Q: I've been having trouble sleeping. Will taking melatonin supplements help? — Lola K., Richmond, Virginia
A: Trouble falling or staying asleep is incredibly common and can result from stress, lack of exercise, certain medications (SSRIs, beta agonists, decongestants, steroids and more), and poor sleeping conditions, such as too much light or noise, blue light from digital devices in the bedroom, a poor mattress, a too-hot room, sleep apnea or a snoring companion — but that's another story.
If you cannot figure out the root cause yourself, talk to your doctor about your medications' side effects or get a referral to a sleep specialist. Disruption of the cycle is associated with health problems, from depression to diabetes and heart disease.
As for melatonin — it's a hormone produced by your brain's pineal gland in response to darkness. It helps regulate your 24-hour sleep-wake cycle (aka circadian rhythms). It probably has other important functions, such as improving immune function, helping maintain bone strength and mediating menopausal symptoms, but research is still ongoing. We do know that being exposed to light can block the production of melatonin — so your first step is to make sure you're sleeping in a dark room. Nightlights and digital clock dials should be red wavelength light only.
Anecdotally, many people swear by melatonin supplements — but the placebo effect works 30% or more of the time, so that could be a factor. The National Center for Complementary and Integrative Health says that there's not enough strong evidence on the effectiveness or safety of melatonin supplementation. However, melatonin may help for short-term problems like jet lag or anxiety before or after surgery. And the American College of Physicians guidelines strongly recommend cognitive behavioral therapy as the first-line treatment for chronic insomnia. You can find a therapist at www.behavioralsleep.org under the "providers" tab.
(c)2021 Michael Roizen, M.D.,
and Mehmet Oz, M.D,