Can Melatonin Help With Sleep and Migraine? What to Know About This Hormone

Can Melatonin Help With Sleep and Migraine? What to Know About This Hormone

When you have migraine, good quality sleep can slip away as easily as migraine attacks can sneak in. Pain and poor sleep — rinse and repeat. What can help end this nightmare? According to research, a natural sleep aid known as melatonin may be able to help with migraine prevention.

What Is Melatonin?

Melatonin is a hormone that's secreted by the pineal gland and regulates the sleep-wake cycle. 

“Melatonin promotes relaxation, reduces alertness, and helps initiate and maintain sleep,” explains Lauren Natbony, MD, medical director, Integrative Headache Medicine of New York. “In addition to its role in sleep regulation, melatonin has antioxidant and anti-inflammatory properties,” she says.

Melatonin supplements can be purchased over the counter, but they’re also available in another place: your own body! It’s possible to boost your body’s own natural melatonin production through diet and lifestyle changes.

Melatonin and Migraine Prevention

But can this sleep hormone help reduce headache frequency or the severity of migraine attacks?

Although commonly advertised as a supplement to help with sleep, research shows melatonin might be an effective migraine preventive. Before exploring how melatonin can improve migraine, let’s revisit the importance of sleep, especially for those with chronic migraine.

Sleep: Trigger, Symptom, and Treatment for Migraine

  

When it comes to migraine, sleep is a jack of all trades. Poor sleep can be both a trigger for and a symptom of migraine, while good, quality sleep can help treat a migraine attack. 

“Sleep is a trigger when it’s irregular: Either too little or too much sleep at inconsistent hours can exacerbate migraine,” says Andrew Charles, MD, director of the UCLA Goldberg Migraine Program in Los Angeles and professor of neurology at the David Geffen School of Medicine at UCLA. “However, when someone has an attack, sleep can be helpful for treatment,” he says. 

Whichever placeholder sleep occupies, its influence is widely felt among those with migraine. 

Melatonin Regulates Processes That Affect Migraine

When you’re managing migraine, you’re also dealing with a host of other issues, such as sleep disorders, hormonal fluctuations, and inflammation. While many biological processes can become entangled with migraine, these issues in particular are directly impacted by melatonin.

Melatonin Influences Circadian Rhythms 

Ever found that staying on your devices at night disrupts sleep? Well, you can thank the pineal gland, which releases melatonin, for that. Melatonin is like a biological vampire, released in darkness and retreating in light. It operates our sleep-wake cycles, aka circadian rhythms, a process that increases alertness during the day and sleepiness at night. 

Unfortunately, circadian rhythms can become disrupted in people with migraine, and melatonin release can be delayed. However, Dr. Natbony notes that “by optimizing the timing of melatonin release, we can potentially reduce the risk of migraine attacks triggered by circadian rhythm disturbances.” 

In order to help restore circadian rhythms to optimal functioning, increase your exposure to natural light during the day and avoid blue light near bedtime. If you do choose to use a melatonin supplement, taking it one to two hours prior to bedtime can also help regulate circadian rhythms.

Melatonin Regulates Hormones

“Hormones play a key role in influencing migraine disease,” says Dr. Charles. “The prevailing hypothesis is that it is due to falling levels of estrogen that happen when estrogen peaks and then falls throughout the month, such as with the menstrual period.”

Fortunately, a potential remedy is nearby, as melatonin also oversees hormone function. “Melatonin helps regulate the secretion of various hormones, including estrogen,” says Natbony. “By promoting hormonal balance, melatonin may help reduce the likelihood of hormone-related migraine triggers.”

Melatonin Is Anti-Inflammatory 

Migraine and inflammation, another closely linked pair, contribute to the neurological disruptions many of us experience. The trigeminovascular system, a branch of nerves responsible for that awful facial and head pain characteristic of migraine, jumps into action when neurogenic inflammation occurs. 

As a result, a protein called calcitonin gene-related peptide (CGRP) floods nearby blood vessels, causing dilation and discomfort. One way this inflammatory cascade is countered is through melatonin, which regulates the release of CGRP.
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 By means of this modulation, melatonin can interfere with trigeminal activation and migraine.
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Additionally, melatonin scavenges free radicals, which are the unstable molecules that increase the risk of developing disease.
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Acting as an antioxidant, melatonin doubles down on its anti-inflammatory properties. “By diminishing inflammation and oxidative stress, melatonin may help prevent or lessen the severity of migraine attacks," says Natbony.

