Melatonin: What You Need To Know
What is melatonin and how does it work?
Melatonin is a hormone that your brain produces in response to darkness. It helps with the timing of your circadian rhythms (24-hour internal clock) and with sleep. Being exposed to light at night can block melatonin production.
Research suggests that melatonin plays other important roles in the body beyond sleep. However, these effects are not fully understood.
Melatonin dietary supplements can be made from animals or microorganisms, but most often they’re made synthetically. The information below is about melatonin dietary supplements.
What are the health benefits of taking melatonin?
Melatonin supplements may help with certain conditions, such as jet lag, delayed sleep-wake phase disorder, some sleep disorders in children, and anxiety before and after surgery.
Jet lag affects people when they travel by air across multiple time zones. With jet lag, you may not feel well overall and you may have disturbed sleep, daytime tiredness, impaired functioning, and digestive problems.
Research suggests that melatonin supplements may help with jet lag. This is based on medium-sized reviews from 2010 and 2014.
- Four studies that included a total of 142 travelers showed that melatonin may be better than a placebo (an inactive substance) in reducing overall symptoms of jet lag after eastward flights. Another study of 234 travelers on eastward flights looked at only sleep quality and found low-quality evidence that melatonin may be better than placebo for improving sleep quality.
- Two studies that included a total of 90 travelers showed that melatonin may be better than a placebo in reducing symptoms of jet lag after westward flights.
Delayed sleep-wake phase disorder (DSWPD)
People with DSWPD have trouble falling asleep at the usual times and waking up in the morning. They typically have difficulty getting to sleep before 2 to 6 a.m. and would prefer to wake up between 10 a.m. and 1 p.m.
Melatonin supplements appear to help with sleep in people with DSWPD, but it’s uncertain whether the benefits outweigh the possible harms. This is based on a clinical practice guideline, a small review, and a more recent study.
- In 2015, the American Academy of Sleep Medicine recommended melatonin supplements given at specific times for DSWPD. The recommendation was a weak one, and it came with uncertainty about whether the benefits of melatonin outweigh its potential harms.
- A 2016 review that looked at a small number of people (52) from two studies showed that melatonin supplements reduced the time it took for people with DSWPD to fall asleep when compared to placebo. On average, it took about 22 minutes less for them to fall asleep.
- A 2018 randomized controlled trial that lasted 4 weeks and included 307 people with DSWPD found that taking melatonin 1 hour before the desired bedtime combined with going to bed at a set time led to several improvements. Those improvements included falling asleep an average of 34 minutes earlier, better sleep during the first third of the night, and better daytime functioning.
Some sleep disorders in children
Sleep problems in children can have undesirable effects on their behavior, daytime functioning, and quality of life. Children with certain conditions, such as atopic dermatitis, asthma, attention-deficit hyperactivity disorder (ADHD), or autism spectrum disorder (ASD), are more prone to sleep problems than other children.
There are no overall guidelines on the best approach to improving sleep in children. However, guidelines for specific conditions recommend behavioral treatments, such as good bedtime habits and parent education, as an initial treatment that may be supplemented with medicines.
- A 2019 review looked at 18 studies of melatonin supplements that included a total of 1,021 children. Most of the studies were small, and all were relatively brief (1 to 13 weeks). Overall, the studies showed that melatonin was better than placebo for improving both the time to fall asleep and total sleep. The effects of melatonin on behavior and daytime functioning, however, weren’t clear because the studies used different ways to measure these outcomes.
The list below shows the review’s results on melatonin’s short-term effects for children with specific conditions.
- Children with ASD fell asleep 37 minutes earlier and slept 48 minutes longer.
- Children with ADHD fell asleep 20 minutes earlier and slept 33 minutes longer.
- Children with atopic dermatitis fell asleep 6.8 minutes earlier and slept 35 minutes longer.
- Children with chronic sleep-onset insomnia fell asleep 24 minutes earlier and slept 25 minutes longer.
