Melatonin supplement usage has been increasing among adults — including college students — in the U.S, per a study published by the Journal of the American Medical Association. These findings could have a significant impact on University students, as drugs such as melatonin may have side effects beyond their intended purpose.
Per the Centers for Disease Control and Prevention, nearly one-third of adults in the U.S. do not receive enough sleep. Some turn to melatonin supplements to improve their sleeping habits.
Student Health Dr. Michael Patrizio explained in an email to The Cavalier Daily that melatonin is a hormone produced by the pineal gland of the brain that regulates the circadian rhythm — a roughly 24 hour sleep-wake cycle. In darkness, the brain produces melatonin which binds to and activates the MT1 and MT2 receptors in the suprachiasmatic nucleus of the brain, telling the body that it is time to sleep.
Rising third-year College student Emily Andrews takes melatonin to sleep better.
“I took melatonin because I had a lot of trouble sleeping in first-year dorms and I had heard it works for some people,” Andrews said in an email to The Cavalier Daily. “I was not prescribed and chose to use it on my own. I hadn’t heard of other supplements or remedies so I began with this one without trying any others.”
Andrews began using melatonin supplements a month into her first year. She started using 3 milligrams of melatonin but gradually increased to 5 milligram and 10 milligram supplements, in response to a loud sleeping environment and stress. She saw an improvement in her sleep following the use of supplements.
“I am able to get much more sleep than before and I feel more alert during class and the day than when I wasn’t sleeping at all,” Andrews said.
According to a study that looked at melatonin supplement use in 55,000 people from 1999 to 2018, melatonin use increased from 0.4 percent of survey participants to 2.1 percent. The use of high doses — over 5 milligrams per day — rose between 2005 and 2018.
Mayo Clinic Dr. Naima Covassin — who led the study — believes that her team's findings highlight the need for clinical studies to look at the long-term safety of melatonin use. She also wants to understand whether it can effectively help people with sleep problems.
The University’s Nutrition Counseling Center offers nutrition education and counseling to individuals and families, promoting optimal health and personal well-being. According to University dietitian Gail Sonaty, there are many factors that may be driving more adults to use melatonin supplements.
“It's becoming more available in grocery stores and drugstores and stuff like that,” Sonaty said. “I think it's being promoted as a fairly safe way to help us sleep. I think a lot of people are being pushed to their max but not taking time for self care, and sleep is often impacted by that.”
Sonaty emphasized the importance of focusing on mental, physical and emotional health for University students, as these can influence sleep patterns. She also discussed potential short and long term side effects of using the supplements.
“In general, it's deemed a pretty safe product,” Sonaty said. “The things that we are concerned about with long term usage — there have been some studies that show potential for reduced production of melatonin naturally after long term use of the pill form of melatonin. So the worry would be that our bodies just won't be producing melatonin in the long run by themselves if we keep supplementing.”
The paper by Covassin and her team also raises safety concerns over the supplementation of melatonin by an increasing number of adults in the U.S. The researchers found that these estimates may raise safety concerns, especially given that the actual content of melatonin in marketed supplements may be up to five times higher than the labeled content and that evidence supporting melatonin use for sleep disturbances is weak.
Sonaty recommended some alternative drugs to melatonin for people concerned about potential side-effects, as well as lifestyle changes one can make that avoid drugs entirely.
“Some people think magnesium glycinate can be helpful,” Sonaty said. “The idea is that it's a little bit easier on your digestive tract and stuff like that. I think even more than supplementation, just making sure that you are nourishing your body the way that you need to throughout the day — so eating consistent meals, consistent snacks and getting well balanced meals.”
Another way to improve one's melatonin production naturally may be through reduced phone usage. In a 2015 study on adolescents and college students, researchers at the Rensselaer Polytechnic Institute found that the use of a self-luminous device — such as a phone or tablet — for one to two hours reduced natural melatonin levels in the subjects by 23 to 38 percent.
In an effort to limit her melatonin supplement usage, rising fourth-year Engineering student Bethany Iudica found other routines that aided her sleep.
“Melatonin alone didn't solve my sleeping issues, especially when I started college — although it has been a major player,” Iudica said in an email to The Cavalier Daily. “My improved sleep schedule can be [attributed] to relaxing nighttime activities before bed, melatonin, anxiety meds and staying off of screens at least an hour before bed.”
While it may be ideal to avoid melatonin supplements entirely, melatonin is sometimes helpful for conditions other than sleep. Sonaty explained that it could be a combination of dietary and societal factors fueling this upward trend in melatonin use, but believes researchers should be concerned about what else might be driving the rise in melatonin supplement usage in adults.
“I think that we should be concerned about the reason behind it,” Sonaty said. “Is it increased depression, anxiety? Is it increased screen time? Is it decreased active time? Is it increased consumption of high sugar, high fat foods, which kind of drives that extended energy in our brains?”
In addition, scientific literature on melatonin supplements has mixed results on the effectiveness of aiding in sleep and anxiety.
Melatonin 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, per the National Center for Complementary and Integrative Health. However, with regards to insomnia, the results are mixed. The NCCIH reports that there is not enough strong evidence on the effectiveness or safety of melatonin supplementation for chronic insomnia to recommend its use, and instead, recommends the use of cognitive behavioral therapy as an initial treatment for insomnia.
Similarly, the National Institute for Occupational Safety and Health reports mixed findings on the effectiveness of melatonin supplements. It warns that melatonin supplements are not approved by the Food and Drug Administration, stating that more research is needed in this area.
“Clinical trials on the effectiveness of melatonin for treating disordered sleep have yielded mixed results,” Patrizio said. “A 2020 review of meta-analyses concluded that melatonin results in small but statistically significant improvements in time to sleep onset and total sleep time, but whether these findings lead to improved patient outcomes remains unclear.”
While melatonin supplement use has increased in adults, research indicates that further research is needed before definitive conclusions can be made about its overall effectiveness and potential health risks.