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Published on July 26, 2022

Why you should reconsider melatonin to sleepWhy you should reconsider melatonin to sleep

Sales of a popular over-the-counter sleep aid spiked even before the pandemic, but are you getting the melatonin you think you are?

Maybe not, according to an expert with Cape Cod Healthcare’s Sleep Lab at Falmouth Hospital, the only sleep lab in the region associated with a hospital.

“Melatonin is not a product regulated by the U.S. Food and Drug Administration,” said Mir F. Shuttari, a pulmonary care specialist and medical director of the sleep lab. “So, any company can claim whatever they want. It’s a nutritional supplement, so the exact amount in any product is very debatable.” 

It’s no surprise that many of us have not been sleeping very well, given the stresses of COVID-19 and daily life the last couple of years. That’s shown up at the sleep lab.

“I have seen a bit of an uptick with different sleep-related problems,” Dr. Shuttari said. “Some of it is insufficient sleep, due to pandemic-related stress. People’s whole sleep patterns have been dysregulated.”

Melatonin is a hormone secreted by the pineal gland in the brain, usually in a rhythm associated with your normal bedtime. It helps to quash the body’s natural arousal response, so you can get a good night’s sleep, Dr. Shuttari said.

Melatonin dietary supplements can be made from animals or microorganisms, but are usually made synthetically, according to the National Institutes for Health. In order to be effective, melatonin supplements should be synthesized human melatonin, Dr. Shuttari said. A typical dose is between one and five milligrams per day taken an hour or two before bedtime.

Researchers for the Mayo Clinic found that melatonin sales increased five times between 1999 and 2018, according to a report published in the Journal of American Medicine in February. Researchers also noted that over the 10-year course of the study, an increasing number of the 55,000 survey participants were taking high doses of melatonin – more than five milligrams per day. But research has not yet shown if melatonin is safe for long-term use, according to a 2017 report in the Journal of Clinical Pharmacy. It is even considered a prescription drug in the United Kingdom.

Unfortunately, without regulation by the FDA, consumers can only judge a melatonin product by what’s on the label, Dr. Shuttari said. And some melatonin products may have hidden surprises. One study by Consumer Affairs found that of the top 30 melatonin brands tested, half had less melatonin than what their labels promised and some had much more than necessary. Some products may also contain antihistamines like diphenhydramine, known by brand names such as Benadryl, which can leave users – particularly the elderly – drowsy in the morning, Dr. Shuttari said.

“So, you need to be really careful as to exactly what you are getting,” he said.

He suggests insomniacs try revising their sleep habits rather than taking over-the-counter supplements or sleep aids. He recommends:

  • Having a consistent bedtime
  • Keep your bedroom cool and dark, watching your caffeine and alcohol intake, and avoiding white light from the TV, phone or computer just before bed.

“Just following some good sleep hygiene principles is a good thing,” he said. “They have proved that people who follow these instructions are able to increase their sleep by an hour or so.”