Does Mixing Melatonin and Alcohol Disrupt Sleep?

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Does Mixing Melatonin and Alcohol Disrupt Sleep?

Understanding Melatonin’s Uses, How it Interacts with Alcohol, and How to Get a Great Night’s Sleep

Insomnia and other sleep disorders can be debilitating. The effects can also be dangerous. Tired driving is as dangerous as drunk driving, and many of us are guilty of doing it from time to time. Excessive drowsiness from lack of sleep can also negatively affect decision-making, your ability to focus, find your words, recall memories, and even make good choices about the foods you’re eating (which, in turn, can affect your sleep, creating a vicious cycle).

To that end, even short-term insomnia can really disrupt your daily life and overall health and wellness. Using natural sleep aids like melatonin supplements and beneficial herbs for sleep can help, and there’s research to back up their efficacy over standard prescription drugs and with far fewer negative side effects.

Melatonin and alcohol: woman sleeping soundly in her bed

If you’ve been struggling for a while, it can be tempting to wind down each evening with a couple of glasses of wine. But is it a good idea to mix melatonin and alcohol?

The good news is that mixing melatonin and alcohol does not appear to cause harm. So, if you’ve had a drink or two, you can go ahead and take your melatonin without worrying about interactions between the two substances.

With that said, there are a few compelling reasons to skip the alcohol before bed all together, even if you don’t use a nightly sleep aid.

In fact, while melatonin works largely by helping to regulate your circadian rhythm (your sleep-wake cycle), alcohol actually has the opposite effect and has been shown to disrupt your circadian rhythm.

To best understand how to get a great night’s sleep, I’ll go over what melatonin is, how to use it, potential pitfalls and side-effects, and why melatonin and alcohol aren’t the best mix. Then, I’ll share some lifestyle changes to improve your rest and sleep quality.

What Is Melatonin?

Melatonin and alcohol: elderly woman taking melatonin pills

Melatonin is a naturally occurring hormone derived from serotonin (serotonin is required to make it). It’s secreted by the pineal gland in response to the day’s change from light to dark and seems to contribute to helping you wind down and fall asleep each night [1].

Too much light exposure in the evenings can disrupt regular melatonin production and reduce your natural melatonin levels. Lower melatonin levels can lead to poor quality sleep, which is why so many healthcare providers recommend trying melatonin supplements.

Melatonin supplements are made from synthetic melatonin, which, like all supplements, isn’t fully regulated or approved by the Food and Drug Administration (FDA), so quality can vary. 

However, the American Academy of Family Physicians considers it a first line of defense for insomnia [2]. That’s because it has a very low risk of potential side effects and has been shown to be effective in many different cases of insomnia. This includes primary insomnia (insomnia with no known cause) and insomnia as a result of jet lag, shift work, post-traumatic brain injury, age, and neurodegenerative disorders [2].

Can You Mix Melatonin and Alcohol?

In short, mixing melatonin with alcohol does not appear to be harmful, but it may make melatonin less effective.

Beyond the combination of melatonin and alcohol, if you have trouble falling asleep and waking up rested, you should probably avoid alcohol consumption close to bedtime in general, even if you don’t take melatonin every night. 

Drinking alcohol close to bedtime can disrupt your circadian rhythm, reduce REM sleep, adversely affect your heart rate, and change your core body temperature, ultimately resulting in poor sleep quality [3].

Further studies show that alcohol use and alcohol abuse seem to blunt — or eliminate altogether — the beneficial effects of melatonin for sleep, anxiety, stress, and depression [4, 5]. This isn’t to say that these studies showed that mixing the two substances was directly harmful, just that the mix seemed to reduce the benefits associated with melatonin.

In other words, if you have a couple of glasses of wine and then take melatonin before bed, there doesn’t seem to be a need to worry about dangerous side effects. However, if you find that you’re consistently struggling with sleep, removing alcohol from the mix might improve both the effectiveness of your melatonin supplement and the quality of your sleep in general.

How about other depressants? While melatonin is a hormone that naturally occurs in your body, mixing synthetic melatonin with depressants like alcohol, benzodiazepines, or zolpidem can be dangerous as you run the risk of over-sedation [2]. Your safest bet is to try one sleep aid at a time and avoid mixing melatonin with over-the-counter and prescription sleeping pills as well. By isolating one treatment at a time, you’ll be more likely to determine what actually works for you.

Alcohol Disrupts Your Circadian Rhythm and Melatonin Production

Melatonin and alcohol: glass of wine on a bedside table

Whether you’re taking melatonin supplements or not, alcohol disrupts your natural melatonin levels and your circadian rhythm [3].