Because there aren’t many studies on children and melatonin supplements, there is a lot we don’t know about the use of melatonin in children. For example, there are uncertainties about what dose to use and when to give it, the effects of melatonin use over long periods of time, and whether melatonin’s benefits outweigh its possible risks. Because melatonin is a hormone, it’s possible that melatonin supplements could affect hormonal development, including puberty, menstrual cycles, and overproduction of the hormone prolactin, but we don’t know for sure.
Because of these uncertainties, it’s best to work with a health care provider if you’re considering giving a child melatonin for sleep problems.
Anxiety before and after surgery
Anxiety before and after surgery happens in up to 80 percent of patients.
Melatonin supplements appear to be helpful in reducing anxiety before surgery, but it’s unclear if it helps to lower anxiety after surgery. This is a based on a 2015 review.
- The 2015 review looked at 12 studies that involved 774 people and assessed melatonin supplements for treating anxiety before surgery, anxiety after surgery, or both. The review found strong evidence that melatonin is better than placebo at reducing anxiety before surgery. Melatonin supplements may be as effective as standard treatment (the antianxiety medicine midazolam). However, the results on melatonin’s benefits for reducing anxiety after surgery were mixed.
Is melatonin helpful for preventing or treating COVID-19?
Current research looking at the effects of melatonin on COVID-19 is only in the early stages. There are a few randomized controlled trials (studies evaluating melatonin in people) in progress. At this point, it is too soon to reach conclusions on whether melatonin is helpful for COVID-19.
Does melatonin help with cancer symptoms?
Studies of the effect of melatonin supplements on cancer symptoms or treatment-related side effects have been small and have had mixed results.
Keep in mind that unproven products should not be used to replace or delay conventional medical treatment for cancer. Also, some products can interfere with standard cancer treatments or have special risks for people who’ve been diagnosed with cancer. Before using any complementary health approach, including melatonin, people who’ve been diagnosed with cancer should talk with their health care providers to make sure that all aspects of their care work together.
Can melatonin help with insomnia?
People with insomnia have trouble falling asleep, staying asleep, or both. When symptoms last a month or longer, it’s called chronic insomnia.
According to practice guidelines from the American Academy of Sleep Medicine (2017) and the American College of Physicians (2016), there’s not enough strong evidence on the effectiveness or safety of melatonin supplementation for chronic insomnia to recommend its use. The American College of Physicians guidelines strongly recommend the use of cognitive behavioral therapy for insomnia (CBT-I) as an initial treatment for insomnia.
Does melatonin work for shift workers?
Shift work that involves night shifts may cause people to feel sleepy at work and make it difficult to sleep during the daytime after a shift ends.
According to two 2014 research reviews, studies on whether melatonin supplements help shift workers were generally small or inconclusive.
- The first review looked at 7 studies that included a total of 263 participants. The results suggested that (1) people taking melatonin may sleep about 24 minutes longer during the daytime, but (2) other aspects of sleep, such as time needed to fall asleep, may not change. The evidence, however, was considered to be of low quality.
- The other review looked at 8 studies (5 of which were also in the first review), with a total of 300 participants, to see whether melatonin helped promote sleep in shift workers. Six of the studies were high quality, and they had inconclusive results. The review did not make any recommendations for melatonin use in shift workers.
Is it safe to take melatonin?
For melatonin supplements, particularly at doses higher than what the body normally produces, there’s not enough information yet about possible side effects to have a clear picture of overall safety. Short-term use of melatonin supplements appears to be safe for most people, but information on the long-term safety of supplementing with melatonin is lacking.
Also keep in mind:
Interactions with medicines
- As with all dietary supplements, people who are taking medicine should consult their health care providers before using melatonin. In particular, people with epilepsy and those taking blood thinner medications need to be under medical supervision when taking melatonin supplements.
