Long-Term Melatonin Use Linked to Increased Heart Failure Risk, New Research Suggests
Recent research presented at the American Heart Association’s scientific meetings indicates a potential link between long-term melatonin use and an increased risk of heart failure. The study, analyzing data from over 130,000 adults diagnosed with insomnia, found that individuals consistently taking melatonin for a year or more exhibited a significantly higher incidence of heart failure compared to a carefully matched control group.
This finding is notably noteworthy given the widespread and growing popularity of melatonin as a sleep aid.While readily available over-the-counter in many countries, including the United States, the long-term cardiovascular effects of melatonin supplementation have remained largely unexplored – until now.
What the Study Revealed
Researchers, led by Dr. Karan Nnadi, examined de-identified patient data from the TriNetX global health research network. The study included 130,828 adults (average age 55.7, 61.4% women) initially diagnosed with insomnia. 65,414 participants had been prescribed melatonin for at least one year, and were meticulously compared to a control group of individuals who had never been prescribed the supplement.
Crucially, the researchers accounted for a wide range of potential confounding factors - 40 in total – including demographics, pre-existing health conditions (like hypertension and nervous system diseases), and other medications. Even after this rigorous balancing, the association between long-term melatonin use and heart failure risk remained statistically important. specifically, the study tracked electronic medical records for five years following the initial matching, looking for codes related to a new diagnosis of heart failure, and also hospitalizations and mortality related to the condition.
“We found that long-term melatonin use was associated with a higher risk of heart failure, even after balancing for many other risk factors,” explained Dr. Nnadi. A sensitivity analysis,requiring participants to have filled at least two melatonin prescriptions 90 days apart,further validated these findings.
Expert Concerns and the Need for Caution
The study’s findings have prompted caution from sleep researchers. Dr. Marie-Pierre St-Onge, Ph.D., chair of the writing group for the American Heart Association’s upcoming scientific statement on multidimensional sleep health, expressed surprise at the reported duration of melatonin use.
“I’m surprised that physicians would prescribe melatonin for insomnia and have patients use it for more than 365 days, since melatonin, at least in the U.S., is not indicated for the treatment of insomnia,” Dr. St-Onge stated. ”In the U.S., melatonin can be taken as an over-the-counter supplement and people should be aware that it should not be taken chronically without a proper indication.”
This highlights a critical point: melatonin is often self-prescribed, and many individuals may be unaware of the potential risks associated with prolonged use. The ease of access to melatonin as a supplement, without the guidance of a healthcare professional, is a growing concern.
Study Limitations and Future Research
While the study provides valuable insights, researchers acknowledge several limitations. The data source includes countries with varying regulations regarding melatonin prescription, and patient location wasn’t available, meaning over-the-counter use in countries without prescription requirements may be underestimated in the analysis. Furthermore,the study relied on diagnostic codes within electronic health records,which may not always accurately reflect the severity of insomnia or the presence of co-occurring psychiatric conditions like depression and anxiety – factors that could independently contribute to both melatonin use and heart risk.
Dr. Nnadi emphasized that the study demonstrates an association, not necessarily a direct cause-and-effect relationship. “Worse insomnia, depression/anxiety or the use of other sleep-enhancing medicines might be linked to both melatonin use and heart risk,” she said. “Also, while the association we found raises safety concerns about the widely used supplement, our study cannot prove a direct cause-and-effect relationship. This means more research is needed to test melatonin’s safety for the heart.”
key Takeaways & Recommendations
* Long-term melatonin use may be associated with an increased risk of heart failure. This finding warrants further investigation.
* Melatonin is not FDA-approved for the treatment of chronic insomnia. Its use should be discussed with a healthcare professional.
* Self-treating with melatonin for extended periods is not recommended. Address underlying sleep issues with a thorough approach, including behavioral therapies and lifestyle modifications.
* Individuals with pre-existing heart conditions should exercise particular caution. Consult with a cardiologist before considering melatonin supplementation.
Vital Note: This research was presented as an abstract at a scientific meeting and has not yet undergone peer review.The findings are considered preliminary and require confirmation through further, rigorously designed studies. However, the initial
