Sleeping Medication: How It Should Be Used and What Its Risks Are

Over the counter melatonin may not be what you should reach for first if you are looking to get better sleep. Tero Vesalaine/Shutterstock

Sleeping medication can help adjust people’s sleep schedule to sleep; however, there are limits and risks associated with such treatment, especially when used without the guidance of a sleep professional or general practitioner.

Studies have shown that melatonin tablets don’t always contain only melatonin, and the label’s dosage isn’t always accurate. In addition, some people are more sensitive to sleeping medication, which may affect them the following day, interfering with their work.

In an email to The Epoch Times, the Director of the Centre for Sleep Science at the University of Western Australia, Jennifer Walsh, PhD, said that medication such as melatonin can help reset a sleep schedule. However, she noted that it should only be taken under the guidance of a sleep professional.

Sleep Health Foundation Board Member and Senior Sleep Scientist in the Adult Sleep Laboratory at Newcastle’s John Hunter Hospital, Gemma Paech, PhD told The Epoch Times that melatonin essentially signals to the brain when tired. She said that many of the medications used for sleep are either melatonin and sedating drugs or sleeping tablets to help individuals sleep at night.

“Both of these things have more short-term temporary uses, particularly sleeping tablets.”

Ineffective In the Long Term

Paech said that sleeping medications are being shown to not be effective in the long term. She said that if people are struggling with insomnia-type symptoms, behavioural treatments are the gold standard and avoiding medication is ideal.

“When it comes to melatonin is really dependent on the time of day that people take it, and so a lot of the times, who will take it at nighttime, but maybe they don’t necessarily need it at nighttime.”

“It really works best when your body is not producing enough melatonin or at the right time.”

Paech said that melatonin, when used in conjunction with light exposure, can be beneficial in shifting body clocks to different time schedules. She said this is handy in the event of an overseas holiday; however, sometimes melatonin is not quite as effective; for instance, it might be less effective for day workers who sleep at night.

She said that some people could be quite sensitive to melatonin, which might result in the melatonin they took at night carrying over into the next day and making them sleepy.

“You can have some negative effects a lot of the time with melatonin as well,” Paech said. “If people buy over the counter online and those sorts of things.”

“If it’s not a controlled thing from your GP, you really just don’t know what’s in the tablets.”

Health workers prepare to destroy fake medicines seized in Beijing on March 14, 2013. A man in Shandong survives after taking 200 fake sleeping pills. STR/AFP/Getty Images

Unknown Contaminants and Unreliable Dosages

Paech said that there are a lot of studies that have looked at what is actually in over-the-counter melatonin supplements and found that they do not only contain melatonin but all kinds of different things.

“A lot of the times, the dosage that’s written on the label is not anywhere near close to the dosage that’s actually in the tablet.”

“If people do feel like they need to some melatonin or another sleeping medication, they really should be getting that on a prescription from their doctor,” she said.

A Pharmacy in the southside of Brisbane is seen on May 14, 2015 in Brisbane, Australia. Bradley Kanaris/Getty Images

Action by the Therapeutic Good Administration (TGA)

In an email to The Epoch Times, the TGA said that melatonin was included in Schedule 3 —Pharmacist Only Medicine— of the Poisons Standard on June 1, 2021. This made melatonin available from pharmacies, for therapeutic use, without a prescription in most of Australia’s states and territories.

The TGA said that supplying melatonin without a prescription is only permitted for treating primary insomnia in patients over 55 years of age. In addition, the tablets supplied under such conditions can only contain 2mg or less of melatonin and must come in packs of 30 tablets or less. The administration said that melatonin remains a prescription-only medicine for any other use.

“For melatonin preparations to be supplied legally, they must be evaluated and registered by the Therapeutics Goods Administration (TGA) before supply in Australia,” the TGA said, noting that medicines registered by the TGA will have an Australian Register of Therapeutic Goods identification number, which appears as “AUST R” followed by numerals on the main panel of the medicine packaging.

“If a medicine does not have an AUST number on the label and has not been assessed by the TGA, it is difficult to know the contents and formulation of such medicines.”

The TGA noted that falsely manufactured, packaged, or advertised products can be subject to criminal and civil penalty provisions under the 1989 Therapeutic Goods Act.

“Suitably authorised compounding pharmacies can prepare melatonin formulations for individual patients holding a valid doctor’s prescription and adhering to professional guidelines of the Pharmacy Board of Australia,” the TGA said.

“These medicines, when compounded for individual named patients, can be exempt from the requirement to be registered by the TGA.

“Consumers who are concerned about counterfeit or unapproved medicines or who suspect they have seen or bought unapproved, unsafe or counterfeit goods can report the matter to the TGA via our website.”

Additionally, they would encourage anyone who has concerns or is unsure how to use a medicine to contact their pharmacist or health professional.