Possible allergic reaction risk
- There may be a risk of allergic reactions to melatonin supplements.
Safety concerns for pregnant and breastfeeding women
- There’s been a lack of research on the safety of melatonin use in pregnant or breastfeeding women.
Safety concerns for older people
- The 2015 guidelines by the American Academy of Sleep Medicine recommend against melatonin use by people with dementia.
- Melatonin may stay active in older people longer than in younger people and cause daytime drowsiness.
Melatonin is regulated as a dietary supplement
- In the United States, melatonin is considered a dietary supplement. This means that it’s regulated less strictly by the Food and Drug Administration (FDA) than a prescription or over-the-counter drug would be. In several other countries, melatonin is available only with a prescription and is considered a drug.
Products may not contain what’s listed on the label
- Some melatonin supplements may not contain what’s listed on the product label. A 2017 study tested 31 different melatonin supplements bought from grocery stores and pharmacies. For most of the supplements, the amount of melatonin in the product didn’t match what was listed on the product label. Also, 26 percent of the supplements contained serotonin, a hormone that can have harmful effects even at relatively low levels.
Is melatonin safe for children?
In addition to issues mentioned above, there are some things to consider regarding melatonin’s safety in children.
Melatonin supplements appear to be safe for most children for short-term use, but there aren’t many studies on children and melatonin. Also, there’s little information on the long-term effects of melatonin use in children. Because melatonin is a hormone, it’s possible that melatonin supplements could affect hormonal development, including puberty, menstrual cycles, and overproduction of the hormone prolactin, but we don’t know for sure.
Possible melatonin supplement side effects reported in children have usually been mild and have included:
- Increased bedwetting or urination in the evening
What are the side effects of melatonin?
A 2015 review on the safety of melatonin supplements indicated that only mild side effects were reported in various short-term studies that involved adults, surgical patients, and critically ill patients. Some of the mild side effects that were reported in the studies included:
The possible long-term side effects of melatonin use are unclear.
Tips To Consider
- Remember that even though the FDA regulates dietary supplements, such as melatonin, the regulations for dietary supplements are different and less strict than those for prescription or over-the-counter drugs.
- Some dietary supplements may interact with medicines or pose risks if you have medical problems or are going to have surgery.
- If you’re pregnant or nursing a child, it’s especially important to see your health care provider before taking any medicine or supplement, including melatonin.
- If you use dietary supplements, such as melatonin, read and follow label instructions. “Natural” doesn’t always mean “safe.” For more information, see Using Dietary Supplements Wisely.
- Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
For More Information
The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
Toll-free in the U.S.: 1-888-644-6226
tty (for deaf and hard-of-hearing callers):
Email: firstname.lastname@example.org (link sends email)
A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed.
NIH Clinical Research Trials and You
The National Institutes of Health (NIH) has created a website, NIH Clinical Research Trials and You, to help people learn about clinical trials, why they matter, and how to participate. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov and other resources, and stories about the personal experiences of clinical trial participants. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.
National Heart, Lung, and Blood Institute (NHLBI)
The NHLBI Health Information Center provides information to health professionals, patients, and the public about heart, lung, and blood diseases and sleep disorders and accepts orders for publications.
P.O. Box 30105
Bethesda, MD 20824-0105
Toll-free in the U.S.: 1-877-NHLBI4U (1-877-645-2448)
Email: email@example.com (link sends email)
- Acuña-Castroviejo D, Escames G, Figueira JC, et al. Clinical trial to test the efficacy of melatonin in COVID-19. Journal of Pineal Research. 2020;69(3):e12683.
- Andersen LP, Gögenur I, Rosenberg J, et al. The safety of melatonin in humans. Clinical Drug Investigation. 2016;36(3):169-175.
- Artigas L, Coma M, Matos-Filipe P, et al. In-silico drug repurposing study predicts the combination of pirfenidone and melatonin as a promising candidate therapy to reduce SARS-CoV-2 infection progression and respiratory distress caused by cytokine storm. PLoS One. 2020;15(10):e0240149.
