Medical Review by Heidi Moawad MD
Summary:
- Melatonin Overview: Melatonin is a hormone that helps regulate sleep-wake cycles and is produced naturally by the pineal gland in response to darkness.
- Effectiveness for Sleep: Melatonin supplements can be effective for specific sleep issues, such as delayed sleep-phase syndrome, insomnia in older adults, and adjusting to jet lag and shift work. However, it is not universally recommended for all sleep disorders.
- Melatonin and Anxiety Interaction: Melatonin might help reduce anxiety indirectly by improving sleep quality, as poor sleep can exacerbate anxiety. However, melatonin is not a direct treatment for anxiety, and its efficacy in reducing anxiety symptoms outside of sleep-related issues is not well-established.
- Potential for Anxiety Relief: Some studies suggest melatonin may reduce anxiety in specific situations, such as before surgery, but it is not conclusively proven as a general treatment for anxiety.
- Supplement Quality and Dosage: Melatonin supplements vary widely in quality due to lack of FDA regulation, with actual melatonin content often differing from what is listed on labels. Recommended starting doses are typically 5 mg or less.
- Side Effects and Risks: Common side effects include dizziness, headache, nausea, and irritability. Melatonin can interact with various medications and is not suitable for individuals with certain health conditions, such as epilepsy, hypertension, and diabetes.
- Precautions and Professional Consultation: People should consult a healthcare provider before taking melatonin, especially if they are pregnant, breastfeeding, or taking other medications. The long-term effects of melatonin use remain under-researched.
Many people use a melatonin supplement for sleep, but more research is needed to determine its impact on anxiety.
Melatonin, a naturally occurring hormone, helps regulate sleep and promote the healthy functioning of your body’s internal clock. Some studies suggest that it may also reduce certain types of anxiety.
In general, melatonin is safe and non-toxic when used in the short term to help with sleep. But for some people, taking melatonin as a supplement is risky.
For people with anxiety and depression, purposefully engaging in pleasurable activities can improve mental health.
What is melatonin?
Melatonin is a hormone that’s naturally produced by your body. It helps regulate your body’s internal clock so that your sleep-wake pattern lines up with the earth’s 24 hour day, so you can sleep when it’s dark at night and stay awake during the daytime.
Your body starts producing higher melatonin levels when the sun goes down and slows its production as the sun rises. This cycle follows a circadian rhythm, meaning that the body’s built-in process mirrors the earth’s daily rotation.
In general, your body starts to secrete melatonin to help you fall asleep about 2 hours before your usual bedtime, with peak levels between 3 to 4 AM.
Melatonin regulation also happens on a seasonal rhythm or a circannual rhythm. This means that your body produces higher amounts of melatonin when the days are shorter and the nights are longer, as they are in the fall and winter seasons.
In short, this hormone lets you know when it’s time to go to sleep and when it’s time to wake up.
How does melatonin work?
The pineal gland produces melatonin. This gland uses an amino acid called tryptophan to create the neurotransmitter serotonin, which is then used to make melatonin.
The pineal gland only produces a single hormone and releases it in response to darkness. Your body produces more melatonin at night than it does during the day.
Once it’s been produced by your pineal gland, melatonin travels throughout your body. After entering the bloodstream and cerebrospinal fluid, the fluid around the brain and spinal cord, melatonin travels to your organs and tissues. There, it communicates to special receptors throughout the body that it’s time for sleep.
Melatonin, sleep, and anxiety
Apart from light and darkness, there are a number of other factors that can affect your body’s melatonin levels. For instance, your body secretes less melatonin naturally as part of the aging process.
Certain diseases are also associated with lower melatonin levels. These include dementia, type 2 diabetes, extreme pain, cancer, and mood disorders like seasonal affective disorder (SAD) and bipolar disorder.
When melatonin levels are low, it’s more likely you’ll have trouble falling asleep or that you’ll experience sleep disturbances throughout the night.
