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“Sleep disorders are a really broad church,” explains Paterson. However, melatonin supplementation is unlikely to work unless you have a specific circadian rhythm sleep disorder which are a group of disorders tied to dysfunctions or misalignments with the body’s internal clock ​​.Īlastair Paterson, a specialist clinical pharmacist with a particular interest in sleep, says: “Unless somebody has a problem with their natural secretion of melatonin or the natural pathways in the brain that cause that melatonin release, it’s probably not that helpful.” “To use melatonin most effectively, you really need to know when the midpoint of night-time sleep is … because if you give melatonin at the wrong time, you often make things worse in a circadian disorder.” Generally, the advice is to take melatonin one to two hours before bedtime, but Espie says, in some cases, that people may need to take it four to six hours before going to bed. “It’s not a blunt instrument, like a sedative, as it intervenes with the timing mechanisms of the sleep-wake cycle,” says Espie. It’s not a blunt instrument, like a sedative, as it intervenes with the timing mechanisms of the sleep–wake cycle Colin Espie, professor of sleep medicine at the University of Oxford Unlike hypnotics, such as zolpidem, taking additional melatonin in the form of a medicine does not work by making you drowsy but by telling the body that it is approaching the time for sleep. The body produces melatonin just after it gets dark, with levels of the hormone peaking in the early hours of the morning and reducing throughout the day although, the amount of melatonin we produce overall declines gradually over our lifespan ​​. “Now, there haven’t been other new drugs in the market, so have gone to off-label low-dose sedative antidepressants, and even tranquilisers are being used.”īut it is not just the powerful sedatives that should be approached with caution, an increasing reliance on the chronobiotic melatonin - a seemingly innocuous hormone that occurs naturally in the body - has long been a cause of concern among sleep experts. “If you look back over the years, you’ll see barbiturates dropping and benzodiazepines coming up, then benzodiazepines dropping and BzRAs coming up,” says Espie.

Over the years, many drugs have been hailed as effective treatments for sleep problems however, as more is understood about how they work, questions often start popping up about safety. But up to half of us will experience insomnia at some point in our lives. There are four things we need in life, says Colin Espie, professor of sleep medicine at the University of Oxford: oxygen, food, water and sleep. Journal of Pharmaceutical Health Services Research.

International Journal of Pharmacy Practice.Antimicrobial resistance and stewardship.