- Auger RR, Burgess HJ, Emens JS, et al. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-wake rhythm disorder (ISWRD). An update for 2015. Journal of Clinical Sleep Medicine. 2015;11(10):1199-1236.
- Auld F, Maschauer EL, Morrison I, et al. Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders. Sleep Medicine Reviews. 2017;34:10-22.
- Bahrampour Juybari K, Pourhanifeh MH, Hosseinzadeh A, et al. Melatonin potentials against viral infections including COVID-19: current evidence and new findings. Virus Research. 2020;287:198108.
- Costello RB, Lentino CV, Boyd CC, et al. The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature. Nutrition Journal. 2014;13:106.
- Esposito S, Laino D, D’Alonzo R, et al. Pediatric sleep disturbances and treatment with melatonin. Journal of Translational Medicine. 2019;17:77.
- García IG, Rodriguez-Rubio M, Mariblanca AR, et al. A randomized multicenter clinical trial to evaluate the efficacy of melatonin in the prophylaxis of SARS-CoV-2 infection in high-risk contacts (MeCOVID Trial): a structured summary of a study protocol for a randomised controlled trial. Trials. 2020;21(1):466.
- Hansen MV, Halladin NL, Rosenberg J, et al. Melatonin for pre- and postoperative anxiety in adults. Cochrane Database of Systematic Reviews. 2015;(4):CD009861. Accessed at www.cochranelibrary.com on October 10, 2019.
- Hazra S, Chaudhuri AG, Tiwary BK, et al. Matrix metallopeptidase 9 as a host protein target of chloroquine and melatonin for immunoregulation in COVID-19: a network-based meta-analysis. Life Sciences. 2020;257:118096.
- Herxheimer A. Jet lag. Clinical Evidence. 2014;2014:2303.
- Kennaway D. Potential safety issues in the use of the hormone melatonin in paediatrics. Journal of Paediatrics and Child Health. 2015;51(6):584-589.
- Liira J, Verbeek JH, Costa G, et al. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work. Cochrane Database of Systematic Reviews. 2014;(8):CD009776. Accessed at www.cochranelibrary.com on October 10, 2019.
- McDonagh MS, Holmes R, Hsu F. Pharmacologic treatments for sleep disorders in children: a systematic review. Journal of Child Neurology. 2019;34(5):237-247.
- Miller MA, Cappuccio FP. A systematic review of COVID-19 and obstructive sleep apnoea. Sleep Medicine Reviews. 2020;55:101382.
- Öztürk G, Akbulut KG, Güney Ş. Melatonin, aging, and COVID-19: Melatonin, aging, and COVID-19: Could melatonin be beneficial for COVID-19 treatment in the elderly? Turkish Journal of Medical Sciences. 2020;50(6):1504-1512.
- Qaseem A, Kansagara D, Forciea MA, et al. Clinical Guidelines Committee of the American College of Physicians. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2016;165(2):125-133.
- Sateia MJ, Buysse DJ, Krystal AD, et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2017;13(2):307-349.
- Sehirli AO, Sayiner S, Serakinci N. Role of melatonin in the treatment of COVID-19; as an adjuvant through cluster differentiation 147 (CD147). Molecular Biological Reports. 2020;47(10):8229-8233.
- Tan D-X, Hardeland R. Targeting host defense system and rescuing compromised mitochondria to increase tolerance against pathogens by melatonin may impact outcome of deadly virus infection pertinent to COVID-19. Molecules. 2020;25(19):4410.
- Zhou Y, Hou Y, Shen J, et al. A network medicine approach to investigation and population-based validation of disease manifestations and drug repurposing for COVID-19. PLoS Biology. 2020;18(11):e3000970.
