As melatonin becomes increasingly accessible for sleep issues, health experts warn against its overuse and highlight potential risks, especially for vulnerable groups, urging a balanced and informed approach to its use.
Melatonin has become a common answer for people who lie awake at night or wake repeatedly before morning, but doctors warn that the hormone is not a universal fix for every sleep complaint. In Turkey, the Health Ministry’s report on improving health found that 23.7% of adults surveyed said they had a sleep problem, with short sleep making up just over half of those cases. Trouble falling asleep accounted for nearly a quarter, while 16% said they could not sleep at all.
As Dr Merve Gümüşay, a psychiatrist at Moodist Psychiatry and Neurology Hospital, told Habertürk, easier access through pharmacies and the internet has helped fuel the idea that melatonin is harmless simply because it is described as natural. She said it can be useful when the right person takes the right preparation at the right time, but stressed that it should not be treated as a catch-all sleeping pill.
Melatonin is a hormone released mainly by the pineal gland in the brain. Its level rises in darkness and falls with morning light, helping to regulate the body’s sleep-wake cycle and circadian rhythm, the roughly 24-hour internal clock that shapes alertness, sleep and other body functions. Gümüşay said it is better understood as a timing signal than as a strong sedative, which is why the hour it is taken can matter as much as the dose.
Research supports that more limited role. A meta-analysis in the Journal of Pineal Research found melatonin could shorten the time it takes to fall asleep, lengthen total sleep time and improve sleep quality compared with placebo in primary sleep disorders. Even so, the benefits were modest, and the treatment appears to work best for certain problems, such as jet lag, delayed sleep-wake phase disorder and some other circadian rhythm disturbances. For chronic insomnia, behavioural treatment and changes to sleep habits remain first-line approaches.
That distinction matters because melatonin’s reputation as a “natural” product can obscure its risks. Gümüşay said short-term use is usually well tolerated in adults, but side effects can include morning grogginess, headaches, dizziness, nausea, stomach upset and vivid dreams. Less commonly, people may experience low blood pressure, vomiting, cramps, restlessness, irritability, temporary anxiety, confusion and a drop in body temperature. If the effects last into the next day, driving, hazardous work and fall risk all become more important.
Older adults are especially vulnerable because the body may clear melatonin more slowly with age. That can make daytime sleepiness and falls a bigger concern for people who already have low blood pressure, balance problems or several other medicines on board. Another common mistake, Gümüşay said, is increasing the dose on one’s own when the first attempt does not work. Safety data on prolonged high-dose use remain limited, and products bought online may vary widely in strength and ingredients.
There are also important interaction risks. Gümüşay warned that melatonin can intensify drowsiness and impair attention when taken with alcohol or other sleep medicines. It may also interact with some blood thinners, epilepsy drugs, immune-modulating treatments and certain antidepressants. People with liver disease may clear it more slowly, while data for kidney failure are limited. Because safety information in pregnancy and breastfeeding is sparse, medical advice is recommended in those cases too, as it is for anyone with epilepsy, autoimmune disease or serious liver or kidney illness.
The bigger message from specialists is that sleeplessness is sometimes a symptom rather than a stand-alone problem. Depression, anxiety disorders, bipolar disorder, substance use, restless legs syndrome, sleep apnoea, thyroid disease and some medicines can all disturb sleep. If a person needs less sleep but feels unusually energised, speaks quickly and has racing thoughts, the issue may point to mania or hypomania rather than ordinary insomnia. In that setting, simply reaching for melatonin can delay the diagnosis and treatment of a more serious condition.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
