Melatonin in capsules, jellies or drops has taken over bedside tables in Spain. The object of desire is clear: sleep long, fast and well; someone said that sleep is the new sex. Melatonin has been in Spain for years; In 2007, the first sleeping medicine whose active ingredient is melatonin was approved, in doses of 2 milligrams (mg) per tablet. In addition, the marketing of food supplements with this hormone is allowed, provided that the doses do not exceed 1.9 mg. Since then, consumption has skyrocketed, reaching its peak during the pandemic, when pharmacists sold as many as 30 boxes a day. A study published in PIT Already in 2018, it has been warned that more than twice as much melatonin is being consumed in the US than in the previous decade, and scientific evidence points to mild side effects that disappear spontaneously. However, some users talk about nightmares and strange dreams after taking it on social networks. Does melatonin change our dreams?
The hormone of darkness, as the Norwegian journalist Sigri Sandberg calls it in her essay an ode to darkness (Captain Swing, 2022) is secreted in the pineal gland when the brain stops receiving the natural light signal, between three and four in the morning it experiences its moment of glory. Its production declines with age. Among its functions is that it prepares us for sleep by dilating blood vessels and lowering body temperature, although it is also a very powerful antioxidant. The secretion of melatonin is altered by the abundance of artificial light. What we are doing when we take a melatonin pill or gum is supplementing our body’s function that has been altered by a life of excessive light, where there is little difference between day and night, a circumstance that disrupts the secretion of hormones governed by circadian rhythms.
Experts call those pills we take “exogenous melatonin” to distinguish it from what we secrete or should secrete without help. “It is the hormone par excellence involved in the regulation of the wake-sleep cycle, and its primary function is the induction of sleep. Its main synthesis is in the pineal gland, although it is currently known to be synthesized in other organs such as the retina, bone marrow, skin, cells of the digestive tract that produce serotonin, the cerebellum and the immune system,” explains Dr. Alba García-Aragón, a medical specialist at the Sleep Research Institute in Madrid.
“The circadian cycle lasts 24 hours. The start of melatonin secretion coincides with the time of day when the concentration of adenosine, a substance created by brain activity during wakefulness, is the highest, and when it accumulates it causes a feeling of exhaustion. In this way, sleep would be facilitated by the accumulation of adenosine and the progressive weakening of light that leads to the secretion of melatonin,” explains García-Aragón.
A meta-analysis of 19 clinical trials involving more than 1,600 adults and children with sleep disorders found that melatonin reduced the time it took to fall asleep by seven minutes, increased the time spent asleep by 8 minutes, and increased overall sleep quality. It also showed that melatonin helped alleviate short-term insomnia caused by jet lag after travel.
There are as many types of melatonin on the market as there are insomniacs in the world. This variety explains the varied experiences that regular users of this supplement have. Those on the market usually differ in dosage and mode of release. “Each type is prescribed based on the symptoms reported by the patient and according to the results obtained in the previous sleep study. For this reason, it is difficult to say that one melatonin is better than another because each treatment must be individualized,” says the doctor.
use and abuse
There are few studies on the use and abuse of melatonin, and the consulted experts speak of a “lack of long-term quality data”. Dr. Odile Romero, coordinator of the Sleep Unit at Vall d’Hebron Hospital in Barcelona, says she had to withdraw melatonin just because of the headaches. In his clinical experience, he also did not see patients who developed addiction or who had nightmares.
However, some users report such bad dreams. “I stopped taking melatonin the day I dreamed I was an accomplice to murder. It was a very vivid dream, and the victim is a giant from Spain. This is the real testimony of someone who prefers to hide his name, and who claims, contrary to the criteria of several experts, that it was melatonin that caused him, to say the least, strange dreams. Claudia DC bought bottles of 60 2 mg pills on Amazon. He also remembers “disturbing, varied and very elaborate dreams. So many things happened to me that I woke up exhausted, as if I had just returned from a trip.” She went to the doctor and was prescribed extended release melatonin and she stopped dreaming. Anabel V. C started taking it to relieve it jet lag from travel. “I left her because of the nightmares. I prefer to sleep badly”. Months later he tried again with smaller daily doses. “Now I have hyperrealistic dreams all night long, as if it were a movie, but they are not nightmares. It serves me for what I need,” he says. MM takes it every night, but he has his own strategy: “I calculate the time and only take it when I know I have eight hours of sleep, otherwise I spend the whole next day hungover.”
