The COVID-19 pandemic continues to affect the quality of sleep of some individuals due to the reported side effect of the virus for some, plus the anxiety and depression that the uncertain environment may bring. But experts warn that the easily accessible melatonin supplements should not be taken on a whim.
Since the start of 2022, Google Trends showed an increase in the number of people searching for melatonin, coinciding with the rise of COVID-19 infections in the country. The top related queries to the topic include its side effects and how it helps us in getting better sleep.
Many believe that melatonin is a sure-fire remedy for sleepless nights, that when you pop the pill in your mouth, it acts as a sleeping pill that will make you fall asleep in no time. But it’s more than just a simple nod-off aid.
Melatonin is actually a hormone in our brains that helps us know when it’s time to sleep and wake up. It has long been linked to our body’s sleep-wake cycle, which repeats every 24 hours.
This hormone is closely related to our body clock since it acts as a circulating messenger on night shift. Neuroscientist and sleep expert Matthew Walker in his book Why We Sleep: Unlocking the Power of Sleep and Dreams described melatonin as a “vampire hormone” that’s more active at night.
“Melatonin has other names, too. These include ‘the hormone of darkness’ and ‘the vampire hormone.’ Not because it is sinister, but simply because melatonin is released at night,” said Walker.
The neuroscientist even went on to describe melatonin as a “powerful bullhorn shouting out a clear message” to our brain that it’s dark.
“It helps regulate the timing of when sleep occurs by systemically signaling darkness throughout the organism. But melatonin has little influence on the generation of sleep itself: a mistaken assumption that many people hold,” said Walker.
While melatonin functions as our nightly reminder to sleep, there are some cases that an added help in the form of a supplement may come in handy. The question is, what’s the right way of using melatonin and why shouldn’t it be viewed as a mere sleeping pill?
How does melatonin function in our body?
For starters, melatonin is a pea-sized hormone produced by the pineal gland in our brains. The gland remains inactive during the day, and it floods the brain with melatonin as it gets dark. As levels of melatonin rise, the cortisol hormone slows down and our body prepares for bedtime.
“The daily rise of melatonin secretion correlates with a subsequent increase in sleep propensity about two hours before the person’s regular bedtime. The time before this secretion is the least likely for sleep to occur, and when it starts, the propensity for sleep increases greatly as the ‘sleep gate’ opens,” a study from Psychiatric Times said.
Melatonin acts as a switch to remind us that it’s time to sleep. However, longer day cycles and aging can throw off its production.
This is where melatonin supplements come in, which comes in synthetic and natural forms. However, it’s best to consult a doctor or sleep specialist to decide which supplement works for you.
“There are some clinical uses for it, but not the way that it’s marketed and used by the vast majority of the general public,” University of California, Los Angeles professor of medicine and psychologist Jennifer Martin told The New York Times in the story "Melatonin Isn't a Sleeping Pill."
Not a primary cure for sleep disorders
While over-the-counter melatonin supplements come in pills, chewables, or liquids, there’s no guarantee that it addresses underlying health problems that disrupt our sleep.
“You have to consider that not all melatonin supplements have the same quality,” said Dr. Keith Aguilera, president of the Philippine Society of Sleep Medicine Inc. “There was a study done in the US which identified the level of melatonin. Some of them can be very potent or a high level of concentration, and there are some supplements that don’t contain any melatonin.”
A study from the US National Center for Integrative Health said there’s no strong evidence on the safety of melatonin for chronic insomnia. Meanwhile, Aguilera added that while melatonin is effective for some, it shouldn’t be used as a one-size-fits-all type of supplement.
Another study from the Journal of Clinical Sleep Medicine found that the melatonin content of more than 70% of supplements varies from what their label claims. It also revealed that the concentration ranged from 83% less than the amount that was listed on the item.
To add, Menlo Park Psychiatry & Sleep Medicine founder Alex Dimitriu, M.D. told online health platform Mindbodygreen that he doesn’t recommend doses over three milligrams, as it may affect the body's ability to naturally produce melatonin.
Meanwhile, Northwestern University Feinberg School of Medicine assistant professor Dr. Sabra Abbott told The New York Times that some patients also would complain that melatonin “didn’t work,” with some even feeling “hungover or groggy the next morning.”
As a result, Aguilera strongly urges people to consult a doctor or sleep specialist before buying over-the-counter melatonin supplements.
“It’s better for a doctor to guide them on whether to use melatonin [supplements] or not, kasi what if hindi pala siya effective? Or you’re dealing with medical ailments na pala.”
People who are dealing with insomnia and having trouble falling or staying asleep are considered symptoms of chronic insomnia. To add, anxiety, depression, sleep apnea, restless legs syndrome, and other sleep-related disorders require medical treatment—to which melatonin might not be considered as a sure-fire cure.
Does melatonin prevent COVID-19?
Aguilera also said there’s no strong amount of evidence that supports a claim that melatonin is a suitable treatment for COVID-19.
“There’s also no evidence that it helps in boosting our immune system. Hindi naman siya ganoon. Unlike Vitamins C and D, wala rin siyang significant improvement in helping our immunity. For me, there’s a lack of evidence especially if you look at COVID-19 itself since there are many factors with that. Our immune system has something to do with the proper amount of sleep, nutrition, and exercise,” he added.
“Sadly, there are some who market melatonin and other medications as a ‘magic bullet.’ There’s no such thing as a ‘magic bullet’ to everything, since it has something to do with the lifestyle of the patient itself,” said Aguilera.
Aguilera said that having a healthy lifestyle and improving our sleep patterns may better help in boosting our immunity instead.
Getting better sleep—especially during the pandemic
While melatonin acts as our body’s sleep alarm, it’s not considered as a mere sleeping pill. Instead, the World Sleep Society suggested these 10 tips to become a successful sleeper:
- Establish a regular bedtime and waking time.
- If you are in the habit of taking siestas, do not exceed 45 minutes of daytime sleep.
- Avoid excessive alcohol ingestion four hours before bedtime, and do not smoke.
- Avoid caffeine six hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.
- Avoid heavy, spicy, or sugary foods four hours before bedtime. A light snack before bed is acceptable.
- Exercise regularly, but not right before bed.
- Use comfortable, inviting bedding.
- Find a comfortable sleep temperature setting and keep the room well ventilated.
- Block out all distracting noise and eliminate as much light as possible.
- Reserve your bed for sleep and sex, avoiding its use for work or general recreation.
Meanwhile, Aguilera advised those with prolonged sleeping problems to consult a doctor or sleep expert to know which treatment works best. He also said that good sleep is not about how long you sleep, but more about the quality that will help you stay rested for the following day.