Please don't comment on whether someone read an article. "Did you even read the article? It mentions that" can be shortened to "The article mentions that".
Sleep aid melatonin is shipped in pills containing ridiculous amounts of the stuff—I’ve seen 10, 12, and 20mg myself, Amazon has a 40mg fast dissolve and 60mg gummies.
This spikes your blood amount with 100x-1000x of your natural cycle of melatonin. Why? Because melatonin is not, repeat not, the signaling molecule that makes you sleepy. It responds to light levels and triggers the cascade of other molecules that make you sleepy, several hours after it peaks. So that's why the 100x overdose—you are trying to kick those secondary mechanisms into overdrive, “hey everyone it is black as the abyss of hell I guess we gotta sleep!!”, because Americans taking melatonin want to pop one just before bed and have it knock them out.
And it does that for like 2 or 3 days before your body starts down-regulating all of its sensitivities to those melatonin byproducts. Nerve cells like to be tickled, not zapped, when you shock them like this they react angrily.
You want to use melatonin to reinforce circadian rhythm and fight jet lag, you do it with amounts in the ~100 micrograms range, slow release if you can find it, and you take that at sunset and let it reinforce your normal cycle. If you're looking for an acute sleep aid, take a walk, get fresh air, drink water, and if those don't help pop a Benadryl/Unisom (it's the same drug either way). If you have doctor’s orders of course follow those, but if you're just trying to self-medicate that’s how you do it.
Absolutely unsurprising that punching your sleep apparatus in the gut once every day for five years increases some sort of stress on your heart.
The other useful thing I learned is that melatonin isn't primarily involved in falling asleep, its main function as a hormone is in staying asleep. I've started taking it sporadically if I wake up in the middle of the night, to make sure I get back to a deep sleep and stay there, and it seems to be super effective for this.
People look at multivitamins and think “more is better”. Unfortunately they are stuffed with ingredients that can’t be absorbed well together, but do result in higher sales…
Are you sure about this? Everything I can find says Benadryl is diphenhydramine, and Unisom is doxylamine. (Both linked to increased dementia risk, for what it's worth.)
https://en.wikipedia.org/wiki/H1_antagonist#First-generation...
For the low dose melatonin, Life Extension brand sells patented MicroActive formula of fast release/slow release melatonin in a 1.5mg dosage and a 6 hour time released 300mcg version. It's a quality brand and those are the dosage ranges I would recommend sticking around.
I have seen the insanely high 30mg+ amounts being sold and that's ridiculous. If you need that much, there's other factors going on. I would look into reducing caffeine intake, doing proper sleep hygiene (google it), and talk to a doctor/get a referral to a sleep specialist if it's an ongoing thing.
But, also look into l-theanine, glycine/magnesium glycinate, valerian root extract, passionflower, lemon balm and things of that sort for occasional sleeplessness or trouble falling asleep. (Visit examine.com & ergo-log.com and search for these ingredients on there to see all the references, how they work, and for more info.)
Natural isn't necessarily better, but I would recommend those any day over Z drugs, antihistamines and a lot of other rx sleep drugs. Make sure you're buying a quality brand though.
Finally, please don't give melatonin to children...
Parents give kids more melatonin than ever, with unknown long-term effects https://arstechnica.com/health/2025/04/melatonin-for-kids-sa...
I also thought this was the case, but everything I've seen suggests that taking melatonin does not alter the natural production of melatonin.
You are correct about everything else though.
These TriNetX studies are usually garbage because they’re entirely dependent on how accurate/up-to-date the medical record is.
The comparison between the US and UK probably leads to two issues - US users use way too much melatonin and swamp heart disease signal, while UK patients prescribed melatonin probably have significant sleep derangement (consider how much effort it takes to get prescribed something for sleep - you need to schedule an appointment, convince your doctor, go to the pharmacy, etc)
Source: https://www.nytimes.com/2025/11/05/well/melatonin-heart-heal...
Regular exercise and a consistent sleep routine (cardio, weight lifting, going to bed early, and waking up early) has been more effective for me.
According to my fitbit, my average sleep duration is 6hr 30min over the last 2 years, down from 7hr30. When I wake up, there's no going back.
The biggest contributor to my reduction in sleep is my job, which in the last few years added stack ranking and by-annual performance reviews which requires daily book keeping of my "company impact".
I also got an echo-cardiogram last week (unrelated) and it came back in top shape (have a calcium score test coming up). Not saying melatonin isn't a risk for cardio health, but as a male in his early 30s with a family history of heart disease, nothing seems to indicate an increase in damage in my case.
The problem here is that they compared people who were already sick enough to need long-term melatonin prescriptions with those who weren’t. That’s not testing melatonin’s effects, it’s just showing that people with serious health problems (like chronic insomnia, depression, or anxiety) tend to have worse outcomes. And surprise, those same conditions are already known to increase heart risks.
Here’s the kicker: in the US, melatonin is over-the-counter. So their "non-melatonin" group probably included plenty of people using it anyway (they just didn’t have a prescription on record).
No info on doses, no explanation of how it might actually cause heart issues, and it’s not even peer-reviewed, it's just a conference abstract. Even the AHA expert they quoted sounds pretty skeptical (but of course, the press release still makes it sound like melatonin is the villain).
Honestly, if you wanted to design a study that would produce misleading results, you’d do exactly this: use observational data, ignore selection bias, and skip adjusting for how severe people’s conditions were. The real takeaway is that people with chronic insomnia have worse health. Groundbreaking stuff (not), applause.
pogue•4h ago