The Flourish, April 2022: Sleep Corner
Sleep Soundly: A Closer Look at Melatonin
There’s a high chance you know someone who takes melatonin supplements. But what is melatonin and how does it affect our sleep? Melatonin is a natural sleep hormone secreted by the pineal gland in the brain. Melatonin begins to be released around 2 hours before your bedtime in response to less light coming in through your retina. Melatonin’s primary function is to regulate the body’s sleep-wake cycle, promoting healthy sleep and orienting one’s circadian rhythm. Melatonin's relationship with sleep has led millions of people to take melatonin supplements as sleep aids.
However, contrary to popular belief, melatonin is not a sleeping pill that makes you fall asleep instantly. If you were to take a sleep-inducing medicine (referred to medically as hypnotics) during the middle of the afternoon, you would likely fall asleep, despite how awake you felt before. If you were to take melatonin in the middle of the afternoon, this wouldn’t be the case. Rather than directly inducing sleep, melatonin tells your body that it’s night time and that it should start winding down, switching the brain from its “daytime functions” to its evening ones.
For this reason, many people use melatonin ineffectively, and studies show that people in the US are taking twice the amount of melatonin they did a decade ago. When melatonin is produced in our brains, it is released in one trillionth of a gram amounts, while the smallest doses of over the counter melatonin supplements come only in milligram doses (1/1000th of a gram). The amount that actually reaches your brain is closer to natural quantities, but doctors still recommend taking between 1-3mgs a day, which is lower than what most users take.
Studies are conflicted as to whether or not melatonin is effective in improving sleep. While some research indicates that melatonin improves sleep latency and lengthens overall sleep time, effects vary highly across individuals. Research is also lacking in the long term effects of melatonin use. Doctors say melatonin is often used by people to self-treat insomnia which could be stemming from larger medical issues such as anxiety or sleep apnea, and for this reason melatonin could delay individuals from receiving a diagnosis and more effective treatment for their underlying conditions. Furthermore, because melatonin is considered a dietary supplement, it is not closely regulated by the Food and Drug Administration (FDA), leading to a troublingly high variation in the content of melatonin products— one study found that 70% of the over the counter melatonin brands examined exceeded the quantity of melatonin in their pills from what their labels displayed by up to 478%. Up to 26% of the supplements also contained serotonin, a neurotransmitter that can have harmful effects in large doses.
So far, medical research indicates that when used in the short term, melatonin is unlikely to do any harm. If you decide to use melatonin to improve your sleep, experts recommend starting with the smallest available doses— .5mg or 1mg— taken 30 minutes to an hour before bedtime. If, after a few days, you see no improvement in your sleep, you can gradually increase your dose. If you find yourself groggy in the morning, it is likely a sign that your dosage is too high for you. To avoid brands with impure or mislabelled products, you can look for a “Good Laboratory Practice” (GLP) or “Good Manufacturing Practice” (GMP) label, which indicate that the product has met federal quality standards for the advertised purity.
Even if melatonin helps you fall asleep faster (sleep latency), there are many ways to improve your sleep routine and environment to promote better sleep quality (which melatonin doesn’t positively impact). For instance, you can help program your body to produce melatonin for sleep at the right time of day by getting exposure to daylight during the morning and afternoon. This can include taking walks outside during the day or even sitting beside a sunny window to do your work. Getting sunlight first thing in the morning is also helpful to reduce morning grogginess and fatigue. Surprisingly, the most effective treatment for chronic insomnia is Cognitive Behavioral Therapy (CBT), because our emotions and stress have such a strong impact on how we sleep. Meditation, using blue-light filters for our devices near bedtime, and keeping our bedroom cool can help as well. Check out our March issue to learn more about sleep hygiene and how to limit your screen time in the evening!