Melatonin: what therapists and consumers need to know

Melatonin: what therapists and consumers need to know

Insomnia is one of the most common health problems that mental health professionals hear about from their patients. In MHConcierge’s experience, many patients are taking, or considering, melatonin. Their PCP may have recommended it, or they may have just decided to try it on their own. “Read This If You Take Melatonin to Sleep at Night” was posted by HuffingtonPost.com recently, and this consumer-friendly article is a concise summary of the benefits of melatonin (limited) and potential concerns (several potential nuisance problems, and possibly significant drug interaction concerns).

The article reports that synthetic melatonin is “chemically identical” to natural melatonin, but also the commercially available supplements often contain other ingredients, such as “filler,” that may cause effects that do not come with natural melatonin. Of course, part of the problem is that melatonin is not regulated by the FDA. In addition, the article reports that researchers found that the ideal dose is 0.3 mg, and most commercially available supplements have considerably more melatonin, up to 10 times the recommended dose. Taking a higher dose is likely to result in lingering melatonin in the bloodstream the next day, which can leave the person groggy.

Researchers found that melatonin supplements actually have pretty minimal benefits; they helped users fall asleep only, on average, seven minutes faster and to sleep only about eight minutes longer.

A meta-analysis done by MIT found that the benefits of a proper dose of melatonin are limited, and after a few days the brain adjusts and melatonin loses its effectiveness. Finally, sleep experts express  concern about research that finds melatonin to cause unintended changes in the body, including cardiovascular, immune, and metabolic systems.

The article quotes a sleep expert who recommends that people with insomnia not bother with melatonin, and will get better results by practicing a consistent bedtime routine, avoiding things behaviors  disrupt sleep, and being active and exposing themselves to sunlight during the day.

MHConcierge’s take: this article provides a convenient summary about the current evidence-based thinking about melatonin. It is consumer-friendly, and could be used as a reference for patients interested in learning more about options for getting help with insomnia. It also can provide an opportunity to recommend to them CBT-Insomnia, a specialized behavioral approach to help patients with sleep disorders, be part of their treatment plan.

The article is available for free online.

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