Are Melatonin Levels Lower in People With Migraine?

Given melatonin’s numerous benefits, you may be wondering if something may be amiss in your melatonin levels. It’s possible, although the link between melatonin and migraine is currently unclear.

One study found that people with migraine — especially those with chronic migraine, aura, and a family history of migraine — had lower levels of melatonin than those without migraine. Additionally, this study concluded that decreased melatonin levels were correlated with poorer sleep quality and increased migraine frequency and severity.
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 Folks with medication-overuse headache were also found to have lower melatonin levels than healthy participants.
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However, another study found that melatonin levels in children ages 10 to 18 with and without migraine do not significantly differ.
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It’s possible that low melatonin levels may be a product of frequent migraine attacks and not necessarily a cause, but more research is needed to determine the nature of this relationship.

Melatonin and Migraine: What the Research Says

Studies show conflicting evidence for melatonin as a migraine preventive.
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Compared with a placebo, melatonin was found to significantly reduce attack duration, frequency, and severity. However, compared with amitriptyline (Elavil) — an antidepressant that’s often prescribed as a first-line migraine preventive — melatonin was less effective. On the bright side, researchers found that melatonin has a better safety profile than amitriptyline.
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Similar results were found in another review, which concluded that melatonin is comparable with valproic acid (Depakene).
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 Keep in mind that melatonin dosage may play a factor, though this is up for debate, according to a review published in Cureus.
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Episodic Migraine and Melatonin

For folks with episodic migraine, the evidence is mixed. One trial found that 3 milligrams (mg) of melatonin plus 20 mg of propranolol (Inderal) outperformed placebo.
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 However, the Canadian Headache Society weakly recommends melatonin for those with episodic migraine.
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 And, a review published in Neurology found no significant differences between melatonin and amitriptyline, valproic acid, topiramate (Topamax), propranolol, and placebo.
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Children and Melatonin

According to a trial published in Headache, melatonin is generally well tolerated among children 10 to 17 years old, without serious adverse events.
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As far as efficacy, one study found that melatonin may hold benefits for children and teens with migraine.
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 According to Alexander Mauskop, MD, director and founder of the New York Headache Center, “Melatonin may be effective as an acute treatment for pediatric migraine.”

Although the dropout rate for this study was high, Dr. Mauskop says that “both low and high doses of melatonin were associated with pain reduction.” He also notes that higher doses of melatonin in conjunction with a nap produced greater benefits in this study. A possible reason for this finding may be that sleep can help relieve migraine attacks, especially in children. Due to uncertainty about whether the nap or melatonin helped with migraine relief in this study, more research is needed to determine if melatonin really works as an acute treatment for children with migraine. 

Additionally, another trial involving children found that treatment with melatonin and propranolol significantly reduced headache frequency.
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What Dosage of Melatonin Is Most Effective?

While melatonin doses may vary and the definitive dosage recommendations are still being researched, Natbony recommends a starting dose of 3 mg for migraine. However, higher doses may be necessary for other headache conditions, including cluster headache, she says.

But don’t expect to see results right away. Natbony cautions: “It may take up to three months of therapy to see a benefit.” 

Natbony recommends taking melatonin one to two hours before bedtime. Additionally, she says extended-release tablets may be helpful for people who struggle to stay asleep. 

Conversely, Mauskop believes that “the immediate-release form could be more effective than the sustained-release one.” Further, he says that “it is possible that, unlike with insomnia, a higher dose is more effective for the prevention of migraines.”

It may be tempting to take a higher dose of melatonin if you can’t sleep. Although no definitive maximum dosage has been set, 10 mg is generally the most commonly used in clinical trials.
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If you’re unsure about which type and dosage of melatonin is best for you, reach out to your doctor to discuss.

What Are the Side Effects of Melatonin?

Melatonin is generally well tolerated. If side effects arise, they may include:

  • Sleepiness
  • Headache
  • Dizziness
  • Nausea
The long-term effects of melatonin aren’t fully known. But it may interfere with your body’s ability to produce melatonin, and it could lead to reduced semen quality.
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Can Melatonin Give Me a Headache?

“Headaches caused by melatonin are relatively rare,” says Natbony. If you do find yourself experiencing any side effects, she cautions to avoid excessively high doses. In addition, be mindful when you take melatonin — taking it too early or too late may cause unwanted side effects.

Can I Take Melatonin Every Night?

