Should you pop a melatonin pill?

As a naturally occurring hormone in the human body, melatonin tells us when it’s time to sleep. The brain’s pineal gland produces this hormone in response to darkness and keeps in check the body’s circadian rhythm, or sleep cycle. Melatonin levels in our blood spike for about 12 hours during the night. Interestingly, a 2019 Fitbit report said India was the second most sleep- deprived among 18 countries surveyed.

For people with sleep disorders, melatonin is available in the form of drugs. While melatonin pills are synthetic, their chemical composition is the same as the hormone. But is it wise to take it as a drug supplement?

“At the moment, it is more popular outside. In India, it’s not that popular because physicians have a natural tendency to prescribe other medications. In that sense, melatonin is not being used in higher numbers by Indian patients," says Vikas Maurya, director and head, pulmonology and sleep disorders, Fortis Hospital, Shalimar Bagh, Delhi. “Another issue is its availability. It is not available everywhere. It is not an OTC (over the counter) drug, it is a prescribed drug since it is a hormone. The patient needs to satisfy all criteria before it can be prescribed."

Dr Maurya explains that melatonin is mainly used by insomnia patients as a sleep inducer. It is also used by many across the world to tackle jetlag. “It is used for insomnia but not as the first line of drug. Maybe as the second or third line (option) drug after using other medication," he adds.

According to an article on the US’ National Sleep Foundation website, the correct dosage, method and time of day melatonin is taken must be appropriate to an individual’s sleep problem if it is to help. “Taking it at the ‘wrong’ time of day may reset your biological clock in an undesirable direction. How much to take, when to take it, and melatonin’s effectiveness, if any, for particular sleep disorders is only beginning to be understood," the article explains. The National Sleep Foundation is a Washington-based health non-profit that works on healthy well-being and sleep education.

A 2019 Time magazine article, titled “Is Melatonin Safe To Take Every Night?", argued that melatonin is “very safe if taken in normal doses"—between 0.5mg-5mg. But it did say it was still advisable to tread a cautious line since melatonin is a hormone, and cited certain “contradictory findings". “While some research has found that melatonin may help treat hyperglycemia in people with diabetes, for example, other studies have shown that, in diabetes, patients who carry certain genetic traits, melatonin may interfere with glucose regulation."

“It’s a natural hormone, that’s why it is different from other sleeping medicines," says Dr Maurya. Could melatonin-rich foods like asparagus and tomatoes be an option? Dr Maurya believes these foods won’t be as effective as drugs. “They have much less of an effect compared to the drugs. But it depends on the dosage." So, the jury is still out on this.