9 Things Sleep Doctors Want You to Know About Melatonin

Melatonin supplements are all-natural, not physically addictive and unlikely to cause significant side effects. With a track record like that, popping a pill or gummy each night as part of your bedtime routine might seem like a good idea. But before you do, there are some things you should know.

Turns out, there are some pretty specific things that melatonin should (and shouldn't) be used for, and taking it habitually might do more harm than good, experts say. Here, we talked with five sleep experts to get their take on melatonin supplements — and what everyone should keep in mind before taking them.

Melatonin is a hormone that our brains produce naturally to help us fall asleep. Your internal melatonin factory is triggered by sleep-promoting cues like darkness and laying down, but certain things can get in the way of production.

"Sometimes our bodies create too much wakefulness hormones like cortisol and adrenaline, making it hard to fall asleep with just our own melatonin," says Nicole Avena, PhD, associate professor of neuroscience at the Mount Sinai School of Medicine in New York. Traveling to a different time zone can throw off the natural release of melatonin too, leading to jet lag.

Melatonin supplements are one natural option that may help with short-term sleep issues that occur when your own melatonin production gets thrown out of whack.

"We routinely use it to help shift the body's circadian rhythm or internal clock," explains Shelby Harris, PsyD, a psychologist and sleep medicine expert and director of sleep health at Sleepopolis. "This is for people who can get a full night's sleep but not on the schedule that they need. We use it occasionally for shift work and jet lag too."

Many other sleep aids are designed to be taken shortly before you want to nod off. But it's actually better to take melatonin a few hours before you plan to go to bed, because it needs that long to start working.

Try a "tiny" dose (more on the dosage in a moment) several hours before bed "to help gradually shift the body clock," Harris says.

"Many people view melatonin as a vitamin, something you take every day for good sleep," says Charissa Chamorro, PhD, a New York-based clinical psychologist specializing in anxiety and sleep issues. But there's actually very little research looking at the long-term use of melatonin, and taking this supplement indefinitely has the potential to cause side effects.

"Some people suggest that long-term use makes your own brain reduce its natural melatonin production but the reality is that this hasn't been routinely proven in research," Harris says.

The bottom line? "Melatonin should only be used to target short-term sleep issues," Chamorro says. "And ideally you should consult with your physician about dosage and timing before taking it."

Melatonin isn't physically addictive. Use it night after night, though, and you might start to ‌feel‌ like you need it to fall asleep, or end up using it as a substitute for good sleep habits.

"Any non-habit forming agent or ritual used routinely for sleep onset may have a psychological basis, as patients may feel dependent upon its usage," says Thomas Yadegar, MD, a pulmonary, critical care and sleep specialist at Providence Cedars-Sinai Tarzana Medical Center in Los Angeles.

If you're regularly having trouble falling asleep or staying asleep or often wake up tired in the morning, you should let your doctor know rather than trying to treat the problem at home with melatonin.

"If you feel like you rely on melatonin or else you cannot sleep naturally every night, you should see your primary care provider and see if the recommend a sleep study to nail down the issue," Avena says.

If it turns out that you have insomnia, sleep apnea or another sleep disorder, you and your doctor can discuss effective treatment options that have been proven to get the sleep you need.

"If there are long-standing issues with insomnia, for instance, I would recommend cognitive behavioral therapy for insomnia (CBTi) which is an evidence-based therapy targeting insomnia and sleep issues. This type of treatment provides safe and effective strategies that individuals can use indefinitely," Chamorro says.

Melatonin might be helpful for children and teens get rest while you're establishing healthy sleep habits or adjusting to a new schedule (like shifting from a later summer bedtime to an earlier bedtime at the start of the school year), according to the American Academy of Pediatrics. But just like with adults, it's not meant to be used indefinitely, and the long-term effects on kids aren't known.

Melatonin supplements also aren't a stand-in for a solid bedtime routine that allows your child to get the sleep that she needs.

"Most sleep issues in children boil down to behavioral problems surrounding bedtime and sleep. If your child is suffering from issues with falling or staying asleep, I would first recommend examining sleep behaviors such as the bedtime routine and things like the bedroom environment that can disrupt sleep," recommends Arlington, Virginia-based pediatric sleep consultant Angela Holliday-Bell, MD.

If you've tackled those things and your child is still having trouble sleeping, ‌then‌ it might make sense to talk with the pediatrician about melatonin and other factors that may be causing sleep problems.

Like other supplements, over-the-counter melatonin products aren't closely regulated.

"There's variability in what's even in bottle to bottle and no governing body making sure that what it says on the bottle is actually what's in it," Harris says.

All of which is to say: You should do your research on a particular melatonin supplement before buying it. Chamorro recommends seeking out products that have been USP-verified. "This label indicates that the supplement has undergone voluntary testing and it meets US Pharmacopeia Convention standards. Supplements with this seal are more reliable and more likely to provide the potency indicated on the label," she says.

You might not realize it, but melatonin has the potential to mess with prescription medications you may be taking and make them less effective, Dr. Yadegar says. These include anticoagulants, blood pressure medications, diabetes medications, hormonal birth control and immunosuppressants, just to name a few.

Just one more reason why you should always talk with your doctor before taking melatonin supplements.

There's actually no standardized dose for melatonin, but most experts agree it's best to start off taking as little as possible (regardless of what the product label might say).

"We use tiny doses, 1/2 to 1 milligram max," Harris says. If it seems like that amount isn't helping, let your doctor know. Together, you can decide whether you should increase your dose or stop taking melatonin and get evaluated for a sleep disorder.