Over time, sleep disorders like insomnia can have a significant impact on your physical and mental health. According to the CDC, as many as 70 million Americans experience chronic sleep issues.
In particular, issues with sleep can trigger or worsen anxiety disorders. Studies show that people with anxiety are also more vulnerable to the effects of poor sleep. Anxiety and lack of sleep can create a feedback loop where you sleep poorly because of worry, and lack of sleep, in turn, contributes to higher anxiety.
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Does melatonin help you sleep?
Melatonin has been proven effective in treating specific sleep issues in certain populations, but it isn’t recommended across the board for all sleep conditions or for all people.
For instance, there’s evidence showing that melatonin is effective when used for a sleep disorder called delayed sleep-phase syndrome (DSPS).
People with DSPS aren’t able to fall asleep until a couple of hours past their desired bedtime, often around 1 or 2 AM. In one study, adults with DSPS who took melatonin at an appropriate time fell asleep faster and slept longer than without the supplement.
Another study of middle-aged and elderly people with primary insomnia had positive results. Researchers demonstrated a clear improvement of insomnia for people over 55 with a 2 mg dose of extended-release melatonin.
Clinical guidelines from the American Academy of Sleep Medicine (AASM) published in 2015 recommend appropriately-timed melatonin to help with jet lag and shift work.
However, a more recent guideline supported by the AASM suggests that melatonin should not be used by people experiencing difficulty falling asleep or staying asleep throughout the night.
Why? After taking all related studies into account, researchers found that evidence was actually against melatonin’s efficacy as a treatment for sleep onset and sleep maintenance insomnia.
Can melatonin reduce anxiety?
Melatonin has proven effective against anxiety in some circumstances, such as in older people with primary insomnia and before surgery.
In fact, research shows that melatonin administered before surgery is as effective at reducing anxiety as benzodiazepines, a class of anti-anxiety medications that includes drugs like Xanax.
But there hasn’t been any definitive research that proves melatonin is an effective treatment for anxiety in all cases.
Still, if you’re prone to anxiety at night or are having trouble falling asleep because of anxiety, melatonin might prove a helpful tool. That’s because, for people with both conditions, insomnia is often caused by a racing mind.
Melatonin may interrupt the feedback loop created by anxiety from insomnia, where anxiety causes insufficient or inadequate sleep, which then causes more extreme levels of anxiety. Melatonin may help you fall asleep faster, which might mean you get more sleep. Getting enough quality sleep is crucial to support mental health.
How to take it
Melatonin is available over the counter as a dietary supplement, and most products recommend a dose between 1 and 10 mg, though some are as high as 12 mg.
How much melatonin you take plays a significant role in determining how effective the supplement is. But because supplements like this one aren’t regulated by the Food and Drug Administration (FDA), there’s no standardized dosing schedule.
Lack of regulation also means that there’s no guarantee that a melatonin supplement you purchase will contain the ingredients listed on its label.
Since there’s no official recommendation from the FDA, we’ve pulled dosage info from clinical research. According to studies, it’s best to start with a lower dosage and work your way up.
A starting dose of 5 mg or fewer is within the recommended range, though you may want to begin even lower if you’re very sensitive to medication side effects.
However, it isn’t safe for you to use melatonin off label for anxiety or for any other indication besides sleep. If you’re planning to use melatonin for sleep or for any other symptom, it’s crucial that you discuss with your doctor first to make sure you can safely use it and to get guidance regarding the dose.
Melatonin side effects
Melatonin is usually associated with the range of side effects listed below. Still, it’s important to note that people reported side effects like dizziness, headache, nausea, and irritation at the same rates as the placebo group in clinical trials.
Here are the possible side effects of melatonin.
- Dizziness
- Headache
- Sleepiness
- Nausea
- Stomach cramps
- Irritability or agitation
- Nightmares
- Lower testosterone levels in males
Compared to the side effects of anti-anxiety medications like Xanax and other benzodiazepines, melatonin has some notable benefits. First off, it’s non-habit forming, which means that taking melatonin to help with sleep is unlikely to cause physical dependence or addiction.
