Is Melatonin Safe?

Is Melatonin Safe?

If there’s one thing that adults and children alike do not get enough of, it’s sleep. When meditation, breathing exercises, and making the bedroom dark and quiet doesn’t work, many people turn to melatonin supplements to help them get to sleep. But, some melatonin users are experiencing bad dreams and nightmares and other downsides of the sleep aid.

The use of melatonin supplements has skyrocketed over the past two decades. A 2022 analysis by researchers at the Mayo Clinic in Rochester, Minnesota found that melatonin supplement consumption rose from .4 percent in 1999-2000 to 2.1 percent in 2017-2018, corresponding to over 6 million people. In addition, the National Center for Health Statistics reports that the number of adults over 18 years old who used melatonin supplements more than doubled between 2007 and 2012.

Melatonin supplements are synthetic and sold in pills, gummies, and other forms. Melatonin can be purchased over the counter because it is considered a dietary supplement and not a prescription drug. Natural melatonin is a hormone produced from serotonin, a chemical that regulates mood, appetite, and circadian rhythm (also known as the body’s 24-hour “biological clock”). When it gets dark, serotonin converts to melatonin, and melatonin tells the brain that it’s time to go to sleep.

Does Melatonin Cause Nightmares?

Many people report having vivid dreams and nightmares after taking melatonin. Researchers don’t know for sure why the supplement causes bad dreams, but they have their theories. One theory is that melatonin can increase the time that people are in REM sleep, a stage of sleep characterized by rapid eye movements, faster heart rate and breathing, and dreaming. According to Sleep Foundation, dreams during REM sleep are “typically more vivid, fantastical, and/or bizarre even though they may involve elements of waking life.”

“If you are spending more time in the stage of sleep where vivid dreams are most likely to occur, this may naturally lead to increases in bad/vivid dreams,” Dr. Michelle Drerup, a behavioral sleep medicine psychologist at the Cleveland Clinic said in a news release.
Melatonin also releases vasotocin, a protein that regulates REM sleep. So, more melatonin means more REM sleep and possibly more vivid dreams, Dr. Drerup added.

Another question researchers are attempting to answer is whether other factors, and not solely melatonin, play a role in causing vivid dreams and nightmares.

The problem with discussing dreams and nightmare is that it’s subjective, Dr. Raj Dasgupta, a critical care and sleep expert told Well + Good, a health and wellness website. Dreams can be affected by a number of factors including eating certain types of food, drinking alcohol, anxiety, stress, sleep apnea, smoking, and other medications.

Dr. Dasgupta, who is also a clinical associate professor of medicine at the University of Southern California, recommends recording your dreams and nightmares the next morning to help you determine what caused them.

“On the nights that you did have these nightmares, describe them,” Dr. Dasgupta said. “Did you take melatonin? Maybe that piece of information—combined with everything else [what you ate and drank, if you exercised, what other supplements you’re taking]—can help you decide, ‘Hey, maybe I should stop the melatonin and see what happens.’”

Is Melatonin Safe for Children?

Adults aren’t the only ones having problems getting to sleep every night. Children also have trouble getting enough sleep, and manufacturers market melatonin gummies and chewable tablets for kids and teens. Some doctors, however, are cautious in recommending melatonin supplements to children. In fact, the American Academy of Sleep Medicine (AASM) recommends that parents talk with a pediatric healthcare professional before giving their child a melatonin supplement.

“Instead of turning to melatonin, parents should work on encouraging their children to develop good sleep habits, like setting a regular bedtime and wake time, having a bedtime routine, and limiting screen time as bedtime approaches,” Dr. M. Adeel Rishi, vice chair of the AASM Public Safety Committee and a pulmonology, sleep medicine, and critical care specialist at Indiana University Health Physicians, said in a news release.

According to the U.S. Centers for Disease Control and Prevention (CDC), the annual number of melatonin ingestions in children that were reported from 2012-2021 to U.S. poison centers increased 530 percent, and melatonin became the most frequently ingested substance among children in 2020. In addition, more than 4,000 of the reported ingestions led to hospitalizations, the CDC reported.

How Much Melatonin Should You Take?

Melatonin supplements are sold in a wide range of doses, anywhere from 1 mg to 1,000 mg. What’s more, the melatonin content in dietary supplements can vary widely from what is listed on the label.

For example, a 2017 study found one supplement had 83 percent less melatonin content than what was listed on the label while another supplement had 478 percent more melatonin than what was listed. The study, published in the Journal of Clinical Sleep Medicine, also found that 26 percent had ingredients containing high levels of serotonin, which promotes wakefulness and affects REM sleep. Serotonin, regulated by the FDA and sold as a synthetic drug, can potentially cause an overdose if someone is already taking a drug containing serotonin. Researchers in this study urged companies to monitor the melatonin content in their products to “ensure consistency and safety of the supplements.”

Dr. Lauren Goldman, a sleep-medicine physician at Cleveland Clinic’s Sleep Disorders Center, suggests taking the lowest dose possible for the shorter amount of time. For instance, Dr. Goldman’s recommendation is 1 mg and then increasing that amount by 1 mg every week, but not exceeding 10 mg until you’ve reduced the amount of time it takes for you to fall asleep.

Dr. Drerup recommends taking between 1 to 3 milligrams of melatonin a night.

“Melatonin is generally safe for most people, but too high of a dose can lead to unpleasant side effects,” Dr. Drerup said. Common side effects from taking melatonin include headaches, dizziness, nausea, and drowsiness.

Drs. Drerup and Goldman both caution against interrupting the melatonin process by playing video games, going on social media, or scrolling through your phone or working on a tablet because the glow of your screen can cause melatonin to drop. The doctors recommend taking melatonin when you start feeling tired and make sure you allow your body to be at full rest when you take it.

Some doctors warn against taking the supplements for extended periods of time. “Minimal research exists on using melatonin beyond a few months,” Dr. Drerup said. “In general, melatonin usage has only been deemed safe for up to three months, even though many people take it for much longer.”

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