Natbony states that melatonin is safe when used for short periods of time. In fact, most experts prefer patients to take “melatonin breaks.” Why? 

“It's something that's naturally produced in our brains by the pineal gland, and so, if you're continually supplementing the melatonin, your brain might get used to not making its own,” explains Christine Lay, MD, professor of neurology and founding director of the headache program at the University of Toronto, in her 2019 talk on sleep for the Migraine World Summit. “So you do need to take periodic breaks every few weeks or couple of months,” she says.

Safety Considerations

While melatonin is considered safe, Natbony cautions that melatonin can interact with certain medications, including blood thinners, sedatives, anticonvulsants, and immunosuppressants.

“Speaking with your doctor before starting any supplement, including melatonin, is crucial,” she says.

Additionally, melatonin may not be safe for people with dementia. It may also be more likely to cause sleepiness in older folks than in younger folks. For those breastfeeding or pregnant and considering melatonin, more research is needed.
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A healthcare provider should always be consulted before giving melatonin to children, and dosages should always be administered by adults, as unsupervised melatonin consumption has led to increased emergency room visits.
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Keep in mind that melatonin supplements — and all supplements — lack strict regulation by the U.S. Food and Drug Administration (FDA) in the United States. Therefore, using trustworthy products that have undergone third-party testing is recommended.

More Research Is Needed About Melatonin for Migraine

Though some scientific evidence exists for melatonin as a migraine preventive, more research is needed. Because the aforementioned studies are limited in scope, future studies examining the difference between melatonin doses and its effect on other headache disorders and comorbidities should be considered.

Title: How Melatonin and Migraine Are Connected. Low levels (research shows people with migraine have lower melatonin levels), prevention (melatonin might help as a migraine preventive; evidence is mixed), supplement (consider a supplement under your doctor's supervision), natural approaches (limit screen time, avoid caffeine, go outside, and modify your diet).
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4 Ways to Boost Melatonin Naturally

Whether you’re waiting for melatonin to kick in or are looking for an alternative solution to supplements, there are other, more natural sources of melatonin to help with sleep: 

  1. Diet. Walnuts, goji berries, bananas, and tart cherries are all good sources of melatonin, says Dr. Lay. Warm milk and almonds also contain this sleep-inducing hormone. 
  2. Avoid caffeine. While incorporating certain foods into your diet can increase melatonin, research shows that avoiding caffeine in the evening can help prevent any dips in melatonin levels.
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  3. Limit screen time in the evening. Given that melatonin responds to environmental cues, Natbony advises to “avoid bright lights, especially blue light from electronic devices, as it can suppress melatonin levels.” Some people find that blue light–blocking glasses are helpful to wear in the evening before bed. And green light may help relieve pain and photophobia during migraine attacks, although more research is needed.
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  4. Go outside. Getting your daily dose of sunshine can help regulate your circadian rhythm, which in turn affects melatonin function. Since folks with migraine may be sensitive to light during or in between attacks, don’t forget to wear a hat or sunglasses.

What the Community Says About Melatonin for Migraine

Real-life experiences can be almost as valuable as research. We asked members of the community about their experiences with melatonin. Some said melatonin has improved their migraine:

I take it for my insomnia, and I no longer wake up at approximately 4 a.m. with a migraine that won’t let me go back to sleep. — Krista T.

I wake up with fewer migraines than before. — Karlie S.

But others said melatonin actually worsens their migraine attacks: 

It helps for going to sleep, but it gets worse for my migraines 😭 — Gaby R.

I’ve tried it for migraines and for sleeping, but it increases my migraines. — Mourad

And still others said melatonin does absolutely nothing at all for them: 

So far the 5 mg per night is NOT helping me sleep. Haven’t noticed migraine changes. — Georgia S.

I take it because I have insomnia. It’s never helped my migraines, though. — Anna Belle L.

Final Thoughts

Melatonin is a hormone produced in the brain, but for some people with migraine, melatonin production may be diminished. As a result, this can negatively affect circadian rhythms, hormone function, and inflammation. Taking 3 mg of melatonin for three months may help recalibrate these processes and decrease migraine attacks. Eating certain foods can also boost melatonin production. Though considered a safe and cost-effective treatment for migraine, more research is needed for conclusive results.

Whether you're looking to improve sleep quality or implement an additional migraine prophylaxis, increasing your melatonin levels through diet, lifestyle changes, and/or a supplement could be a simple and helpful addition to your migraine toolbox.