Does long-term melatonin use raise the risk of heart failure? A new study suggests a link, but it does not prove causation. Researchers presented findings at the American Heart Association’s Scientific Sessions that show a higher incidence of heart failure among adults with chronic insomnia who took melatonin for at least 12 months.
Researchers tracked over 130,000 adults with insomnia, comparing those who used the supplement for at least a year against similar individuals who did not. The results showed a significant difference in outcomes over a five-year period. The data indicated that melatonin users had a 90% higher risk of developing heart failure compared to non-users. Additionally, hospitalization rates for the condition were nearly triple in the melatonin group.
The numbers paint a stark picture. Among those using the supplement, 4.6% developed heart failure, and 19% required hospital care. In the non-user group, only 2.7% were diagnosed with the condition, and 6.6% required hospitalization. Deaths from all causes were also higher among the melatonin group, at 7.8% compared to 4.3% in the control group. These figures have sparked concern among consumers who often view the supplement as a harmless sleep aid.
It is important to understand that this study identifies an association, not a direct cause-and-effect relationship. The researchers could not account for every variable that might influence both sleep patterns and heart health. For instance, people with more severe insomnia may have underlying health issues that increase their risk regardless of melatonin use. Depression or anxiety could also play a role, as these conditions are linked to both sleep difficulties and cardiovascular problems.
Another factor complicates the findings. The researchers noted that early, undiagnosed heart problems might affect sleep, potentially leading someone to start taking melatonin after the underlying health issue had already begun. To test this theory, analysts looked at data from the National Health and Nutrition Examination Survey (NHANES). That analysis did not find a statistically significant increase in heart disease or heart failure among recent melatonin users after accounting for depression and sleep problems.
This contrast between studies highlights a common challenge in medical research. One dataset shows a concerning trend while another, using different methods and populations, finds no significant link. This discrepancy suggests that the relationship between long-term melatonin use and heart health is more complex than a simple “take this supplement and you will have a heart attack” narrative. The evidence remains mixed, requiring further investigation to determine if the supplement itself poses a risk or if the connection is merely a correlation with other health factors.
Given the uncertainty, experts recommend a cautious approach to melatonin. The National Council on Aging (NCOA) suggests that people who rely on nightly melatonin should consider evidence-based alternatives. Sleep hygiene, which involves keeping a consistent schedule and avoiding late caffeine, is a foundational step. Regular exercise earlier in the day can also help regulate the circadian rhythm without the potential unknowns of a supplement.
For those struggling with persistent insomnia, cognitive behavioral therapy for insomnia (CBT-I) is often recommended. This structured therapy typically lasts 6 to 8 weeks and is considered the gold standard for treating chronic sleep issues. While melatonin may be appropriate for short-term situations like jet lag or shift work, its long-term use as a daily sleep aid is not currently supported by strong evidence. Anyone concerned about their sleep or heart health should consult a healthcare professional before continuing a regimen.
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