Deprived of Sleep, Many Turn to Melatonin Despite Risks

Sometimes packaged in gummy bear fruit flavors, melatonin can have an alluring appeal to sleep-deprived parents looking for relief for themselves and their children.

Muhammad Adeel Rishi, MD, vice chair of the Public Safety Committee for the American Academy of Sleep Medicine, says he has a doctor colleague who started taking melatonin to help him during the pandemic when he was having trouble falling asleep at night. His doctor friend started giving the hormone to his own children, who were also having sleep issues.

But Rishi says there are important reasons to not use melatonin for insomnia until more information is available.

Melatonin affects sleep, but this hormone also influences other functions in the body.

“It has an impact on body temperature, blood sugar, and even the tone of blood vessels,” Rishi says.

And because melatonin is available over the counter in the United States, it hasn’t been approved as a medicine under the FDA.

Imprecise Doses

While melatonin doses typically range from 1 to 5 milligrams, bottles examined have been off target with much more or less hormone in the product than listed on the label.

Researchers from the University of Guelph in Ontario, Canada, tested 30 commercially available formulas and found the melatonin content varied from the ingredients labeled on the bottles by more than 10%.

In addition to melatonin, the researchers found other substances in the bottles too: In about a quarter of the products, they also identified another chemical messenger called serotonin.

Impurities

While melatonin plays a role in setting the body’s biological clock and the sleep and wake cycle, serotonin is also at work. Occurring naturally in our bodies, serotonin is involved in mood and helps with deep REM sleep. But adding serotonin in unknown amounts could be unhealthy.

Rishi says it can be dangerous to use a product as a medication when doses can be so off and there are unknown byproducts in it.

Serotonin can influence the heart, blood vessels, and brain, so it’s not something Rishi wants to see people taking without paying attention. People taking medication for mood disorders could be especially affected by the serotonin in their sleep aid, he warns.

For anyone taking melatonin, Rishi recommends they check the bottle to see whether they are using a product with a USP verified check mark, which indicates that the product meets the standards of the U.S. Pharmacopeia Convention.

The risk of impurities is a good reason for kids to not be given the hormone, but another worry is whether melatonin interferes with puberty in children – which is also a question researchers at the Children’s Hospital of Eastern Ontario in Ottawa, Canada, are asking.

Disrupting Puberty

While short-term melatonin use is considered safe, the researchers report, concerns that long-term use might delay children’s sexual maturation require more study. One theory is that nightly melatonin use might interrupt the decline of natural hormone levels and interfere with the start of puberty.