Sleep Supplements: Can You Get Addicted to Melatonin?

A Guide to Using Melatonin Safely and Effectively

Can you get addicted to melatonin: person pressing an alarm clock

When sleep proves elusive, melatonin is a popular research-backed choice for helping you get the essential rest you need. As a way to promote a good night’s sleep, it is gentler and more natural than prescription medication. 

But can you get addicted to melatonin, as you can with some traditional sleeping pills? It’s an important question, but the short and reassuring answer is no.

That doesn’t, however, mean that more melatonin is better, nor that you should take it every night.

In this article, we’ll unpack the best ways to use melatonin as well as discuss the other diet and lifestyle changes that can help you get better sleep.

Can you get addicted to melatonin: The Healing Power of Sleep infographic by Dr. Ruscio

What Is Melatonin?

Melatonin is a hormone secreted at night by the pineal gland, a tiny organ close to the center of the brain. The hormone helps to regulate the body’s 24-hour biological clock (circadian rhythm) and promotes sleep.

The onset of darkness is the natural stimulus for melatonin release, but influences such as traveling across time zones or being exposed to bright lights at night can interfere with this natural process, causing sleep disturbances [1 Trusted SourcePubMedGo to source].

Melatonin is synthesized in the body from serotonin, which in turn is produced from tryptophan (an essential amino acid found in protein foods). The process is helped along by vitamin B6, so eating a balanced diet that provides good amounts of these nutrients is helpful for melatonin production.

Some foods, including cherries and kiwi fruit, also contain small amounts of melatonin directly [1 Trusted SourcePubMedGo to source]. However, when you’re looking to boost your melatonin levels enough to have a therapeutic impact (i.e. to help you sleep better), melatonin supplements, which deliver a defined dose of melatonin, are the more relevant choice.

Can You Get Addicted to Melatonin?

None of the many studies that have been done on melatonin supplementation has found any evidence that the hormone is habit-forming or addictive. 

In fact, melatonin might be helpful to people who are currently trying to get off addictive medications. A review of randomized controlled trials (RCTs) and observational studies found evidence that melatonin could be useful for 81 adults attempting to discontinue hypnotics and benzodiazepine drugs.

Specifically, around two-thirds to three-quarters of those who took melatonin were able to withdraw completely from these medications. In contrast, 25% or less who took placebo were able to totally get off these drugs [2 Trusted SourcePubMedGo to source].

You may have seen reports that taking melatonin supplements encourages your body to become dependent on an external source and that this discourages natural production of the hormone. However, there are no studies that support this notion and some evidence (albeit somewhat dated) that suggests this is not the case, even when melatonin is used at very high doses for over a month [3 Trusted SourcePubMedGo to source, 4 Trusted SourcePubMedGo to source].

That said, it’s wise to only take melatonin as and when you need it and to support your body with other healthy sleep-promoting practices as a priority.

What the Research Says on Melatonin and Sleep

Bottle of sleeping pills

Melatonin is the natural sleep aid that is most studied, though more research is still needed on long-term use. Clinical trials suggest that adults and children can benefit but that in menopausal women and people with dementia the results aren’t as good:

In Adults (Positive Effect)

  • A 2013 systematic review and meta-analysis (SR/MA) of 19 randomized controlled trials (RCTs) involving 1,683 participants found good evidence that melatonin improved overall sleep quality. The time it took to fall asleep decreased by 7 minutes, and total time asleep increased by 8 minutes. This isn’t huge, but still useful, and there were fewer concerning side effects than with drugs [5 Trusted SourcePubMedGo to source].
  • A 2017 SR/MA of 12 RCTs (1,510 patients) found that melatonin reduced the period of time taken to fall asleep in people with primary insomnia (insomnia that isn’t the result of another medical condition). The same was also the case in people with delayed sleep phase disorder (in which people don’t feel sleepy until at least two hours after an acceptable bedtime) [6 Trusted SourcePubMedGo to source].
  • A 2014 SR/MA of 15 RCTs (718 participants) found some evidence that melatonin can improve sleep length in shift workers [7 Trusted SourcePubMedGo to source].