Even one night of drinking is enough to disrupt your circadian rhythm and levels of melatonin and cortisol (over the short term). This isn’t a cause for concern if you’re just having a drink or two here and there , but if you are struggling with regular sleep issues, it’s worth considering your alcohol consumption. 

More prolonged alcohol abuse (alcohol use disorder) has been shown to cause more severe and persistent changes in melatonin levels, cortisol levels, and circadian rhythms [3].

For those with alcohol use disorder who stop drinking, the withdrawal effect can also temporarily disrupt circadian rhythms. However, abstaining from alcohol for about a month has been shown to lead to the re-synchronization of that sleep-wake cycle. Melatonin disruption itself, however, can continue for 3-12 weeks [3].

For difficulty sleeping during this period (recovery from alcohol abuse disorder), melatonin supplements have unfortunately not been shown to be very effective [4, 5]. However, given the low cost and risk of side effects, it may be worth a try if other lifestyle measures haven’t helped to improve sleep. 

How Much Melatonin Do You Need?

Most studies show that melatonin is effective at between 0.1 to 10 mg taken within two hours of bedtime, but a maximum dose hasn’t been defined [2]. I’ve found that the range of efficacy is much smaller in my clinic, with an ideal of 1-3 mg doses for most people. 

The amount of melatonin you take can change how it affects you in a non-linear way. In some cases, using a dose as high as 10 mg seems to actually have the opposite of the desired effect, creating wakefulness and insomnia. This is an anecdotal observation without any clear research exploring it, but it’s worth noting as you work on determining your ideal dose.

With any over-the-counter dietary supplement not regulated by the FDA, it’s important to know the source of your product, ensure that you’re buying from a reputable brand, and look into the quality of ingredients. Always check expiration dates and use the minimal effective dose for you. 

What Are the Potential Side Effects of Melatonin?

Potential side-effects of melatonin are mild, including drowsiness, daytime sleepiness, headaches, and nausea [2]. What’s most important to know about melatonin is that your body processes about 90% of it through the liver. This means if you have impaired liver function or use other medications that could tax your liver, you should talk to your healthcare provider before trying it, just in case there’s a contraindication. 

Furthermore, there’s inadequate research to support taking melatonin while pregnant, in addition to contraindications (reasons not to use a treatment) for patients on dialysis and those with autoimmunity challenges. That’s because those on dialysis may have challenges clearing melatonin through urination, and melatonin stimulates the immune system and may exacerbate autoimmunity [2]. 

The research seems to suggest that melatonin isn’t habit-forming, but more work needs to be done to better understand potential dependency in long-term use. 

Sleep Hygiene and Best Lifestyle Practices

How to Improve Sleep infographic by Dr. Ruscio

The Sleep Foundation defines sleep hygiene as good habits that put you in the best position to sleep well every single night [6]. While certain habits around sleep are almost always helpful, personalized strategies can tailor to shift work, mental health challenges, and other special circumstances. Great sleep hygiene gets you mentally and physically ready for bed each night and supports a good night’s sleep throughout the evening. 

Lifestyle habits for healthy sleep hygiene include: 

  • Setting a consistent sleep schedule
  • Establishing a routine before bed
  • Avoiding certain foods close to bedtime
  • Creating an environment for optimal sleep and comfort
  • Managing screen time and limiting consumption of stressful or engaging content before bed
  • Practicing relaxation and stress management techniques
  • Regular exercise
  • Addressing gut problems through diet and probiotics
  • Addressing breathing problems that could impact sleep quality

Let’s dive a little bit deeper into each of these to help you figure out where your sleep hygiene could use some tweaking.

Your Sleep Schedule

Setting a consistent sleep-wake cycle, in which you rise and sleep at the same time every morning, is critical to healthy, good-quality sleep. That’s because it helps your body reset its own circadian rhythm (body clock) to help you naturally sleep and rise. If you can avoid overnighters or shift work, do that. It may help align your sleep pattern with the sun’s rise and set. 

Creating this sort of consistent bedtime and wake time can be a big challenge, so try making the shift gradual. If your goal is to get eight hours of sleep, and you have to wake up every morning at 7:00 am, you want to eventually be asleep by 11:00 pm. However, if your body is currently used to going to bed at 1:00 am, start your routine for bed at 12:30 am at first. Then move it up to 12 am, then 11:30 pm, etc., until you’re in the habit of starting your bedtime routine with enough of a buffer to have you in bed and snoozing by 11 pm. 

Your Bedtime Routine and Evening Diet

Adjusting your sleep schedule to better correspond with your sleep goals and personal life is hard if your bedtime routine is all over the place (or non-existent). I suggest starting the process of getting ready for bed at least an hour before your bedtime goal. Ideally, you’ll work your way up to two hours. 

