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When it comes to natural sleep aids such as melatonin, it is worth noting that you are not the only person to consider this option. Over 27% of U.S. adults take melatonin for sleep in the last two months compared to just 0.4% in 1999-2000. With this increase in popularity, it's important to question the safety and efficacy concerns of the solution you are considering and whether a natural alternative for sleep concerns is a better choice.
Melatonin is generally safe short-term with some side effects. Although research is mixed, evidence suggests safety varies as a function of duration of use, dose, and individual differences. Some key studies contribute to a greater understanding of melatonin's safety profile.
The short-term (one to two months) use of melatonin supplements appears to be safe for most people. A systematic review of 2,130 patients found that common adverse effects (relative to placebo) were daytime sleepiness, headache, and dizziness. All adverse effects were reported more frequently in the melatonin groups than placebo, but were considered of minor clinical significance given their mild nature.
Specifically, taking low to moderate doses (5 mg daily or less) appears to be safe for both short- and long-term use. Overall, most long-term studies show safety with no difference between melatonin and placebo regarding long-term adverse effects.
For those interested in comprehensive information regarding sleep enhancement methods, our guide to natural sleep alternatives details several evidence-based options.
Long-term melatonin effects remain unclear. According to the U.S. Department of Health and Human Services, there hasn't been much study of melatonin's long-term safety and use. The fact that there is no long-term safety data is a serious concern for those who use melatonin regularly.
We asked Dr. Michael Grandner, Sleep Expert and Professor of Neuroscience and Physiological Sciences, what he thinks about long-term use of melatonin. He says: "Melatonin seems safe to use in the short-term, but the lack of long-term safety data means we should be cautious about regular use, especially at higher doses." This uncertainty about long-term use has encouraged sleep specialists to suggest focusing on addressing the root causes of sleep disorders rather than relying on long-term melatonin supplementation.
It is important to understand who should avoid melatonin and what side effects to expect in order to make a safe decision.
Melatonin has several contraindications for people who have had organ transplants, have depression, bleeding disorders, or seizures. Additionally, pregnant women, breastfeeding mothers, and those with depression are among the discouraged melatonin users.
Specific contraindications include:
For more information about who should consider alternatives, see our article on melatonin safety concerns.
Most common melatonin side effects are drowsiness and headaches. Many people report experiencing dreams that might be classified as vivid or even nightmares. Higher doses cause additional effects, including dizziness, feeling sleepy during the day, stomach aches, dry mouth, itchy skin, arm or leg pain, odd dreams, and night sweats.
For more suggestions on managing these effects, see our comprehensive article on melatonin side effects.
The biggest safety issue with melatonin isn't the hormone itself but the lack of regulation in dietary supplements.
A 2023 study analyzed gummies and found the actual amount of melatonin was between 74 and 347% of the amount advertised on the product label. The researchers showed that 22 of 25 products were mislabeled.
Another study found 70% variance in melatonin supplements, showing large differences between labeled dosage and actual content. This means it is very difficult to know the dose you are actually taking, which affects safety and effectiveness.
How can you be certain that you are purchasing a supplement that is worth your money? According to sleep experts, you shouldn't rely solely on marketing claims; instead, investigate brands by checking websites such as Consumer Lab testing, which conducts independent testing of supplements for dose and purity. Look for supplements that have been evaluated by third parties and tested for dose and quality.
For guidance on choosing quality supplements, see our article on supplement safety guidelines.
Melatonin can lessen the effectiveness of some medications and cause unwanted consequences when taken with other drugs.
We asked Dr. Suzanne Gorovoy, Sleep Expert, Clinical Psychologist, and Behavioral Sleep Medicine Specialist, about melatonin's interaction potential. She says: "Melatonin can interact with anticoagulants, diabetes medications, and immune-suppressing drugs, making medical supervision essential for people taking these medications." For those taking multiple medications, it is important to consult with a medical professional before taking melatonin.
Melatonin interacts with blood thinners and may affect how these medications work in your body.
Due to a lack of research, melatonin safety in children is not fully explored. Researchers have some concern that melatonin could affect puberty, but more research needs to be conducted. Over 260,000 poison control calls were made regarding excessive melatonin ingestion in children and adolescents over the last decade.
If you are a parent looking for sleep support for your child, consider safer alternatives from our article on pediatric sleep strategies.
If melatonin is not appropriate for you, consider several natural alternatives that have scientific support for sleep help.
Magnesium supports hundreds of processes in the body and is critical for brain health and heart function. Magnesium's relaxing effect may be partly attributed to its role in regulating melatonin production. A 2022 study suggested that magnesium supplements improved sleep both during the day and at night in older adults.
Magnesium glycinate is the most effective form for sleep support, as it is well tolerated and more bioavailable than other forms. For a complete comparison, see our guide on magnesium vs melatonin.
