Many Americans face sleep difficulties, with approximately 30% reporting trouble falling asleep and one in five using sleep aids, according to the American Academy of Sleep Medicine. Melatonin, a popular option, is a hormone that regulates the sleep-wake cycle and is available in various forms, such as gummies and pills. Sales of melatonin supplements in the U.S. increased from $285 million in 2016 to over $821 million in 2020, as reported by the CDC.
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Insomnia can hinder one's ability to fall or stay asleep, often stemming from anxiety, racing thoughts, or unhealthy sleep associations. Experts indicate that melatonin addresses sleep timing but does not tackle the core issues of insomnia. Dr. Nathaniel Gordon, an assistant professor of medicine and sleep specialist, emphasizes that most insomnia cases are due to hyperarousal rather than melatonin deficiency, recommending against its use for acute or chronic insomnia due to limited effectiveness on sleep quality or duration.
Research shows that melatonin may help individuals fall asleep only about seven minutes faster than a placebo. Despite this, many people persist with melatonin use due to its availability, low cost, and perceived safety.
However, melatonin is not without risks. Dosage varies widely, with some over-the-counter products containing 5–10 mg, while effective doses can be as low as 0.5 mg. Higher dosages may lead to morning grogginess, and side effects can include headaches, dizziness, nausea, and vivid dreams. Further, a study published in JAMA revealed that 88% of melatonin gummy products were inaccurately labeled, with actual contents deviating significantly from stated amounts.
Safety issues also arise, particularly for children, who may confuse gummy melatonin for candy. Reports to poison control centers regarding accidental melatonin ingestions increased by 530% from 2012 to 2021, and pediatric emergency visits related to melatonin rose 421% between 2009 and 2020.
For chronic insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the most effective treatment. This structured program focuses on altering the thoughts and behaviors that disrupt sleep. It aims to increase 'sleep pressure' and establish a routine, enabling individuals to reclaim their sleep environment. Dr. Gordon indicates that CBT-I offers similar success as medications but without associated side effects. For those struggling with insomnia, appointments with Dr. Gordon can be made at 757-446-5908, or a referral can be requested through a primary care physician.