Melatonin Isn’t a Sleep Fix — It’s a Signal: Thoughts from an Integrative Psych NP

Lately, more and more people are turning to melatonin to help them fall asleep. You can find it on every pharmacy shelf, marketed as the natural solution for restless nights. And while melatonin does have a role to play in regulating sleep, the idea that it’s a shortcut or substitute for good sleep habits is where many people go wrong.

As an integrative psychiatric nurse practitioner, I work with patients every day who struggle with sleep. And the truth is, good sleep doesn’t come from a bottle — it comes from balance. Hormones, stress, light exposure, movement, nutrition, mindset — all of it matters. Melatonin can be a helpful tool, but it’s not a magic one.

What Melatonin Actually Does

Melatonin is a hormone your brain naturally produces when it starts to get dark. It’s your body’s signal that night has arrived — a nudge to slow down, power off, and prepare for rest. When everything’s running smoothly, melatonin levels rise in the evening, peak during the night, and fall in the morning as daylight hits your eyes.

The problem is, most of us live in a world that constantly confuses that signal. Screens late at night, stress, caffeine, alcohol, and inconsistent schedules all tell the brain, “It’s not time for bed yet.” That’s when people reach for supplements — hoping melatonin will override the chaos.

And sometimes it helps. Small, well-timed doses can gently reset the body’s internal clock — for example, if you’re jet-lagged or adjusting to shift work. But melatonin doesn’t “make” you sleep. It simply tells your body that night has arrived. If the rest of your system isn’t prepared for that message, it won’t land.

The Problem with “More Is Better”

In America, melatonin isn’t regulated like a prescription drug. That means doses can vary wildly — some gummies or capsules contain far more melatonin than the label claims. And people assume that if one milligram helps, five or ten must help more.

That’s not how it works.

High doses can actually backfire — causing morning grogginess, vivid dreams, or even more disrupted sleep cycles.

In adults, most research supports using occasional 0.5–1 mg about an hour before bed, not the “mega-doses” that have become common to take endlessly.

Think of melatonin like a dimmer switch, not a sledgehammer. The goal isn’t to force sleep but to remind your body that it’s time to rest. When people start taking large doses night after night, they’re usually treating a deeper problem — stress, lifestyle, or poor sleep hygiene — with the wrong tool.

Why Sleep Hygiene Still Comes First

Before reaching for any supplement, I always start by asking: What does your routine look like? 

Because no supplement will fix a nervous system that’s stuck in overdrive or a body that’s out of rhythm.

Here are the basics that still make the biggest difference (and here's an in-depth blog where I detail what it takes to master sleep):

• Consistency is everything. Go to bed and wake up around the same time every day, even on weekends.

• Get real light exposure early in the day. Step outside for sunlight within an hour of waking up — it anchors your body clock.

• Dim lights at night. Especially blue light from screens. Light is one of the strongest signals for your circadian rhythm.

• Keep your bedroom dark, cool, and quiet. It should feel like a cue for rest, not a second office.

• Avoid caffeine after 2 p.m. It lingers in your system longer than most people realize.

• Wind down. Read, stretch, breathe — give your mind a chance to slow down before bed.

Most people don’t have a melatonin problem. They have a rhythm problem. And if you’re staying up late, sleeping in, or scrolling before bed, your brain’s natural melatonin signal never has a chance to sync up properly.

When Melatonin Can Be Useful

There are situations where melatonin makes sense — but they’re usually short-term or targeted:

• Jet lag or travel — to help shift your sleep schedule across time zones.

• Shift work — for those working nights or rotating schedules, to help re-establish a predictable rhythm.

• Delayed sleep phase — when someone naturally falls asleep much later than desired (common in teenagers and people with ADHD).

Even in those cases, melatonin works best alongside behavioural changes: light exposure, meal timing, and consistent wake times.

If you’re using melatonin regularly but still waking up tired, it’s time to look deeper — not just at your sleep, but at your system: stress hormones, diet, inflammation, gut health, or medications that may be interfering.

Be Careful with Long-Term or High-Dose Use

Because melatonin is sold over-the-counter, many assume it’s completely harmless. But that’s not entirely true. Short-term use at low doses is safe for most adults, but long-term data are still limited — especially for people with psychiatric conditions or those on multiple medications.

Some psychiatric medications already affect sleep and circadian rhythm. Add melatonin on top, and you can get unpredictable results — not dangerous, but sometimes counterproductive. Which really suggest we need to consider whether the medication routine is the right one, deprescribing is sometimes the first step to improving wellness.

Melatonin can also interfere with other hormones, particularly reproductive ones. While the research isn’t conclusive, it’s another reason not to treat it as a nightly staple unless a professional has recommended it.

As with any supplement: natural doesn’t mean unlimited.

What I Recommend Instead

When I help patients rebuild healthy sleep from an integrative perspective, melatonin sometimes plays a supporting role — but it’s never the star. My focus is on restoring the body’s ability to create its own rhythm again.

That means:

• Lowering evening stress hormones. Deep breathing, mindfulness, journaling, or gentle stretching can all help.

• Balancing nutrition. Blood sugar swings and caffeine crashes can wreck sleep cycles. A balanced evening meal matters.

• Movement. Regular exercise — especially outdoors — helps anchor circadian rhythms. Just keep intense workouts earlier in the day.

• Checking medication timing. Stimulants, thyroid meds, and some antidepressants can affect sleep; small timing adjustments can help.

• Addressing mental health. Anxiety, trauma, and racing thoughts are often at the root of insomnia. Melatonin won’t touch those.

Once those foundations are set, small doses of melatonin can be layered in for specific goals. The difference is that now, it works — because the body’s system is aligned to respond to the signal.

The Bottom Line

Melatonin isn’t the enemy — it’s just misunderstood. It’s a signal, not a sedative. Used correctly and sparingly, it can help you reset your body clock. Used as a nightly crutch, it can mask what your body is trying to tell you.

If you’re not sleeping, your body isn’t broken — it’s communicating. It’s telling you that something’s off in the system: your stress, your light exposure, your rhythm, your habits. Fix those, and melatonin often becomes unnecessary.

So before upping your dose, dim the lights, step outside in the morning, and treat sleep as sacred. Because no supplement will ever replace the simple, powerful practice of teaching your body — gently and consistently — when it’s time to rest.

If your sleep feels off and you’re tired of quick fixes that don’t work, let’s talk. I work with patients in Missouri, D.C., Maryland, Colorado to create integrative, personalized plans that actually move the needle — not just mask symptoms.

Book a virtual consult (coaching call for those across the U.S) and take the next step toward real, sustainable sleep health.