A systematic review of 60 studies (n=6,894) concluded that valerian may be effective in improving sleep quality and decreasing insomnia through neurotransmitter modulation. Patients taking valerian had 80% greater chance of reporting improved sleep compared to placebo.
However, valerian root is safe as a natural sleep aid for adults when taking it daily for up to 28 days. Limited research suggests 300-600 mg of valerian up to one hour before bedtime may help people fall asleep and improve sleep quality.
For more information about herbal sleep aids, see our comprehensive guide on natural sleep remedies.
L-Theanine induces relaxation without sedation and is found in tea leaves. Some researchers suggest that L-Theanine mitigates caffeine's negative effects on sleep. L-Theanine doesn't cause drowsiness the next day, unlike many sleep aids.
Glycine functions in sleep regulation as an amino acid and neurotransmitter. Up to 30 grams daily appears to have few side effects, with sleep benefits often achieved at doses as low as 3 grams.
For further insights into amino acid sleep support, see our article on GABA vs melatonin.
We asked Dr. Areti Vassilopoulos, Sleep Expert, Pediatric Health Psychologist, and Assistant Professor of Child Psychology, about when to seek professional help. She says: "Natural sleep aids can be helpful for occasional sleep issues, but continual insomnia usually indicates underlying issues that require evaluation and treatment beyond supplementation."
Using any type of sleep aid typically is not the best long-term solution for insomnia. If you have persistent sleep disruption, sleep specialists recommend consulting your primary doctor or sleep specialist to obtain appropriate treatment or meet with a sleep psychologist for cognitive behavioral therapy for insomnia.
If you are looking for evidence-based behavioral treatment, consider reviewing CBT-I therapy options for long-term solutions.
A comprehensive literature review reported on herbal and natural supplements studied for sleep, including valerian, hops, kava, German chamomile, cherry, tryptophan, theanine, melatonin, magnesium, and zinc. Certain supplements show promise - valerian, hops, and melatonin in particular - for improving sleep quality and alleviating insomnia symptoms through neurotransmitter systems and sleep-wake cycle control.
The review noted that supplement quality varies widely, and some products contained contaminants or caused drug interactions. The conclusions emphasized that individuals should consult healthcare professionals before using supplements, especially those with underlying health conditions or taking prescribed medications.
Whether using melatonin or natural sleep supplements, follow these safety guidelines.
Often, people take a melatonin dose higher than required. For most people, 1-3 mg is more than enough and works just as well as higher doses with fewer side effects. Adults should begin with lower doses before increasing if they do not receive benefits.
For natural alternatives:
For comprehensive dosing guidance, see our article on natural sleep enhancement methods.
While short-term use of natural sleep remedies tends to be safe for most adults, we are still learning about long-term supplement safety. We recommend using sleep remedies for no longer than one to two months, then taking a break and observing your sleep habits.
If you continue struggling with sleep after taking a break from natural sleep therapies, refer to our comprehensive guide on sleep maintenance insomnia for additional strategies.
Natural sleep aids, including melatonin, are generally perceived as safer than prescription medications because they have fewer side effects. However, they should only be viewed as a short-term solution while working to resolve root causes through addressing sleep hygiene and lifestyle habits.
Before beginning any sleep supplements:
For comprehensive sleep improvement without supplements, explore our sleep hygiene tips and 10 tips to improve sleep.
Additional resources for sleep improvement include:
Melatonin is not inherently "dangerous," but it is not without risks and limitations. Short-term usage appears to be safe for most otherwise healthy people, but the lack of long-term safety data and quality control issues in the supplement industry necessitate caution. Natural alternatives like magnesium, valerian root, and amino acids may achieve similar goals while having their own safety and efficacy profiles.
The most important aspect of improving sleep is understanding that supplements are only one component of a comprehensive approach to sleep health, not a standalone remedy. Persistent sleep issues often indicate underlying problems that require careful evaluation and evidence-based treatments.
If you are ready for a personalized approach to sleep health without resorting to supplements, check out our Sleep Reset program to target the full range of behavioral interventions and lifestyle changes that improve sleep from the ground up.
Dr. Shiyan Yeo
Dr. Shiyan Yeo is a medical doctor with over a decade of experience treating patients with chronic conditions. She graduated from the University of Manchester with a Bachelor of Medicine and Surgery (MBChB UK) and spent several years working at the National Health Service (NHS) in the United Kingdom, several Singapore government hospitals, and private functional medicine hospitals. Dr. Yeo specializes in root cause analysis, addressing hormonal, gut health, and lifestyle factors to treat chronic conditions. Drawing from her own experiences, she is dedicated to empowering others to optimize their health. She loves traveling, exploring nature, and spending quality time with family and friends.