Two people interviewed for this report buy melatonin in the United States to get higher concentrations. In the United States, it is sold as a dietary supplement and is not regulated by the FDA. Here, the European Food Safety Authority considers any dose greater than 2 mg to be a drug, which is why Enrique M. buys 12 mg at any CVS in Miami. – And I take them two at a time, I already notice that a lot of time has passed, but I don’t have nightmares – he says. Yenima. S. also brings them from outside. “I take 5mg. when I have rebellious insomnia, the 1.9 authorized in Europe is of no use to me”.
hangover and sleepiness
Research reports that the most common side effects of melatonin consumption are a feeling of hangover and sleepiness during the day, headache, dizziness, hypothermia and fatigue. “In any case, almost all reported side effects are considered mild or moderate in severity and tend to resolve spontaneously within a few days or immediately after stopping treatment,” points out Dr. García-Aragón.
Can you get addicted to melatonin? Again, there are few studies on this, and those that do exist deny it. While many patients claim that they are addicted. On Tiktok, the hashtag #melatoninaaddict has a million views, and on Reddit forums, nothing else is being talked about. Neither of the two platforms can compete with the clinical trial, but the truth is that both have very active conversations on the subject. dr. Romero is not aware of any physical dependence on melatonin, nor has she found any scientific evidence for it. “But I think there is a placebo effect and many people find it easier to fall asleep by taking certain products with melatonin or other supplements with an anxiolytic profile,” he explains. García-Aragón has not found physical addiction in his counseling either. “That’s why I didn’t notice withdrawal symptoms when I stopped using it,” says this expert, who also noted “a certain psychological dependence in patients under prolonged melatonin treatment.”
García-Aragón indicates that melatonin is only effective when a person has a circadian rhythm disorder. For example, progress or delay in the onset of melatonin secretion or due to insufficient hormone secretion. “If insomnia is chronic, the result of another organic pathology, the original problem that changes the sleep pattern should be solved”. According to his opinion, the most common mistake in the use of melatonin is “chronic consumption without prior testing of melatonin secretion, the only way to know how the internal secretion is regulated”.
The so-called intensive users have been taking increasing doses of hormones for more than five years. Are these practices dangerous? dr. Romero says that she has not noticed “significant side effects” and points out: “There are debates and scientific controversies about whether high doses of melatonin can saturate the MT1 and MT2 receptors, which are responsible for binding with the hormone, and this would reduce its effect.” As a precaution and in the absence of studies supporting the safety of long-term melatonin consumption, Dr. García-Aragón does not recommend maintaining treatment for longer than three months.
Several systematic reviews of studies have attempted to qualify the side effects of long-term melatonin use and indeed found a lack of scientific evidence. Experts believe that the risks of intensive consumption are minimal, but they also warn that there is no quality data to confirm this.
Are we dramatizing hyperrealistic nightmares and blaming melatonin? This study claims that 85% of adults have at least one nightmare per year, and between 4% and 10% of the population have one per week, possibly related to stress. But no work has ventured to assert that nightmares or very vivid dreams can be related to the drug. Until this 2019 review, which listed nightmares as a “rare but serious” side effect of melatonin supplements.
Its authors, who coined the term “melatonin dreams,” believe that bad dreams can be explained by one of the hormone’s proven effects: lengthening the time we sleep.
We dream a lot in REM sleep. A 2004 study showed that people who took 3 mg of melatonin spent significantly more time in this phase where rapid eye and muscle movements occur, and brain metabolism increased by 20%. It is not a phase associated with rest. “Usually, REM sleep starts 90 minutes after you fall asleep, the first period lasts 10 minutes, and then it gets longer throughout the night. In the REM phase, dreams and the worst nightmares occur,” specifies another study from 2021. More sleep can open the door to dreamland. And also nightmares.
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