Yes, you can safely take melatonin the night before your endoscopy.
Based on current perioperative guidelines, melatonin should be continued through the night before surgery, including endoscopy procedures 1. This recommendation is supported by high-quality evidence demonstrating both safety and potential benefits in the perioperative period.
Why Melatonin is Safe to Continue
The Society for Perioperative Assessment and Quality Improvement (SPAQI) explicitly recommends continuing melatonin in their 2021 consensus statement on preoperative supplement management 1. This stands in contrast to many other supplements that require discontinuation 2 weeks before surgery.
Key Supporting Evidence:
Anxiety reduction: A Cochrane review found that preoperative melatonin reduces anxiety compared to placebo and may be as effective as midazolam (a commonly used preoperative sedative) 1
Safety profile: Available evidence demonstrates melatonin is safe in the perioperative period with minimal adverse effects 1
Potential delirium prevention: Melatonin may decrease delirium in hospitalized elderly patients 1, with one cardiac surgery study showing reduced postoperative delirium rates (8.4% vs 20.8%) when melatonin was given the night before surgery 2
No interference with anesthesia: Unlike benzodiazepines, melatonin provides anxiolysis and sedation without significant postoperative impairment of psychomotor performance 3
Practical Considerations
Timing: If you're already taking melatonin regularly for sleep, continue your usual dose the night before. If considering it specifically for preoperative anxiety, typical doses studied range from 3-6 mg taken 60-90 minutes before desired effect 4, 5, 3.
No fasting concerns: Since melatonin is typically taken at bedtime (well before your fasting period for endoscopy begins), there are no conflicts with NPO (nothing by mouth) requirements.
Important Caveats
While melatonin is safe to continue, inform your anesthesia team that you're taking it, as with any medication or supplement. The endoscopy team should be aware of all substances you're taking, even those that don't require discontinuation.
The evidence consistently shows melatonin poses no perioperative risks and may actually provide benefits for anxiety and sleep quality around your procedure 1, 4, 6.