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Does Melatonin Help with Insomnia?

Contributor: Stuart Quan, MD
5 minute read
A man asleep in bed.

Insomnia is common. According to the National Institutes of Health (NIH), up to 19% of adults in the United States report not earning enough rest or sleep every day. As more people struggle, melatonin — a medication for insomnia — has exploded in popularity. In fact, the NIH reports that its usage has increased more than five-fold since 1999.

“Insomnia can really affect your quality of life, and it can be associated with economic loss. But it can be treated,” says Stuart Quan, MD, a Mass General Brigham sleep medicine specialist.

“What helps with insomnia? The first therapy I recommend for chronic insomnia is cognitive behavioral therapy (CBT). CBT is talk therapy and strategies that can help you overcome the reasons for sleep problems. For people who don’t respond completely to CBT, the hormone melatonin can be effective, and it’s generally safe,” Dr. Quan advises.

If you’re considering melatonin, Dr. Quan says it’s important to understand how it works and how to use it.

Understanding insomnia

Insomnia is difficulty going to sleep, difficulty staying asleep, or waking up too much during the night. The condition can impact overall health and causes symptoms and struggles during the day, such as:

  • Cranky, irritable, or anxious feelings

  • Feeling sleepy

  • More mistakes during the day or clumsiness

  • Trouble staying focused or concentrating

“Everybody gets insomnia every once in a while,” Dr. Quan notes. “But sleep is important. If you have insomnia for 2 or 3 weeks or longer, it could be a symptom of a sleep disorder or another medical problem. And insomnia is often associated with mood disorders, specifically depression. For those reasons, you should see your physician.”

If you’re having difficulty sleeping and can’t see your doctor right away, Dr. Quan says you can try melatonin.

What does melatonin do?

The body produces melatonin, a natural hormone, in response to darkness. The hormone helps with insomnia because it regulates your sleep-wake cycles, known as circadian rhythms. It can also make you sleepy.

The body naturally releases melatonin about 2 hours before you go to bed. It’s a signal to help your body know when to go to sleep. Levels of melatonin stay elevated during the night. They then drop during the daytime.

If [melatonin] works, it will work pretty much right away. If you don’t notice any effect within a couple of days, you’re probably not going to have much of an effect.

Stuart Quan, MD

Sleep Medicine Specialist

Mass General Brigham

When should you take melatonin?

Melatonin supplements can help some people fall asleep and stay asleep. For insomnia, Dr. Quan recommends a dosage between 1 and 3 milligrams about an hour before your desired bedtime.

Is it safe to take melatonin every night?

It’s safe to take melatonin every night. But consider stopping after a few weeks to see if you still need it.

Dr. Quan recommends sustained-release melatonin, which releases melatonin into your system in a slow, controlled way.

How long does melatonin last?

Sustained-release melatonin should last through the night and then wear off in time for you to start your day. Studies have shown that sustained-release forms of melatonin are more effective for insomnia than immediate-release types.

“If it works, it will work pretty much right away. If you don’t notice any effect within a couple of days, you’re probably not going to have much of an effect,” he adds.

Issues to consider with melatonin and insomnia

Although you don’t need a prescription to get melatonin in the U.S., it’s still a medication. Dr. Quan cautions patients to understand what they’re using.

“Melatonin is considered a dietary supplement, so it’s not regulated by the U.S. Food and Drug Administration (FDA) as carefully as other medications. Therefore, what you buy at the drugstore or the health food store is not necessarily held to the same standard as other over-the-counter sleep aids for insomnia or prescription drugs,” Dr. Quan says.

He suggests looking for a supplement that has been tested and verified by a third-party lab to contain the amount of melatonin stated on the bottle.

Medication for insomnia

Melatonin has fewer risks and side effects than other medications for insomnia, but it can cause:

  • Dizziness

  • Dry mouth

  • Excessive sleepiness

  • Headache

  • Nausea or stomachache

  • Strange dreams

Because there’s a lack of data on long-term use of melatonin, Dr. Quan recommends that you talk with your doctor if you feel like you need it to sleep better for long periods of time. There’s also limited information on melatonin’s safety for certain people, including:

  • Children

  • People with dementia

  • Pregnant individuals

  • Those taking other medications, such as blood thinners, antiseizure drugs, birth control, immunosuppressants, and medications for diabetes and blood pressure (hypertension)

Stuart Quan, MD


Sleep Medicine Specialist