Thinking About Taking Melatonin? A Sleep Specialist Explains What You Should Know

If you've ever had trouble sleeping, you're not alone. Many people reach for melatonin because it's easy to find, doesn't require a prescription, and feels like a simple, "natural" solution.

But here's an important question: If you need something to help you sleep, what is your sleep trying to tell you?

According to sleep medicine specialist Eric Hernandez, MD, PhD, "Insomnia is often a symptom, not the disease. If you're using something to help you sleep, you may be covering up something more serious that needs to be evaluated."

What melatonin actually does

Melatonin is a hormone your brain already makes every day. Its main role is to help regulate your circadian rhythm.

Dr. Hernandez explains it this way, "I look at it as an alarm clock that tells your brain when it's time to fall asleep. It is not a very good sedative in and of itself, but it helps your brain think that it is bedtime. Your brain does the rest."

This is why melatonin can be helpful for things like jet lag or certain circadian rhythm disorders, but it often isn't a complete solution for people with ongoing sleep problems.

What a new study is raising questions about

A preliminary study presented at the American Heart Association's Scientific Sessions 2025 and summarized by the American Academy of Sleep Medicine is raising questions about long-term melatonin use in people with chronic insomnia.

The study suggests that people with chronic insomnia who used melatonin long-term had higher rates of heart failure, hospitalization, and death compared to similar people who did not use melatonin.

It's important to know:

• This study does not prove that melatonin causes these problems
• The findings are not yet peer-reviewed
• The study only shows an association, not cause and effect

Still, it raises questions that long-term reliance on sleep aids, including melatonin, may signal deeper health issues that shouldn't be ignored.

Why needing melatonin can be a warning sign

People don't usually take melatonin randomly. They take it because something about their sleep isn't working.

Dr. Hernandez compares insomnia to a cough. A cough isn't a disease, it's a symptom. If you just give a person a cough suppressant to treat the cough, but not treat the underlying pneumonia, the real problem never gets addressed.

"If someone needs melatonin to sleep, that's a sign something about their sleep is wrong," says Hernandez.

In other words, relying on melatonin long-term may mask an underlying sleep disorder or health issue that needs proper diagnosis and treatment.

So…is melatonin safe for long-term use?

"This observational study brings up the possibility that it may not be," says Hernandez. "However, based on how melatonin works in the body, I feel that it is safer than almost all other prescription medications for insomnia out there. Your brain already makes melatonin every day. It is not something that your body does not already have exposure to."

But like any supplement or medication, it shouldn't be used as a long-term solution without understanding why you need it in the first place.

"This study brings up the possibility that if you need melatonin, something about your sleep is wrong and that may impact your health," says Hernandez.

When should you talk to a doctor about your sleep?

Dr. Hernandez's advice is simple, "Sleep is extremely important to overall health. If you do not sleep well, you do not stay healthy."

• If you feel like you need melatonin to sleep, talk to a doctor.
• If you are thinking about using some herbal medicine to sleep, consult a doctor.
• If you're not sleeping well, talk to a doctor.

Sleep problems can have many causes, from breathing disorders like sleep apnea, to circadian rhythm issues, to stress, medical conditions, or medication side effects. The right treatment depends on what's causing the problem, not just the symptoms.

"As I mentioned, insomnia is often a symptom, not the disease," says Hernandez. "If a person is having trouble sleeping, there is usually a reason. The treatment depends on the reason."

Expert Sleep Care Close to Home

If you're not sleeping well, you're not alone. And you don't have to figure it out on your own.

Good sleep isn't a luxury; it's a foundation of your health. And while melatonin isn't "bad," needing it regularly can be a sign that something deeper is going on.

CentraCare's Sleep Medicine team can diagnose and treat a wide range of sleep-related disorders. Your doctor may recommend a sleep study as your first step to help identify what's really going on and build a plan that helps you sleep and feel better.