Because your body won’t become habituated to the supplement, you won’t experience withdrawal if you stop taking melatonin. This isn’t true of other anxiety and sleep medications, like benzodiazepines and zolpidem.
Finally, it’s less likely that melatonin will leave you feeling tired or “hungover” the next morning. That being said, in some clinical settings, people taking melatonin did have next-day sleepiness.
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Risks and dangers
People often assume that because a dietary supplement is natural, that it’s also necessarily safe. When used appropriately, melatonin is relatively safe. But there are still certain risks you should be aware of if you’re considering taking it.
Lack of regulation
Because melatonin is a supplement rather than a drug, it’s not regulated by the FDA. This means there’s no regulatory board accounting for the quality of the supplement you’re taking or assuring you that the pill you take contains the ingredients printed on its packaging.
In fact, a study performed by the AASM showed some distressing findings. Researchers surveyed 31 melatonin supplements and found that their actual melatonin concentrations differed substantially from what was listed on the label. 71% of the supplements tested were marketed using inaccurate listings of melatonin content.
Even more alarming was the fact that more than a quarter of the supplements tested were shown to contain serotonin, which can have hazardous interactions with other drugs and can be harmful to some, even in small doses.
Long-term use
Melatonin is safe for short-term use, up to 6 months. But some researchers believe that using melatonin for extended periods of time may cause changes to your hormone levels. That being said, there has been no clinical indication of long-term changes to hormone levels so far.
Because there hasn’t been enough research done on the longer-term use of melatonin, we’re still unsure about the possible impacts the supplement has over time.
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Drug interactions
We want you to know about the possible dangers and interactions before you decide to start taking melatonin.
Melatonin supplements can interact with other medications, so you shouldn’t take them if you’re currently taking any of the meds listed below.
- Medications to prevent seizures (anticonvulsants)
- Blood thinners (anticoagulants)
- Antiplatelet medications
- Sedatives (benzodiazepines)
- Diabetes medications
- Oral contraceptives
- Medications that suppress your immune system (immunosuppressants)
- Ani psychotics
It’s always a good idea to check with your doctor before starting a melatonin supplement. But if you’re taking any of the meds listed above, please don’t take melatonin until you’ve cleared it with a medical professional.
Who else shouldn’t take it
Don’t take melatonin if any of the following apply to you.
- Epilepsy: melatonin may increase your risk of having a seizure.
- Hypertension: melatonin may increase blood pressure levels for people with hypertension who take blood pressure meds.
- Diabetes: melatonin may increase blood sugar levels. If you have diabetes and want to take the supplement, you’ll need to observe your blood sugar.
- Bleeding disorder: melatonin may slow clotting, so don’t use it if you take other medications that slow coagulation or if you have a bleeding disorder that slows your blood’s clotting time.
- Undergoing immunosuppressive therapy: melatonin may increase your body’s immune response and thereby decrease the efficacy of any drugs you’re taking to suppress your immune system.
- Pregnancy: avoid taking melatonin if you’re pregnant since it’s still unclear what impact it might have on a developing fetus. Try these safe treatments for pregnancy insomnia.
- Breastfeeding: melatonin is passed into breast milk, so don’t take it if you have a child who’s breastfeeding.
Melatonin may be helpful if you’re experiencing anxiety related to or co-occurring with insomnia, but it’s not generally recommended as a treatment for anxiety.
Rather than trying to manage a possible anxiety disorder with an over-the-counter dietary supplement, we suggest you talk with a medical professional. You may be able to receive both anxiety and insomnia treatments with Lemonaid.
Takeaway
- Melatonin is not a treatment for anxiety, but it may secondarily ease anxiety by easing certain sleep disruptions.
- More research is needed to establish safety for long-term use.
- It interacts with some medications and health conditions, so it’s not right for everyone.
- Talk to a medical professional about melatonin if you have mental health conditions or chronic insomnia.
