Melatonin for Insomnia Review, Dosage and Side Effects

Nearly one in three American adults suffer from insomnia, according to the American Academy of Sleep Medicine. In addition to negatively affect energy levels, mood and short-term cognitive performance, insomnia can result in broad-spectrum adverse effects on health.

Although prescription medications are available to facilitate the onset of sleep, many patients prefer to take naturally derived, non-prescription supplements such as melatonin.

Melatonin is known as the sleep hormone for its role in the maintenance of the body’s sleep-wake cycle. Some scientific evidence suggests that melatonin is an effective treatment for insomnia.

Research shows that using melatonin for insomnia can modestly reduce the time it takes to fall asleep (sleep latency) and improve the quality of sleep. This supplement is also not habit-forming and is considered safe for most healthy adults.

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Melatonin for Insomnia

Melatonin, also known as N-acetyl-5-methoxytryptamine, is an indole neurohormone that is produced in the brain.

Melatonin is synthesized and released by the pineal gland, a pea-sized gland deep within the brain. Once released, melatonin circulates through the body to act on distal targets that regulate sleep and wakefulness.

Levels of melatonin differ during the day and night. When darkness is detected in the ambient environment, melatonin is synthesized and released. In contrast, light suppresses melatonin synthesis.

A number of different factors can interfere with the body’s natural regulation of melatonin levels. This may result in insomnia or impaired sleep quality.

Taking melatonin supplements may help to relieve insomnia symptoms, but it may not work for everyone. Supplemental melatonin is most often produced in controlled laboratory settings, although it can also be obtained from animal pineal gland.

Common Symptoms of Insomnia

Insomnia refers to habitual difficulty falling asleep or staying asleep. Symptoms of insomnia vary widely from individual to individual. Some of the most common symptoms of insomnia include:

• Difficulty getting to sleep at night, such as taking more than 30 minutes to fall asleep
• Awakening during the night
• Waking up too early in the morning
• Failure to feel rested after a night of sleep
• Feeling sleepy or tired during the daytime
• Irritability
• Depressed mood
• Anxiety
• Difficulty concentrating, such as failure to pay attention or remember information
• Increased accidents or errors in your work
• Tension headaches
• Gastrointestinal distress, such as abdominal cramping or mild diarrhea
• Anxiety about your ability to get to sleep or stay asleep
• Slow reaction times and impaired mental performance

Studies show that taking a melatonin supplement can help people suffering from insomnia and may reduce some of the symptoms associated with sleeplessness.

While not everyone is able to fall asleep after taking melatonin pills, it does show a statistically significant rate of efficacy. It may be more effective for some forms of insomnia than others.

Primary vs. Secondary Insomnia

There are two main types of insomnia: primary and secondary. In primary insomnia, the difficulty getting to sleep or staying asleep is its own disorder. This may be caused by some sort of physiological disturbance and typically lasts one month or more.

In contrast, secondary insomnia is a symptom of some other problem. This is the most common form of insomnia.

Secondary insomnia may arise because of certain illnesses, pain, depressed mood, anxiety, medication side effects, use of caffeine or alcohol, or another type of sleep disorder.

Melatonin treatment appears to be effective in helping people with primary insomnia fall asleep faster, but there is contradictory evidence with regards to its use for secondary insomnia.

In some studies, it has been found to improve secondary insomnia linked to depression, bipolar disorder, schizophrenia, Alzheiemr’s disease, epilepsy, cystic fibrosis and other conditions.

However, there have been conflicting results when it is used for secondary insomnia in patients with Parkinson’s disease. It is not considered effective for secondary insomnia in patients with traumatic brain injury or after tracheostomy or laparoscopic cholescystectomy.

Effectiveness of Melatonin for Insomnia

There is considerable clinical evidence supporting the effectiveness of melatonin for insomnia and related sleep disorders. It may not work as powerfully as some prescription sleep aids, but may prefer this supplement because of its low risk of side effects.

Taking melatonin can increase the amount of rapid-eye movement (REM) sleep a person experiences, which may lead to greater feelings of restfulness upon waking.

Taking melatonin also speeds up the process of getting to sleep, known as sleep latency. It is unclear how melatonin affects sleep architecture, which impacts sleep quality, although people often subjectively report that melatonin helps enhance the quality of their sleep.

Melatonin treatments for insomnia may be particularly effective for older adults, who do not naturally produce as much of the hormone.

Taking oral melatonin may help older adults fall asleep more quickly, maintain sleep for a longer period of time, and enhance sleep quality. This can have additional anti-aging benefits for the elderly.

Melatonin has also been shown to be effective in treating sleep-wake cycle disturbances particularly in children or adolescents with autism, cerebral palsy, and intellectual disabilities.

Melatonin for Insomnia and Anxiety

Many people with insomnia develop mild anxiety about sleeping, as they are continually faced with insufficient sleep.

It may be effective to take melatonin for insomnia and anxiety, as the sleep-inducing effects of the supplement can reduce mild anxiety symptoms.

There is significant anecdotal evidence from user reviews that melatonin can help to improve anxiousness and decrease stress about falling asleep. However, it has not been well researched for this use.

It has been researched for its effects on other forms of anxiety, such as pre-operative anxiety. Melatonin is sometimes used as an alternative to midazolam for pre-operative anxiety and sedation in children.

How to Take Melatonin for Insomnia

There is no strong scientific consensus about the correct dosage of melatonin for insomnia. Fast-release and slow-release formulations are available, both of which have been shown to improve insomnia symptoms.

For primary insomnia, most research suggests that a dosage of 2 to 3 mg before bedtime is effective in promoting sleep.

Using higher doses, such as 5 mg, may be appropriate for shorter time frames such as one week.

Similar dosages appear to be effective for secondary insomnia, although it is best to consult with your doctor about the most appropriate dose for you. Starting low and gradually increasing the dose may be effective.

Before giving melatonin to a child with insomnia, consult with a doctor to determine the appropriate dosage. Children will require smaller doses than adults.

Side Effects of Melatonin for Insomnia

Oral melatonin supplements are generally well tolerated and are rated as Likely Safe when used orally and appropriately, according to the Natural Medicines Database.

The most common side effects of melatonin for insomnia include dizziness, nausea, headache, and drowsiness. Because melatonin induces drowsiness, people who have taken melatonin should not operate heavy machinery or drive a car for at least 4 to 5 hours.

Less common side effects include:

• Mild depressive symptoms
• Impaired alertness
• Feelings of confusion
• Low blood pressure
• Mild tremor
• Lower seizure threshold

Melatonin may also cause harmful interactions with prescribed or over-the-counter medications. Consult with a doctor before taking it if you are currently using drugs for any health conditions.

Interactions have been noted with anticoagulant medications, NSAIDs, ibuprofen, anticonvulsants, anti-diabetics drugs, hypertension medications, caffeine, oral contraceptives, fluvoxamine, immunosuppressants, and echinacea.

Avoid using melatonin in combination with prescription sleep aids or herbs that have sedative properties. Some herbs, such as valerian root and chamomile, may be safe for use with melatonin, but you should consult with a doctor first before combining supplements.

Taking melatonin for insomnia may not work for everyone who uses it. If you do not experience beneficial effects after using this supplement, you should not increase the dosage as this could increase the risk of adverse effects.

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