Food is medicine: The science behind melatonin

Important points:

• Research suggests that melatonin supplementation is a safe and effective treatment for insomnia.
• As it grows in popularity, especially among children, health care providers are seeking clearer guidance on its use.

Melatonin is one of the most popular and easily available supplements today.

Dr. Justin Tonto, Melatonin, a naturally occurring compound in humans, is “very important to our sleep-wake cycle,” says the Penn State College of Medicine, assistant professor in the Department of Family and Community Medicine at Penn State Milton S. Hershey Medical Center. He told Helio. circadian rhythm). ”

According to the NIH, the brain produces melatonin in response to darkness. As such, melatonin supplements are commonly used to treat sleep problems such as circadian rhythm disorders and insomnia, said Tonto, who is also a member of the Helio Primary Care Peer Perspectives Committee.

“A typical dose is 3 to 5 mg taken 30 minutes before bedtime,” he said. “While the effects are typically mild, they are so safe that the benefits easily outweigh the risks.”

Previous research has shown that melatonin is also present in eggs, fish, nuts, some mushrooms, and cereals.

Of note, although the American Academy of Sleep Medicine (AASM) and the American College of Physicians say they do not recommend supplements as a treatment for insomnia due to the strength of the evidence, a 2022 study found that , about 70% of primary care physicians believe so.

“We have a lot of patients who have tried melatonin. It doesn’t work for everyone, but it does help many patients sleep better,” Tonto said.

Additionally, this supplement is gaining popularity as a sleep aid for children.Survey results announced at JAMA Pediatrics A November 2023 study showed that about 1 in 5 school-age children and pre-teens had the disease, and researchers said the prevalence was It is said to be surprisingly high. In September 2022, the AASM recommended that parents consult a medical professional about melatonin before giving it to children. Health care providers want clearer guidelines for its use in young people.

Some studies have shown that increased use of over-the-counter melatonin may put children at risk. According to his 2022 report from the CDC, annual pediatric melatonin intake from 2012 to 2021 was 260,435, an increase of 530%. Serious adverse outcomes and pediatric hospitalizations also increased, primarily due to her increased unintentional melatonin intake in children under 5 years of age.

However, Tonto said, “I don’t see any problem with how popular melatonin is with kids.” Sleep hygiene is usually more effective, but melatonin is very safe, so there is no harm in using it. ”

According to the NIH, melatonin supplements can help with sleep-wake phase delays, jet lag, and even anxiety before and after surgery. Recent research into the safety and effectiveness of melatonin has further revealed the supplement’s benefits.

For example, double-blind, randomized, placebo-controlled studies sleeping pills in 2020 evaluated the effectiveness of melatonin on sleep disturbances in primary insomnia in midlife. Researchers found that 3 mg of immediate-release melatonin supplements significantly improved several objective aspects of sleep quality, including early wake time, total sleep time, and rapid eye movement rate. However, the patients’ subjective sleep experience was different, and the researchers also wrote that nearly all subjective sleep variables were unaffected by melatonin treatment, particularly in patients with insomnia. The researchers also noted that melatonin was safe. There were no significant differences between the melatonin and placebo groups regarding the incidence of adverse events. In fact, “no clinically relevant changes were observed in vital signs or laboratory blood or urine tests,” the researchers said.

In 2022, researchers conducted the first systematic review and series of meta-analyses to evaluate the effects of melatonin on people with sleep disorders and mental health disorders, and found that melatonin significantly improved sleep onset latency and total sleep time. I found evidence that it does. Researchers also found that melatonin significantly improved total sleep time and sleep onset latency in adolescents and children with various neurodevelopmental disorders, including autism spectrum disorder, intellectual disability, and ADHD. They say that, in contrast to other “studies pointing to melatonin’s anxiolytic properties” and “anecdotal evidence,” melatonin is effective in people with other mental health disorders such as depression and anxiety. I couldn’t find any evidence that.

Looking specifically at the evidence for children, a meta-analysis of randomized controlled trials published in 2019 found that melatonin is an effective and well-tolerated agent for the short-term treatment of sleep onset insomnia in this population. It became clear. Evidence also showed that melatonin improves total sleep time and prolongs sleep onset time, melatonin onset in dim light and sleep onset latency.

Some studies criticize melatonin as a dietary supplement. For example, the following research letters have been published: Japan Automobile Manufacturers Association “The majority of melatonin gummies were inaccurately labeled, and most contained more than the declared amounts of melatonin and CBD.”

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