Sleep Aid Melatonin Can Trigger Side Effects

What insomnia sufferers should know about over-the-counter supplement.

The National Sleep Foundation advises that healthy adults need between seven and nine hours of sleep per night. But for one out of three Americans, that goal is elusive. These individuals have difficulty falling asleep, staying asleep or both. Many turn to over-the-counter sleep aids. The popular dietary supplement melatonin is often used this way.

Melatonin is a hormone made naturally by the pineal gland, a pea-sized organ found deep in the middle of the brain. Melatonin is produced in response to darkness. It serves as a messenger to tell the body it is time to sleep. The dietary supplement is synthesized in a laboratory. Melatonin supplements are available in multiple forms, including pills, gummies and liquid.

Melatonin works by inhibiting signals in the brain that promote wakefulness. This encourages sleep by making users feel tired as they get closer to bedtime. It typically takes one to two hours for melatonin to work, so it is recommended that the supplements be taken up to two hours before going to bed.

Difficulty falling and/or staying asleep is called insomnia. It is linked to many chronic diseases and conditions, such as Type 2 diabetes, heart disease, obesity and depression. Insomnia can also lead to errors on the job as well as vehicle accidents, which result in many injuries and considerable disability each year.

It makes sense, then, that the use of melatonin to battle insomnia has increased by 500 percent in the US over the past two decades. This amounts to more than 6 million Americans.

With so many people relying on melatonin to get a good night’s sleep, it is important to consider the supplement’s safety and potential side effects.

The Food and Drug Administration regulates dietary supplements such as melatonin less strictly than prescription and over-the-counter drugs. So, melatonin has not met the FDA’s rigorous safety and effectiveness standards set for medications. In some countries, melatonin is considered a drug and available only by prescription.

Research on melatonin’s safety and effectiveness when used long term is ongoing, but available evidence suggests it is relatively safe for short-term use.

Melatonin does have side effects, however, which are usually mild. Consult your doctor or pharmacist before taking melatonin to be sure it is safe for you to use.

Short-term side effects of melatonin include:

  1. Daytime sleepiness. This is the most common side effect. Melatonin makes users feel tired. Unfortunately, this tiredness can continue into the next day. It is more common in older individuals because melatonin stays active in them longer than in younger people.
  2. Sleep pattern changes. Taking melatonin increases the body’s natural level of the hormone. This can shift the timing of the sleep-wake cycle, or circadian rhythm.
  3. Headaches. These can be triggered by a high dose of melatonin or a sensitivity to it.
  4. Dizziness. The exact cause of this side effect is unknown. One theory is that melatonin lowers blood pressure, which results in dizziness.
  5. Stomach discomfort. Melatonin can cause symptoms such as nausea or stomach cramps, especially when first starting to take the supplement. If this side effect worsens through continued use, contact a health care provider.

The possibility of experiencing side effects depends primarily on the dose taken. Melatonin supplements are available in strengths ranging from 1 mg to 12 mg per dose.

There is no standard recommended dose, so finding an effective dose that does not cause uncomfortable side effects may require trial and error. It is recommended, however, that users start with a low dose and increase gradually, if needed. Melatonin doses of 10 mg or higher tend to cause more side effects than lower dosages.

Side effects are typically mild and easily managed by adjusting the dosage or form of the supplement. Sublingual (under the tongue) melatonin, for example, is less likely to cause stomach discomfort than pills or gummies. Headaches can often be eased by taking ibuprofen or acetaminophen.

Users that experience severe or unmanageable side effects should contact a health care provider for guidance.

© FHCN article by Patti DiPanfilo. mkb
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