In Children (Positive Effect)

  • A 2019 SR/MA of 22 RCTs (1,758 participants) found that melatonin helped children with ADHD (attention deficit hyperactivity disorder) fall asleep on average 28 minutes earlier and sleep an average of 33 minutes longer [8 Trusted SourcePubMedGo to source].
  • A 2020 SR/MA of 7 RCTs (387 children and adolescents) found similarly that, compared to placebo, melatonin reduced the time taken to fall asleep and increased total sleep time. Overall, melatonin was safe and effective for short-term treatment of sleep-onset insomnia in kids and teens [9 Trusted SourcePubMedGo to source].

In Menopausal Women (No Effect)

  • A 2021 SR/MA of 8 RCTs (812 menopausal women) found moderate-quality evidence that melatonin improved some physical symptoms of menopause, but there was no effect on sleep quality in this group [10 Trusted SourcePubMedGo to source].

In People with Dementia/Alzheimer’s Disease (No Effect)

  • A 2020 SR/MA of 9 RCTs (649 dementia patients) found that melatonin did not improve sleep in patients with moderate to severe dementia [11].
  • A 2014 SR/MA of 5 RCTs (583 Alzheimer’s patients) also found no evidence that melatonin was beneficial to Alzheimer’s patients with moderate to severe dementia and sleep problems [12 Trusted SourcePubMedGo to source].

Choosing and Using Melatonin Safely

It’s worth remembering that over-the-counter (OTC) dietary supplements are not regulated by the FDA (Food and Drug Administration). So doing your homework before purchasing is a good general principle. With reference to melatonin specifically, a 2017 study found that the amount of melatonin in melatonin supplements was often different from the quantity listed [13 Trusted SourcePubMedGo to source].

One simple check you can do is to make sure the manufacturer you buy from employs independent (third-party) testing of their product.

Dosage

When it comes to the dosage of melatonin, more is not necessarily better. 

While doses of up to 10mg of melatonin are readily available, there’s evidence that taking more than 5mg brings no extra benefit, and evidence from jet-lag studies indicates that as little as 0.5mg can bring benefit [14 Trusted SourcePubMedGo to source].

From my anecdotal experience with patients, the most efficacious dosage range for people who have trouble falling asleep seems to be around the 1-3mg mark taken a couple of hours before bedtime. In the clinic we’ve come across people who experienced a worsening of insomnia and wakefulness when they took higher doses, nearer to 10mg. 

You may need some trial and error to find a dose that best suits you, but don’t be surprised if you find that reducing your dosage has a better effect on your sleep than increasing it.

Possible Side Effects

Common side effects of melatonin tend to be mild and may include [15 Trusted SourcePubMedGo to source]:

  • Drowsiness
  • Daytime sleepiness
  • Headaches
  • Nausea

While there is evidence that people build a tolerance to melatonin, it’s best not to take it alongside pharmaceutical sleep medications or alcohol, to avoid over-sedation [15 Trusted SourcePubMedGo to source].

Pregnant and breastfeeding women should avoid melatonin as there’s too little evidence of safety in these groups. If you have liver or kidney problems or an autoimmune issue, you also should avoid melatonin [15 Trusted SourcePubMedGo to source].

Diet and Lifestyle Changes for Better Sleep

Various healthy food for keto diet

Although short-term use of melatonin is absolutely fine as a solution to a temporary sleep problem, it needs to be supported with a solid base of good sleep hygiene — i.e., diet and lifestyle practices that will promote better-quality sleep.

The Gut/Sleep Connection

Getting better sleep often starts with addressing the health of your gut. This is because imbalances in the gut (particularly in the ratios of certain inflammatory and anti-inflammatory bacteria) can have effects that can extend to disturbances in your sleep cycle.

In a healthy gut, the microbiota creates chemical messengers, such as serotonin and dopamine, that influence your levels of sleepiness and alertness. One review found that sleep disorders occurred at the rate of 37.5% in people with irritable bowel syndrome (IBS) (who often also have disturbed gut microflora). This rate is higher than in the general population [16 Trusted SourcePubMedGo to source].

Clinical trials have shown that probiotics (supplements of good gut bacteria) can work as a sleep aid, improving sleep quality and reducing sleep disruptions both for healthy individuals and for those with depression, insomnia, and work-related stress [17 Trusted SourcePubMedGo to source, 18 Trusted SourcePubMedGo to source, 19 Trusted SourcePubMedGo to source, 20 Trusted SourcePubMedGo to source].

Following a healthy diet as outlined below will also support good gut health and contribute to improved sleep.

