Melatonin is a hormone that the body naturally produces to regulate the sleep-wake cycle or night and day cycles. However, the melatonin found in supplements is usually synthesized in a laboratory.
The body produces more melatonin when it is dark, which helps signal the body to sleep. On the other hand, when there is light, melatonin production decreases, signaling the body to be awake. Some individuals with sleep difficulties have low levels of melatonin, and taking melatonin supplements is believed to aid their sleep.
Melatonin is commonly used to alleviate insomnia and improve sleep quality in various conditions, such as jet lag. It is also employed for managing depression, chronic pain, dementia, and numerous other conditions. However, most of these uses lack strong scientific evidence.
According to an observational study from Karolinska Institutet in Sweden, the use of melatonin appears to be linked with a reduction in self-harm among young people. The study suggests that medical sleep treatment could be an effective way to decrease self-harm in young individuals suffering from anxiety and depression.
In particular, the study found that the risk of self-harm tended to increase in the months leading up to melatonin prescription, but decreased thereafter, especially among girls.
The findings of the study were published today in The Journal of Child Psychology and Psychiatry.
It is the most commonly prescribed drug for sleep disturbances in children and young people in Sweden.
In recent years, there has been a significant rise in the use of melatonin, and since 2020, it can be purchased over the counter in Sweden.
Dr. Sarah Bergen, who led the study, states that the investigation aimed to examine whether medical sleep treatment could be linked to a decreased rate of intentional self-harm in young individuals due to the well-established association between sleep problems, depression, and self-harm. Dr. Bergen is a docent at the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet.
In Sweden, the study identified more than 25,500 children and teenagers aged 6 to 18 who were prescribed melatonin. Among them, over 87 percent had at least one psychiatric disorder, such as attention-deficit hyperactivity disorder (ADHD), anxiety disorders, depression, or autism spectrum disorder. Girls were five times more likely to self-harm than boys.
To estimate the risk of self-harm while on or off medication, the researchers compared the risk during the last unmedicated month with the twelve months after the initiation of melatonin treatment, accounting for background factors like genetics, sleep disorder severity, or psychiatric disorders that may impact associations.
The study found that the risk of self-harm increased shortly before melatonin was prescribed and decreased by approximately half in the months following the start of treatment. This reduction in risk was especially noticeable among adolescent girls who had depression and/or anxiety disorders.
“There is currently a youth mental health crisis, and the risk of self-harm and suicide is high,” adds Sarah Bergen.
The results “support the hypothesis that sleep interventions may reduce self-harm in this population, especially in girls.”
Since the study was observational, it cannot establish a cause-and-effect relationship between melatonin usage and a decrease in self-harm rates. Additionally, analyses were conducted to verify if the findings could have been influenced by the use of other medications. Even after excluding users of antidepressants, the outcomes were comparable.
This means “melatonin might be responsible for the reduced self-harm rates,” according to first author Dr. Marica Leone, “but we cannot rule out that the use of other psychiatric medications or psychotherapy may have influenced the findings.”
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