Black Health
Endogenous hormone (sold as dietary supplement in US) Jet lag Delayed sleep phase disorder Insomnia (off-label) Shift-work sleep disorder

Melatonin (Natrol, Nature Made, various OTC brands) and Black patients

Brand names: Natrol, Nature Made, various OTC brands

Last reviewed: Sources checked:

What Melatonin does

Melatonin is a hormone made by the pineal gland that regulates the sleep-wake cycle. In the US it is sold as a dietary supplement (not FDA-regulated as a drug), so quality and labeled dose accuracy vary widely between brands.

What the evidence says for Black patients

Melatonin works modestly for jet lag and delayed sleep phase. Evidence for chronic insomnia is weak. Two equity-related points:

  • Shift-work exposure. Black Americans are over-represented in shift-work occupations (healthcare, food service, transportation). Melatonin is a reasonable, low-risk adjunct to behavioral sleep-hygiene strategies for shift-adjusted sleep.
  • Product quality concerns. A 2023 JAMA study (Cohen et al., JAMA 2023;329:1402–4) found melatonin gummies contained 74–347 percent of labeled dose and some contained unlabeled cannabidiol. Patients should choose USP-verified or NSF-certified products and start at low doses (0.3–3 mg). Gummy melatonin should be kept away from children — US pediatric melatonin poisoning calls increased 530 percent from 2012 to 2021 (Lelak et al., MMWR 2022).

Common alternatives

Cognitive behavioral therapy for insomnia (CBT-I) — first-line per ACP. Low-dose doxepin (3–6 mg), ramelteon (prescription melatonin agonist), trazodone. Environmental changes (blackout curtains, screen reduction).

Side effects

  • Drowsiness next morning
  • Headache, vivid dreams
  • Dizziness
  • Interactions with sedatives, alcohol

Factors that affect adherence

Take 30 minutes to 2 hours before bed. Low doses (0.3–3 mg) often work as well as high doses (5–10 mg) and cause fewer next-day effects. Choose USP-verified products. Keep out of reach of children.

Questions to ask your doctor

Bring this list to your next appointment.

  • Is CBT-I available to me before we try supplements?
  • What dose and timing are right for my sleep problem?
  • Which brands do you recommend for quality?

References

  1. Cohen PA, Avula B, Wang YH, et al. Quantity of melatonin and CBD in melatonin gummies sold in the US. JAMA. 2023;329:1401–1402.
  2. Lelak K, Vohra V, Neuman MI, et al. Pediatric melatonin ingestions — United States, 2012–2021. MMWR. 2022;71:725–729.
  3. Qaseem A, Kansagara D, Forciea MA, et al. Management of chronic insomnia disorder in adults: ACP clinical practice guideline. Ann Intern Med. 2016;165:125–133.

Medical disclaimer

This page is patient education, not prescribing guidance. It summarizes the published evidence about how this medication has been studied in Black patients — it is not a substitute for the judgment of your personal clinician. Never start, stop, or change a prescription based on something you read here. If you have questions about your medication, call your prescriber or pharmacist. For emergencies, call 911.

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