A Sleep-Friendly Diet

Exactly which diet suits your needs and preference will be quite individual, but a gut-healthy diet is also one that will promote good sleep. Many of my patients do well on a Mediterranean-style diet or a paleo diet, both of which are anti-inflammatory. Whichever regimen you go for, it should include:

  • Plentiful fresh fruits and vegetables
  • Lean, unprocessed protein, such as lean meat, fish, beans, and tofu
  • Dairy or calcium-enriched plant alternatives
  • Some healthy whole grains

While your main focus should be good nutrition rather than weight loss, it does still pay to keep an eye on portion sizes. That’s because managing weight through a healthy diet has been shown to help in sleep disorders, including obstructive sleep apnea [21 Trusted SourcePubMedGo to source, 22 Trusted SourcePubMedGo to source].

Minimizing caffeine and alcohol is also a good idea, as both of these can disrupt restful sleep and contribute to insomnia [23 Trusted SourcePubMedGo to source]. Aim to avoid caffeinated drinks beyond early afternoon and stick to no more than one small alcoholic drink a day.

Physical Activity

Getting regular exercise may help you sleep better, whatever age group you fall into. For example:

  • In adults, a systematic review of three meta-analyses found that regular exercise helps adults to sleep an average of 19% better overall [24 Trusted SourcePubMedGo to source].
  • In young people, exercise reduced exam-related stress, and this in turn buffered the negative effect on sleep and well-being [25 Trusted SourcePubMedGo to source].
  • In older people, a reciprocal relationship has been noted between exercise and sleep quality. Those who exercised reported better sleep quality, while sleeping well also made it more likely that they would then subsequently exercise [26 Trusted SourcePubMedGo to source].

The Physical Activity Guidelines for Americans recommend at least 150 minutes of moderate-intensity, cardiovascular physical activity a week, which equates to 30 minutes at least 5 times a week of an activity such as running, brisk walking, cycling, or swimming [27]. This should be balanced with 20-minute strength-training sessions performed 2-3 times per week.

Improved Sleep Hygiene

Sleep Supplements: Can You Get Addicted to Melatonin? - How%20to%20Improve%20Sleep Landscape L

Having good sleep hygiene means acquiring good habits and practices that are conducive to sleeping well on a regular basis.

Consistently getting sufficient sleep (at least seven hours per night) is the first important aspect [28 Trusted SourcePubMedGo to source], and other important ways to improve sleep hygiene include:

  • Set a consistent bedtime and waking time. 
  • Avoid all-nighters and shift work if possible. 
  • Eat dinner at least two hours before bedtime.
  • Avoid bright lights and screen use for at least two hours before bed.
  • Modify your bedroom environment to be dark, cool, and comfortable so as to support good sleep.
  • Have a calming pre-bedtime routine — for example, read or take a warm bath in the half hour to hour before sleep.

A sleep tracker, such as the Oura Ring, can be very useful to help you track sleep-wake cycles and sleep stages and ultimately improve your sleep hygiene [29 Trusted SourcePubMedGo to source].

Breathing Issues

Addressing breathing problems, like mouth breathing, snoring, or sleep apnea, is another important part of getting more restful sleep. An at-home test with a portable device like the WatchPAT is useful to diagnose sleep apnea, while myofunctional therapy — a set of physical therapy exercises of the mouth that improve bite, breathing, and facial posture — can improve sleep quality in people with sleep apnea. 

One systematic review and meta-analysis found that myofunctional therapy decreased obstructive apnea episodes by approximately 50% in adults. The therapy also improved low oxygen saturation, snoring, and sleepiness [30 Trusted SourcePubMedGo to source].

Melatonin Is Unlikely to Be Addictive

To summarize, there’s no need to be concerned about the use of melatonin. In short, the question of “can you get addicted to melatonin” has been settled through a plethora of research that shows no such habit-forming effect. 

That said, you should find the lowest dosage of melatonin that works for you and only use it when necessary, and ideally not as an everyday supplement. When you’re struggling with sleep challenges, it’s more important to work holistically to address all the relevant issues, which could mean looking at your diet and exercise regimen as well as optimizing gut health.

My book, Healthy Gut, Healthy You, explains more about sleep and how it factors into your overall and gut health. But for more personalized guidance on sleep-related problems or any other health issue of concern, you can request an in-person or virtual consultation.

➕ References
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