Try soaking in a bath or taking a hot shower to relax your body and mind in preparation for sleep. Dim your lights and turn off the TV to help your eyes adjust to a darker environment. Listen to relaxing music to unwind [7]. Stop eating at least two hours before bed and skip spicy or heavy foods that could cause digestive upset in the night. Consider listening to something relaxing, like petting your dog or cat, or doing a quiet activity to allow your brain to start shutting off well before your head hits the pillow.

Your Sleep Environment

Your bedroom should feel like your sanctuary. If you’re due for a new mattress, start doing some research. Many reputable mattress companies offer 100-day guarantees and financing options. However, mattresses can still be expensive. Just consider that you spend about one-third of your life in bed to help yourself grasp the importance of a good mattress.

The temperature in your room is also important for good sleep. Research shows that keeping the thermostat at about 60°F leads to better sleep [8]. 

You also want to make sure that unwanted light doesn’t wake you before you’re ready. Consider blackout curtains or eye covers in addition to placing your phone or other blinking lights in a drawer or underneath something else to block out light until you’re ready to wake. 

Noise control is also important. Grab yourself some earplugs if your partner snores. It’s also fine to sleep in a different room from your loved one. Also use earplugs if you know the trash truck comes early and slams around outside, or if you have an overly excited pet that makes noises in the night.

Your Screen Time and Stimulating Content

Overexposure to blue light from cell phones and TVs can disrupt your circadian rhythm and your natural melatonin production. For this reason, it’s important to start winding down from screen time early. Most smart phones now have a built-in blue light blocker to take the blue light out of your phone at a given time each evening. Use that feature and time it with sunset. Taking a step further, a systematic review and meta-analysis actually found that all forms of light can disrupt circadian rhythm, so minimizing backlit screens (screens that light up like a TV, iPad, or phone) is a great idea [9]. Turn off your TV at least two hours before bed as well. 

Avoiding stimulating or stressful content right before bed as well. It probably won’t help you relax to watch stories about unsolved murders or read work emails right before bed. Lastly, scrolling through social media might seem like a mind-numbing activity, but it’s addictive because it’s stimulating [10]. So if you can curb that at night, that’s ideal.

Your Relaxation and Exercise

Timing is everything. Daily exercise is important for a good night’s sleep and maintaining energy levels throughout the day, especially for those with sleep apnea [11, 12, 13]. But exercising too close to bedtime can have the opposite effect [14]. Importantly, and related to the next section, exercise offers positive benefits for your gut flora, which is linked to sleep.

Relaxation techniques such as meditation, cognitive behavioral skills, deep breathing, and progressive relaxation can all serve to better prepare you for bedtime [15, 16].

Your Gut

Gut health and sleep are part of a feedback loop in which one affects the other in both directions. Taking a daily probiotic supplement is a simple place to start with improving your gut health, and eventually your sleep problems too. 

Multiple clinical trials have shown a correlation between improved sleep quality and probiotic usage, including clinical trials involving participants with IBS, constipation, depression, insomnia, and those in a stressful situation such as studying for medical exams [17, 18, 19, 20, 21].

A daily probiotic isn’t a replacement for a healthy diet of whole foods. If you’d like to talk with someone at our clinic about how to get your diet on track to support your gut, please reach out. Start here for more info on eating for a healthy gut.

Your Breathing Problems

Breathing issues such as sleep apnea and snoring can lead to poor sleep quality. If you have trouble breathing at night, it can also be dangerous for your health. 

Our clinic offers myofunctional therapy (physical therapy for the mouth). This has been shown in a number of studies to be effective in reducing daytime sleepiness, increasing sleep quality, improving low oxygen saturation, and reducing snoring [22, 23].

The Bottom Line on Melatonin and Alcohol

Top view of a man happily sleeping in his bed

While melatonin can be an effective sleep aid, combining it with alcohol can make it less effective. However, mixing melatonin and alcohol doesn’t appear to be harmful, so shouldn’t be a cause for worry if it happens every now and then.

Alcohol use and abuse in general are contraindicated for good quality sleep, even if a glass or two helps you relax at the end of the day. If you do choose to drink alcohol, try not to start too late in the evening and keep it to a minimum.

Melatonin is a natural hormone secreted by the pineal gland, which is sensitive to light. Practicing good sleep hygiene is a great way to encourage your body to produce its own healthy melatonin levels. 

Taking a melatonin supplement is a safe way to help get your body’s natural rhythms back on track and establish a beneficial and consistent sleep schedule. 

For a more comprehensive look at your sleep challenges or other health concerns you might be having, request a consultation at our functional medicine center.

➕ References
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