedtime procrastination reported more depression, anxiety, and insomnia compared with those who ranked lower in bedtime procrastination.
Foods With Natural Melatonin
Gummies and other supplements with melatonin get all the attention, but you can snack on melatonin-rich foods, such as tart cherries, turkey, milk, eggs, fish, kiwi, almonds, walnuts, flaxseeds, mushrooms, grapes, and tomatoes, too, according to an article published in April 2022 in the book Current Topics in Functional Food.
There isn’t a great deal of research yet on how much of an impact eating these foods will have on sleep quality, but these foods can be an enjoyable part of any diet, so long as you don’t have any allergies or dietary reasons not to consume them.
The Bottom Line
Since only 28 percent of American adults get the amount and quality of sleep that is solid enough to be deemed “restorative sleep,” according to a study published in July 2022 in the journal Frontiers in Sleep, melatonin use is booming in America.
In addition to promoting sleep, melatonin plays an important role in managing blood pressure and levels of cortisol, the stress hormone. A review published in July 2012 in the journal Food & Nutrition Research also found that melatonin may even offer protective benefits against some cancers, such as breast cancer, though further research is needed in this area.
“Newer research indicates that melatonin is also a powerful antioxidant and immune modulator, and offers anti-inflammatory benefits, exerting multiple positive effects on the body besides just promoting sleep,” Palanisamy says.
With all of those benefits, it’s no surprise many people find that supplementing with melatonin has helped them conquer sleep issues and improve their overall well-being as a result. However, if you use supplemental melatonin nightly for more than a month, it’s not only a waste of money, but could also lead to health challenges.
So, instead of reaching for a melatonin supplement, consider natural alternatives to melatonin that are proven and recommended by doctors to help improve sleep quality.
