Melatonin supplements for treating sleep disorders have grown in popularity over the past few years. But is their consumption safe? Health professionals doubt it.
Posted at 12:00 a.m.
“Patients are often told by their neighbor, their uncle or their friends to try it. But it is neither a sleeping pill nor a miracle drug. The largest studies show that it reduces the time it takes to fall asleep by 7 to 20 minutes. That’s not going to solve your sleep disorder,” says pharmacist Yann Gosselin-Gaudreault straight away.
PHOTO MARCO CAMPANOZZI, THE PRESS
Despite its limited effects, sales of melatonin have exploded in recent years.
Between 2018 and 2022, Quebec has seen a marked growth in melatonin sales. During this period, the value of sales increased by more than 50%, according to partial data from the Quebec Association of Pharmacy Distributors.
Melatonin, a hormone naturally secreted by the brain in the dark, helps prepare the body for falling asleep. Marketed from the 2000s, melatonin supplements, inexpensive and natural, seemed to be the miracle solution against sleep disorders. However, studies on their effectiveness have proven to be less conclusive than expected.
A positive impact of melatonin is observed in connection with jet lag, circadian sleep rhythm disorders or to reduce anxiety before surgery. However, there is little “strong evidence on its effectiveness or safety” for treating chronic insomnia, the US Institutes of Health state on their website.
Boom in children
Despite its limited effects, sales of melatonin have exploded in recent years. This strong enthusiasm is also felt among the youngest. Between 2012 and 2021, the United States noted a 530% increase in melatonin consumption among children. The experts consulted by The Press also observed an upward trend among youth in Quebec.
Since melatonin is very accessible and talked about a lot, people tend to give their children more of it.
The Dr Christophe Moderie, resident in psychiatry at McGill University
Strawberry, cherry, pomegranate: melatonin supplements come in many shapes, colors, and flavors. They can be attractive to toddlers. In the last two years, the Center antipoison du Québec has noted a 50% increase in exposure to melatonin in children, with 480 cases in 2019, 660 in 2020 and 720 in 2021. Half of the cases were aged 5 years or less. In 2022, less than 1% of reported cases were deemed moderate or severe, and none resulted in death.
Melatonin may be beneficial in little ones, especially those with attention deficit disorder and autism spectrum disorder. “However, keep in mind that melatonin can help reduce sleep problems in children, but will not be effective in all situations,” says François P. Turgeon, assistant clinical professor at the Faculty of Pharmacy of ‘Montreal university.
Furthermore, since melatonin is a hormone, “it is possible that melatonin supplements affect hormone development, including puberty, menstrual cycles and overproduction of the hormone prolactin, but we are not sure”, can -we read on the website of the American Institutes of Health.
The Dr Moderie therefore recommends not administering melatonin to young people without first meeting with a pediatrician, family doctor or health care professional.
Very high doses
PHOTO DMITRIY SHIRONOSOV, GETTY IMAGES
The doses of melatonin sold in Quebec are between 5 and 10 mg, while our brain naturally produces 0.00006 mg of melatonin per millilitre.
Unlike Canada, some countries prohibit the sale of melatonin without a prescription, including Switzerland, Denmark, the Czech Republic and the United Kingdom. In Germany and Belgium, melatonin is considered a drug from 0.3 mg. In France, the regulations authorize the free sale of supplements of less than 2 mg of melatonin per day.
The doses sold in Quebec are often much higher.
We are talking about a dose of 5 to 10 mg. It is much more than what is secreted in a natural way.
The Dr Christophe Moderie, resident in psychiatry at McGill University
At its peak of production, in the middle of the night, our brain produces 0.00006 mg of melatonin per millilitre. “We are not even in the same unit of measurement”, underlines the doctor.
Studies on the long-term use of melatonin remain limited. “It’s a big problem, especially at such high doses as you can find at the pharmacy,” says Dr.r Moderie.
Reliable labels…really?
Since melatonin is considered a natural product rather than a drug, there is a lot of variability between different tablets, different companies and different production lots, says Dr.r Moderie.
In 2017, an Ontario study evaluated 30 commercial supplements, including different brands and forms sold in Canada. The melatonin content in the tablets was found to be up to 478% higher than the content stated on the label.
Furthermore, the batch-to-batch variation in a given product could be as high as 465%. For the authors of the study, manufacturers absolutely must strengthen controls to ensure that melatonin supplements correspond to what is written on the label.
An “easy fix”
Melatonin is sometimes “the easy solution” to treat sleep disorders, observes Dr.r Moderie, who recommends favoring behavioral measures instead. Among other things, he suggests not using devices that emit blue light, such as smartphones or computers, at least an hour before bed, avoiding caffeine starting in the afternoon, and taking physical activity during the day.