From the Guidelines
Melatonin is not recommended as a first-line treatment for sleep aid due to limited evidence of its efficacy.
Evidence Summary
- The American Academy of Sleep Medicine clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults states that the overall quality of evidence for melatonin is very low due to potential publication bias, heterogeneity, and imprecision 1.
- Meta-analysis of melatonin 2 mg in older adults (> 55 years) showed a small, non-clinically significant effect on sleep quality, with a standardized mean difference (SMD) of +0.21 (CI: −0.36 to +0.77 SMD) 1.
- The guideline notes that there is insufficient evidence to determine the efficacy of melatonin in improving sleep onset, maintenance, or quality, and no adequate data for meta-analysis of adverse effects was available 1.
- Other studies have shown that melatonin has small effects on sleep latency, with little effect on wake after sleep onset (WASO) or total sleep time (TST) 1.
- The use of non-prescription agents, including melatonin, is not recommended due to limited evidence of efficacy and safety, and potential for serious side effects or abuse 1.
- Cognitive-behavioral therapies are recommended as the first-line treatment for chronic insomnia, with pharmacotherapy considered only when necessary and with careful consideration of the benefits and harms 1.
From the Research
Melatonin as a Sleep Aid
The use of melatonin as a sleep aid has been studied in various research papers. The evidence suggests that melatonin can be effective in reducing sleep latency and improving sleep quality in individuals with sleep disorders [ 2, 3].
Dosage and Effectiveness
The effective melatonin doses varied according to each age group, from 0.5 to 3 mg in children, 3 to 5 mg in adolescents, 1 to 5 mg in adults, and 1 to 6 mg in elderly people [ 2 ]. Some studies have found that melatonin can be effective in reducing sleep latency and improving sleep quality, especially in insomnia, jet lag, and sleep disorders in neurologically impaired patients [ 4 ].
Safety and Side Effects
Melatonin has been shown to be well tolerated and have no obvious short- or long-term adverse effects [ 3 ]. Side effects are mild when taking usual doses [ 2 ].
Limitations and Future Research
Despite the potential benefits of melatonin as a sleep aid, there are limitations to the current research. Some studies have noted that the optimal dosage and timing of drug administration is still unclear [ 5, 6,4]. Additionally, further studies evaluating dose-response relationships and drug interactions are warranted [ 4 ].
Key Findings
- Melatonin can be effective in reducing sleep latency and improving sleep quality in individuals with sleep disorders [ 2, 3]
- The effective melatonin doses varied according to each age group [ 2 ]
- Melatonin has been shown to be well tolerated and have no obvious short- or long-term adverse effects [ 3 ]
- Further research is needed to determine the optimal dosage and timing of drug administration, as well as to evaluate dose-response relationships and drug interactions [ 4 ]