A study published in 2018 in Healthcare found that in a study of nearly 20,000 individuals, it was reported that almost 27.3% individuals reported they had some type of sleep disorder. Another more recent study indicates that nearly 33% of adults reported insufficient sleep and short-sleep cycles. With growing economies, increasing labor needs and rising wage challenges, insufficient sleep has grown to become a worldwide phenomenon. In fact, many experts attribute these growing trends to increasing stress levels as a part of a viscious cycle: “It is believed that the relationship between stress and sleep is bidirectional—that is, stress can disrupt sleep and sleep loss can increase subsequent stress level.”
Research has also overwhelmingly indicated that lack of sleep can lead to numerous health detriments, including chronic disease, mental health deterioration and even behavioral disorders.
People are increasingly realizing this problem; with increasingly busy lives, more screen time and poorer sleep hygiene, individuals are increasingly relying on supplements, such as melatonin, to help them sleep more.
A new study published by the American Heart Association late last year found an association between long-term melatonin use and heart failure. Specifically, the study reviewed records of over 130,000 adults who used melatonin for needs related to insomnia or sleep disturbances and found a higher likelihood of being diagnosed with heart failure leading to hospitalization. Though not necessarily a finding of causality, the study calls for more research and awareness into the common and routine use of melatonin by millions of individuals daily.
Melatonin is a hormone that is naturally produced by the body to help regulate the sleep-wake cycle; typically, its levels increase during darkness and decrease during daylight, mirroring natural human circadian rhythms. The hormone binds to MT1 and MT2 receptors, triggering a variety of downstream physiological processes to induce fatigue, sleepiness and a generalized “tone of rest.”
For years, synthetic preparations of melatonin have been available for purchase by consumers over-the-counter and commonly marketed as a sleeping aid or solution for circiadian disturbances. However, as the substance is considered a supplement and not a medicine, formulations by manufacturers often bypass strict regulatory controls. In fact, in Europe and countries in Asia, melatonin cannot be acquired without a doctor’s prescription due to the significant impacts it can have with long-term use.
Another study published last year in the World Journal of Pediatrics found that the long-term effects of melatonin on children are simply unknown, despite skyrocketing use in pediatric populations globally. The study also cites that there is no clear efficacy or safety data which can strongly point towards downstream physiologic and pathologic impacts. Despite a lack of clear data on the safety and prognostic findings, melatonin use in young children is common, underscoring the need for more research in age-specific cohorts. Per a recent literature review, it was found that “the use of melatonin as a sleep aid for children younger than age 6 has increased around the world over the last 20 years, and especially over the last decade. In countries where melatonin requires a prescription, these prescriptions have increased by as much as 500% in some areas. Moreover, the studies showed increases in extended use of melatonin, with young children getting refills two and three years after the initial prescription.”
Fortunately, there has been more awareness and education over the past decade regarding non-medication related interventions to improve sleep for both pediatric and adult populations. Wellness clinics are increasingly emerging across the globe to help institute better sleep routines and methods for patients. New wearbles and activity trackers are including sleep monitoring into their hardware. Even new phone applications have been developed solely for the endeavor of helping users sleep. There is also more research and conversation around this topic. Experts broadly encourage improving sleep hygiene with easy but key changes including maintaining a consistent schedule, a darker environment during sleeping hours, less screen time prior to sleep, and consistent day-time habits that promote more regular circadian rhythms, including caffeine restriction and exercise. Through these methods, the hope is that societal outcomes for sleep efficacy can improve.
