How to safely use melatonin (and other sleep aids)

You’ve tried to fall asleep, but no matter how many sheep you count, the clock tells you that you are down to just a few hours until the alarm rings.

How our bodies know when to sleep

We all know what it’s like to have trouble falling or staying asleep.

Sleep is regulated by two processes:

• The sleep/wake cycle tells our bodies to get sleepy once we have been awake for a long period.
• The circadian rhythm uses light to tell our bodies when to sleep and wake. When our eyes see light, like the sun, our brains release hormones that help us stay awake. When it gets dark, our bodies stop releasing the “waking” hormones and start releasing the “sleeping” hormones, including melatonin.

If these processes are working perfectly, you’ll get perfect sleep. But for many, the events of everyday life can disrupt one or both of these processes. Though 15% of people suffer from chronic insomnia, many more people have occasional trouble sleeping.

What are sleep aids?

“Many things can disrupt sleep. Once our sleep schedule has been thrown off, it can be hard to get back on track, which is why many people turn to over-the-counter sleep aids,” said Sarah Zallek, MD, medical director for the sleep center at OSF HealthCare Illinois Neurological Institute.

Melatonin has become a popular over-the-counter sleep aid because it is a more natural way of inducing sleep.

“Melatonin has some value,” said Dr. Zallek.

Brands like ZzzQuil Pure Zzzs and Unisom claim to improve sleep by giving your body an extra dose of melatonin.

Other over-the-counter sleep aids use diphenhydramine (or antihistamines). These are brands like Benadryl, Tylenol PM and Advil PM. These medications help alleviate allergies, so they should not be taken to help sleep.

Do these aids really help?

Dr. Zallek cautions it’s better to treat the underlying cause of sleeping problems instead of taking a sleep aid.

“Most of the time, we don’t need medication to fix a sleep problem, even if it’s over-the-counter,” said Dr. Zallek.

If you’re having trouble sleeping, do more of the things that promote sleep and fewer of the things that disrupt it.

When to take sleep aids

When taken correctly, over-the-counter melatonin sleep aids can help your body get back into a good rhythm of falling asleep at night and waking up in the morning.

“If you’ve run into a sleep disruption, melatonin can help shift your sleep rhythm so your body can adjust to falling asleep at night and waking up when you need to in the morning,” said Dr. Zallek.

Once your body is in the rhythm, you should stop taking melatonin.

How much melatonin is too much?

While not habit-forming, it is possible to overdose on melatonin.

“Everything in the wrong dose is dangerous,” said Dr. Zallek.

It’s especially important to keep melatonin away from children.

“People might think melatonin is safer because it’s over-the-counter. They may leave it on the nightstand or kitchen counter. Kids see that and think it’s candy, but it’s not. It’s still a medication that needs to be kept out of reach,” said Dr. Zallek.

Always aim to take the smallest dose. Since your body naturally produces melatonin, you won’t need a lot to fall asleep.

Start with 1 mg of melatonin. If you find you need more, you can increase your dosage. However, avoid going over 5 mg.

Choose a melatonin supplement verified by the USP Dietary Supplement Verification Program.

Melatonin side effects

Melatonin is generally safe if following the right dosages. However, you may experience some side effects.

• Agitation
• Daytime sleepiness
• Dizziness
• Drowsiness
• Grogginess, especially in the morning
• Headache
• Mood changes

Healthy sleep

We all know what a good night’s sleep feels like. We fall asleep easily, sleep soundly through the night, wake up feeling refreshed and get a full seven to eight hours of sleep. This is the ideal.

To get good, quality sleep, follow good sleep hygiene habits, such as:

• Go to bed at the same time every night
• Avoid daytime naps
• Limit caffeine
• Use your bed just for sleep
• Turn off screens at least 30 minutes before bed

For those whose sleep doesn’t improve after implementing good sleep habits, seeing a provider specializing in sleep medicine can help them find relief.