Melatonin is a hormone and dietary supplement commonly used as a sleep aid.

Although it has an outstanding safety profile, melatonin’s growing popularity has raised some concerns.

These concerns are mainly due to a lack of research on its long-term effects, as well as its wide-ranging effects as a hormone.

This article reviews the potential side effects of melatonin supplements.

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Melatonin is a neurohormone produced by the pineal glands in your brain, mainly at night.

It prepares your body for sleep and is sometimes called the “hormone of sleep” or “hormone of darkness.”

Melatonin supplements are frequently used as a sleep aid. They help you fall asleep, improve sleep quality, and increase sleep duration. However, they don’t appear to be as effective as many other sleep medications (1).

Sleep isn’t the only body function melatonin affects. This hormone also plays a role in your body’s antioxidant defenses and helps regulate blood pressure, body temperature, and cortisol levels, as well as sexual and immune function (2).

In the United States, melatonin is available over the counter. Since June 2021, it has also been available over the counter in Australia for people over 55 (3).

In contrast, it’s a prescription drug in most European countries and approved for use only in older adults with sleep disorders (4, 5).

Its use is growing, raising concerns about its possible side effects.

Summary

Melatonin is a hormone your brain produces in response to fading light. It prepares your body for sleep and is often used as a sleep aid.

A few studies have investigated the safety of melatonin, but none have found any serious side effects. It also doesn’t seem to cause any dependence or withdrawal symptoms (6, 7).

Some medical professionals are concerned that it may reduce the natural production of melatonin in the body. However, short-term studies suggest no such effects (8, 9, 10).

Several studies have reported general symptoms, including dizziness, headache, nausea, and agitation. However, these were equally common in the treatment and placebo groups and couldn’t be attributed to melatonin (6).

Melatonin supplements are generally considered safe in the short term, even when taken in very high doses. However, more research on its long-term safety is needed, especially in children (11).

A few mild side effects and drug interactions are discussed in the chapters below.

Summary

Melatonin supplements are considered safe, and no studies have noted any serious side effects to date. However, more research is needed to evaluate its long-term effects.

Use in children

Parents sometimes give melatonin supplements to children who have trouble falling asleep (12).

However, the Food and Drug Administration has neither approved its use nor evaluated its safety in children.

In Europe, melatonin supplements are a prescription-only medicine intended for adults. However, one Norwegian study found that their unapproved use in children was on the rise (5).

While there is no specific cause for concern, many experts are reluctant to recommend this supplement for children.

This reluctance stems in part from its wide-ranging effects, which are not completely understood. Children are also considered a sensitive group, as they are still growing and developing.

Long-term studies are needed before melatonin can be used with absolute safety in children (13).

Summary

While parents occasionally give melatonin supplements to their children, most health professionals don’t recommend its use in this age group.

As a sleep aid, melatonin supplements should be taken in the evening.

When taken at other times of the day, they may cause undesirable sleepiness. Keep in mind that sleepiness is technically not a side effect but rather their intended function (14, 15).

Nevertheless, sleepiness is a possible problem in people who have a reduced melatonin clearance rate, which is the rate at which a drug is removed from the body. An impaired clearance rate extends the time melatonin levels stay high after taking supplements.

While this may not be an issue in most healthy adults, reduced melatonin clearance has been reported in older adults and infants. It is unknown whether this has any effects on melatonin levels the morning after taking supplements (16, 17).

Yet, even when melatonin supplements or injections are given during the daytime, they do not seem to affect the ability to maintain focus.

Studies in healthy people injected with 10 or 100 mg of melatonin or given 5 mg by mouth found no effects on reaction times, attention, concentration, or driving performance compared with a placebo (15, 18).

More studies are needed before scientists can fully understand the effects of melatonin supplements on daytime sleepiness.

Summary

Melatonin supplements may cause daytime sleepiness when taken during the day. You should use melatonin only in the evening.

Several other concerns have been raised, but most have not been thoroughly researched:

  • Interaction with sleeping pills. One study found that taking the sleep medication zolpidem along with melatonin worsened zolpidem’s adverse effects on memory and muscle performance (19).
  • Decreased body temperature. Melatonin causes a slight drop in body temperature. While this is generally not a problem, it could make a difference in people who have difficulty keeping warm (20).
  • Blood thinning. Melatonin may also reduce blood coagulation. As a result, you
    should speak with your doctor before taking high doses of it if you also take warfarin or other blood thinners (21).
Summary

Melatonin may interact with medications, such as sleeping pills, and can act as a blood thinner when taken in high doses.

To aid sleep, the standard dosage ranges from 1–10 mg per day. However, the optimal dose has not been formally established (22).

Since not all melatonin supplements are the same, make sure to follow the instructions on the label.

Also, keep in mind that the quality of over-the-counter supplements is not monitored by health authorities. Try to choose brands that are reputable and certified by a third party, such as Informed Choice or NSF International.

Many experts do not recommend use of melatonin supplements in children and adolescents until more evidence confirms their safety in these groups (6).

Since melatonin is transferred into breast milk, people who are breastfeeding should keep in mind that it might cause excessive daytime sleepiness in nursing infants (23).

Summary

The common dosage of melatonin ranges from 1–10 mg per day, but make sure to follow the instructions on the label. Parents should not give it to their children without first consulting a healthcare professional.

You can increase your melatonin levels without supplementing.

A few hours before bedtime, dim all lights at home and avoid watching TV and using your computer or smartphone.

Too much artificial light can reduce the production of melatonin in your brain, making it harder for you to fall asleep (24).

You can also strengthen your sleep-wake cycle by exposing yourself to plenty of natural light during the day, especially in the morning (25).

Other factors that have been associated with lower natural melatonin levels are stress and shift work.

Summary

You can increase your melatonin production naturally by sticking to a regular sleep schedule and avoiding artificial light late in the evening.

Melatonin supplements haven’t been linked to any serious side effects, even at very high doses.

However, most experts agree that more research on melatonin’s long-term safety is needed.

Therefore, sensitive individuals, such as children and those who are pregnant or breastfeeding, should consult a healthcare professional before taking it.

Even so, melatonin has an excellent safety profile and appears to be an effective sleep aid. If you often experience poor sleep, it may be worth trying.