Melatonin: Sleeping Better May Be Costing Your Heart Dearly
It seems harmless, but it may not be. One of the most widely used sleep supplements has just been linked to serious heart risks.
Melatonin is widely known as a "natural" sleep-enhancing supplement, used by millions of people worldwide. It is often seen as a safe, even beneficial option for overall health.
However, a new study raises an important question: could this seemingly harmless habit have long-term impacts on the heart?
Chronic insomnia affects a significant portion of the adult population, and, faced with difficulty sleeping, many people resort to melatonin without a prescription. Despite its popularity, there is still little robust evidence on the effects of prolonged use of this supplement, especially regarding cardiovascular health.
To investigate this possible relationship, researchers analyzed data from a large international database of medical records, including adults diagnosed with insomnia. They compared two groups: people who had used melatonin for at least one year and people with insomnia who had never used the supplement.
To ensure a fair comparison, the groups were carefully balanced considering factors such as age, pre-existing conditions, medication use, and lifestyle.
Participants were followed for five years, during which time scientists observed the development of heart failure, heart-related hospitalizations, and overall mortality. This type of study allows for the identification of important associations in large populations, even if it does not directly prove a cause-and-effect relationship.
The results were noteworthy. People who used melatonin long-term had a significantly higher rate of heart failure compared to those who did not. Furthermore, hospitalizations for heart problems were much more frequent among users of the supplement, and overall mortality was also higher in this group.
Even after further analysis to confirm the consistency of the data, the results remained similar. This reinforces the possibility that prolonged melatonin use is associated with risks that are not yet fully understood.
It is important to emphasize that this type of study does not prove that melatonin directly causes these problems. However, the findings are sufficient to question the idea that the supplement is completely harmless, especially when used for long periods without medical supervision.
Therefore, the researchers advocate for the need for more rigorous clinical studies to better understand this relationship. In the meantime, melatonin use should be approached with caution, taking into account professional guidance and individual risk-benefit assessment.
READ MORE:
Effect of Long-term Melatonin Supplementation on Incidence of Heart Failure in Patients with Insomnia
Ekenedilichukwu Nnadi, Maureen Masara, Rita Offor, Selin Unal, Rebhi Rebah,
Muhammed Atere, Bisrat Nigussie, and Suzette Graham-Hill
Circulation. The American Heart Association's. Volume 152, Number Suppl_3
Abstract:
Chronic insomnia affects up to one-third of adults, and over-the-counter melatonin is increasingly promoted as a “cardiometabolic-friendly” sleep aid. Robust data on its long-term cardiovascular safety are lacking. We queried the TriNetX Global Research Network for adults ≥ 18 years with an insomnia diagnosis (ICD-10 F51.0). The exposed cohort required ≥ 1 melatonin prescription and ≥ 365 exposure-days; controls had no melatonin exposure. Patients with prior heart failure (HF) or other prescription hypnotics were excluded. Propensity-score matching (1:1, caliper 0.1) balanced 65, 414 melatonin users with 65, 414 controls on demographics, 15 comorbidities, concomitant cardiometabolic drugs, laboratories, vitals, and health-care utilization (all post-match standardized mean differences < 0.02). Outcomes were assessed 5 years after the index date. The primary endpoint was incident HF (ICD-10 I50.). Secondary endpoints were HF hospitalization and all-cause mortality. Hazard ratios (HR) were obtained from stratified Cox models. During 5-year follow-up, incident HF occurred in 3,021 melatonin users (4.6%) versus 1, 797 controls (2.7%), corresponding to an HR of 1.89 (95% CI 1.78–2.00) and an absolute risk difference of 1.9% (p < 0.001). HF-related hospitalization occurred in 12, 411 users (19.0%) and 4, 309 controls (6.6%)—HR 3.44 (95% CI 3.32–3.56). All-cause mortality was higher in melatonin users (5, 118 [7.8%] vs 2, 820 [4.3%]; HR 2.09, 95% CI 1.99–2.18). Results were consistent in sensitivity analyses requiring ≥ 2 melatonin fills ≥ 90 days apart (HR for HF 1.82). In a large, multinational real-world cohort rigorously matched on >40 baseline variables, long-term melatonin supplementation in insomnia was associated with an 89% higher hazard of incident heart failure, a three-fold increase in HF-related hospitalizations, and a doubling of all-cause mortality over 5 years. These findings challenge the perception of melatonin as a benign chronic therapy and underscore the need for randomized trials to clarify its cardiovascular safety profile.
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