Your Guide To Melatonin For Sleep
You may have heard of melatonin as a widely marketed sleep-aid, but do you know how it works? Melatonin plays a large part in the sleep cycle. It is released naturally into your body as you are falling asleep and continues throughout the night. With sleep being one of the most critical functions of the human body, melatonin is an essential hormone for good health.
Melatonin has been used as a supplemental treatment for several symptoms of sleep disorders for years, but research is still determining how effective it really is. Because it is a supplement, the FDA regulations on manufacturers of synthetic melatonin are loose, and being a good diligent consumer becomes even more important. Before we get too far into what this supplement can do and how to buy it, you should understand how natural melatonin is produced and how it fits into the sleep cycle.
Natural Melatonin Production and the Sleep Cycle
There are four parts to the sleep-cycle:
- Stage 1 non-REM sleep
- Stage 2 non-REM sleep
- Stage 3 non-REM sleep
- REM sleep
Before all of this occurs, you have to first get to sleep and that need to sleep is driven by two internal mechanisms – circadian rhythm and sleep-wake homeostasis.
Circadian Rhythm and Melatonin
Circadian rhythm is controlled by your body’s biological clock and accounts for regular fluctuations in how awake you are, body temperature, metabolism, and the release of hormones. Your internal clock, often referred to a as biological clock, uses environmental cues such as light and temperature to regulate your circadian rhythm.
The Effect Light Has on Sleep
One of the major influences on this system is your exposure to light or darkness. From a nerve pathway in the eye, light stimulates an area of the brain called the hypothalamus where this biological clock (or the suprachiasmatic nucleus) lives.
One of the hormones released by your circadian rhythm is melatonin. More precisely, the reduced amount of exposed light along with other signals tells your circadian rhythm to signal your pineal gland (a pea-sized gland that sits just above the middle of your brain) to release the hormone melatonin into your blood. There is actually a direct linkage between receiving this light signal and your ability to produce melatonin. Bright lights directly inhibit the production of melatonin.
That’s right, melatonin is naturally produced by your body. However, the melatonin often seen on shelves is almost always synthetic. So, if your body already naturally produces melatonin why would you want to pay for it?
Treatment With Melatonin
Synthetic melatonin is used to help supplement your natural melatonin production. This means you’re adding more melatonin on top of the hormones your body already makes. This often leads to questions around how much melatonin you should take and how much melatonin is too much?
Melatonin is often taken 0.2 – 5 mg at a time about an hour before bed. It is suggested that you start with a low dose and work your way up from there. This recommendation is for adults. It is best to consult a pediatrician about the use of melatonin with your children. As the need for melatonin at this age may be symptomatic of other issues, and dosages can be completely different.
Why Should I Take It 1 Hour Before Bed?
The timing will probably vary a bit for you depending on the form of melatonin you ingest, but in general, it takes around 60 minutes for melatonin to be absorbed from your stomach into your bloodstream. Taking a melatonin supplement outside of your normal sleep cycle could cause interruptions to your body’s circadian rhythm and should only be done under the care and advice of your doctor.
Building a Tolerance to Melatonin
Other than some anecdotal evidence, there appears to be no scientific evidence that you can build a tolerance to melatonin. There are also no known withdrawal symptoms associated with stopping the use of melatonin, making it a non-addictive substance.
When Should I Avoid Melatonin Supplementation?
Before you begin any new supplement it is always best to speak with your primary care provider and come up with a plan together. If you are pregnant or breastfeeding or have an autoimmune disorder, a seizure disorder, or depression you should skip taking melatonin all together unless otherwise directed by your doctor. Melatonin supplements could raise your blood sugar levels and increase blood pressure levels in people taking some hypertension medications.
In cases listed on the National Poison Control website, melatonin had little to no side-effects if taken in a much higher dosage than recommended.
- In the first case, a 2-year-old boy swallowed up to 138mg of melatonin over the course of an hour. He ended up sleeping for a few hours and then was fine.
- In another case, a 4-year-old girl swallowed an estimated 39 mg of melatonin. She showed no signs of drowsiness or other symptoms.
- In the third case listed on the site, a 50-year-old woman took 100 mg of melatonin time-release tablets and ended up feeling drowsiness for 12 hours and a slightly increased pulse rate for a few of those hours.
An article titled “The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature” and published by the Nutrition Journal in 2014 reviewed multiple studies to assess how well melatonin supplementation worked for different types of sleep disorders. These studies were categorized into three groups:
- Shift workers and individuals with jet lag to rebalance the sleep-wake cycle.
- People with insomnia to promote sleep.
- Healthy volunteers to improve the quality of their sleep.
