What experts say about sleep supplements

Melatonin is among the most popular sleep supplements, with nearly two-thirds of adults saying they've used melatonin to help them sleep, according to a 2023 survey from the American Academy of Sleep Medicine (AASM).

"It's not something that is generally harmful or toxic which is probably why people are tempted to take more when a little bit doesn't work," said Milena Pavlova, a neurologist at Brigham and Women's Faulkner Hospital and associate professor of neurology at Harvard Medical School.

Melatonin is a hormone that's released by the brain in response to darkness, which helps the body begin to shut down for the night, Weeks reports. Synthetic melatonin is readily available at pharmacies and online, but experts warn that, since melatonin isn't regulated by FDA, it's not always easy to know if the product you're buying matches what's on the label.

"We don't actually know what's in it," said Indira Gurubhagavatula, professor of medicine in the division of sleep medicine at the University of Pennsylvania. "It varies pill to pill, bottle to bottle."

And despite melatonin's positive reputation as a sleep aid, it's actually more of a timing hormone. According to Gurubhagavatula, some doctors use melatonin to help patients reset their body's circadian rhythm, and said that, while it can help with sleep, it doesn't necessarily have a sedative effect.

That means the key to success with melatonin is timing and lighting. Pavlova said she tells her patients to figure out how many hours of sleep they need and count backwards, taking melatonin one hour before they should fall asleep. Keeping lights dim, no brighter than a candle, will also help the hormone work.

Another popular sleep aid supplement is magnesium, which is often marketed as a way to increase the effects of melatonin and improve relaxation, Weeks reports.

However, Gurubhagavatula said the evidence published so far hasn't convinced her. A 2023 review published by the Office for Science and Society at McGill University found that magnesium doesn't work as well for sleep aid as its reputation would suggest.

Pavlova agreed, saying that, while magnesium could help some patients who experience migraines, it doesn't seem to make much of a difference when it comes to sleep.

Antihistamines, like Benadryl, are also sometimes used as sleep aids. These medications contain diphenhydramine, which can make people sleepy. Doxylamine, an ingredient found in some antihistamine and insomnia medications, can also help people fall asleep. However, experts say these medications come with a variety of side effects, most notably a hangover-like effect the next day.

"The big problem with antihistamines is they can make people extremely groggy and really impair cognitive function the next day," said Gurubhagavatula. "And while the ingredients in antihistamines can help people fall asleep, they don't promote good quality sleep."

What you can do to help you sleep

According to Pavlova, sleep aids can help provide temporary relief for someone experiencing a stressful life event, but they shouldn't be used on a regular basis.

To get a better night's sleep, you should start by eliminating substances that interfere with your sleep, Weeks reports. For example, alcohol may make it easier to fall asleep, but, according to Pavlova, "you end up paying for it in the second half of the night," because people typically get less consistent sleep and wake up more often after drinking.

Having a cup of coffee in the afternoon could also interfere with your ability to fall asleep. Pavlova said if your bedtime is 10 p.m., you shouldn't have any caffeine past noon.

According to Gurubhagavatula, physical activity — even in small amounts during the day — can help you fall asleep at bedtime.

Overthinking is another major thing that keeps people up at night, Weeks reports. People often bring their problems to bed because it's the first time they've been alone with their thoughts that day, Gurubhagavatula said.

But focusing on problems when it's time for bed can cause stress hormones to kick in, which makes it harder to attain quality sleep. Gurubhagavatula recommends setting time aside during the day to journal or simply think so those thoughts have less of a chance of interfering with your nightly routine.

However, if a person incorporates all those changes and still can't get a good night's rest, they could have a disorder like sleep apnea, Weeks reports. According to NIH, a person has chronic insomnia if they have unexplained trouble falling or staying asleep at least three nights a week for three months or longer.

"Insomnia is sometimes just a warning light," said Gurubhagavatula. "Any time you feel like you can't address it by yourself, reach out to a healthcare provider around you," rather than reaching for a sleep supplement. (Weeks, TIME, 4/10)

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