- Ziaei A, Davoodian P, Dadvand H, et al. Evaluation of the efficacy and safety of melatonin in moderately ill patients with COVID-19: a structured summary of a study protocol for a randomized controlled trial. Trials. 2020;21(1):882.
- Barion A, Zee PC. A clinical approach to circadian rhythm sleep disorders. Sleep Medicine. 2007;8(6):566-577.
- Brasure M, MacDonald R, Fuchs E, et al. Management of insomnia disorder. Comparative Effectiveness Reviews no. 159. Rockville, MD: Agency for Healthcare Research and Quality; 2015. AHRQ publication no. 15(16)-EHC027-EF.
- Bruni O, Alonso-Alconada, Besag F, et al. Current role of melatonin in pediatric neurology: clinical recommendations. European Journal of Paediatric Neurology. 2015;19(2):122-133.
- Chen WY, Giobbie-Hurder A, Gantman K, et al. A randomized, placebo-controlled trial of melatonin on breast cancer survivors: impact on sleep, mood, and hot flashes. Breast Cancer Research and Treatment. 2014;145(2):381-388.
- Del Fabbro E, Dev R, Hui D, et al. Effects of melatonin on appetite and other symptoms in patients with advanced cancer and cachexia: a double-blind placebo-controlled trial. Journal of Clinical Oncology. 2013;31(10):1271-1276.
- Erland LAE, Saxena PK. Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content. Journal of Clinical Sleep Medicine. 2017;13(2):275-281.
- Grigg-Damberger MM, Ianakieva D. Poor quality control of over-the-counter melatonin: what they say is often not what you get. Journal of Clinical Sleep Medicine. 2017;13(2);163-165.
- Hansen MV, Andersen LT, Madsen MT, et al. Effect of melatonin on depressive symptoms and anxiety in patients undergoing breast cancer surgery: a randomized, double-blind, placebo-controlled trial. Breast Cancer Research and Treatment. 2014;145(3);683-695.
- Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag (review). Cochrane Database of Systematic Reviews. 2010;(1):CD001520. Accessed at www.cochranelibrary.com on October 10, 2019.
- Madsen MT, Hansen MV, Andersen LT, et al. Effect of melatonin on sleep in the perioperative period after breast cancer surgery: a randomized, double-blind, placebo-controlled trial. Journal of Clinical Sleep Medicine. 2016;12(2):225-233.
- Masters A, Pandi-Perumal SR, Seixas A, et al. Melatonin, the hormone of darkness: from sleep promotion to Ebola treatment. Brain Disorders & Therapy. 2014;4(1):1000151.
- Posadzki P, Bajpai R, Kyaw BM, et al. Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action. BMC Medicine. 2018;16(1):18.
- Rasmussen CL, Olsen MK, Johnsen AT, et al. Effects of melatonin on physical fatigue and other symptoms in patients with advanced cancer receiving palliative care: a double-blind placebo-controlled crossover trial. Cancer. 2015;121(20):3727-3736.
- Reiter RJ, Rosales-Corral SA, Tan D-X, et al. Melatonin, a full service anti-cancer agent: inhibition of initiation, progression and metastasis. International Journal of Molecular Sciences. 2017;18(4):E843.
- Sletten TL, Magee M, Murray JM, et al. Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: a double-blind, randomised clinical trial. PLoS Medicine. 2018;15(6):e1002587.
- Tordjman S, Chokron S, Delorme R, et al. Melatonin: pharmacology, functions and therapeutic benefits. Current Neuropharmacology. 2017;15(3):434-443.
- Vural EMS, van Munster BC, de Rooij SE. Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature. Drugs & Aging. 2014;31(6):441-451.
- Wilt TJ, MacDonald R, Brasure M, et al. Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians. Annals of Internal Medicine. 2016;165(2):103-113.
NCCIH thanks D. Craig Hopp, Ph.D., and David Shurtleff, Ph.D., NCCIH, for their review of this publication.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.
NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.