Sleep/Wake Rebalance For Shift Workers
Out of the eight studies that were reviewed only two of the studies favored melatonin use with shift workers. Unfortunately, both of those studies were found to be of low quality (the testing performed was not up to standards). The remaining high and highest quality studies reported the results as inconclusive, meaning that neither melatonin supplementation or the control used for testing were favored.
Sleep/Wake Rebalance For Jet Lag
The eight studies that were reviewed for melatonin’s ability to rebalance the sleep/wake cycle for jet lag found seven of the studies to be of high quality. Out of the seven high-quality studies, six of them favored melatonin use and one study was inconclusive.
Four high-quality studies of melatonin supplementation with people suffering from insomnia were reviewed. Half of the studies reviewed were in favor of using melatonin to promote better sleep in insomnia patients, the other half were inconclusive showing favor to neither melatonin or the control used in the study.
12 high-quality and 3 low-quality studies of healthy volunteers using melatonin to promote better sleep were reviewed. These studies were further divided into three groups based on the sleep outcome that was being evaluated by researchers. They include:
- Initiation of sleep and sleep efficacy.
- Occurrence of daytime sleepiness or somnolence.
- Induction of phase shift and hormone changes
Initiation of Sleep and Sleep Efficacy
Five of the high-quality studies (out of seven total studies) reviewed showed results in favor of using melatonin supplements to fall asleep faster and/or have better sleep quality.
Daytime Sleepiness or Somnolence
All five of the studies reviewed in this group were of high quality. Four of the five studies favored melatonin. The study that was not in favor of melatonin supplementation had a small sample size.
Phase Shift and Hormone Changes
Of the five studies that were reviewed for this group, the results were rather low quality and inconclusive.
Melatonin Consumer Tips
You’ve read the data, you have a pretty good understanding of what melatonin is and what it can do for you, but we haven’t really talked about what to look for if you and your doctor decide supplementing with melatonin is right for you. Melatonin comes in many different forms from slow-release capsules to liquids, gel-tabs, chewables, and gummies. The way you ingest melatonin may be important, but how strict the manufacturer stays to what they report on their label is more important when deciding which brand to try.
A 2017 study on melatonin supplements available on the market, published by the Journal of Clinical Sleep Medicine, reported that “melatonin content was found to range from -83% to +478% of the labeled content.” In fact, different lots of the same product varied in their melatonin content by as much as 465%. Aside from these variances, eight of the tested products contained serotonin, which is created when synthetic melatonin begins to degrade.
Talk to Your Doctor
Your doctor has access to studies and experience you may not be aware of. They also have the best knowledge of your medical history and any medications you are on. They can work with you to find the right combination of therapy, supplementation, or medication that will help to resolve your issues with sleep.
If you and your doctor determine that melatonin supplementation is right, they may be able to recommend a specific brand and give instructions on when and how to take it.
Three well-known organizations do voluntary testing for supplement companies. These organizations are:
- NSF International
- U.S. Pharmacopeia (USP) – A non-profit organization that sets the most widely accepted standards for supplement testing.
These third-party testing companies are paid by supplement companies to complete testing on their products and provide unbiased results. In return, if the company complies with the standards set by the testing organization, they will be able to use the testing organization’s certification logo in their marketing. This works as a way for good consumers to recognize the companies that work hard to provide quality supplement products and stand behind their brand.
Why Is Third-Party Testing Is Important?
Because melatonin is a supplement and not a medication it is covered under a different set of regulations by the FDA than conventional food and drug products. Without stronger regulations and enforcement by the FDA, consumers have to rely on manufacturers to provide accurate labeling data. The best way to be certain that this data is accurate is to look for the seal of approval by the testing companies listed above. Some of these companies even make their test results available to consumers to review on-line.
We’ve Learned A Lot About Melatonin Together
At the beginning of this article, we found out that melatonin is actually a natural hormone secreted by the pineal gland. It is activated by light entering our eyes and sending nerve signals from our retina to our hypothalamus. This magical hormone enters our bloodstream and helps our bodies enter a restful state as we transfer from being awake to going to sleep.
Supplemental melatonin has shown some promise in treating things like jet-lag and insomnia, but there are still many more research studies that need to be done to find out its true effectiveness. Due to the lack of studies, effective dosage can be difficult to pin down so remember to start low and work your way up. Aim for trying to take your melatonin an hour or so before going to bed. You may have to experiment with this timeframe to see what works best for you.
I know I’ve said it many times, but it’s very important to work with your primary care provider to make sure that supplementing with melatonin is right for you. If you both agree that it is, look to credible third-party testing certifications to help you navigate which brands to buy.