Migraine statistics are eye-opening. Globally, over one billion people are living with migraine. Overwhelmingly, those with migraine have not been properly diagnosed or treated (1). This leaves most people searching for effective relief with little to no negative side effects.
Maybe you are looking to avoid taking a prescribed medication? Or you might be frustrated that you aren’t getting enough relief from your current prescription or over-the-counter remedy? Maybe there is relief for you in this melatonin migraine link? Can melatonin treat and prevent migraine?
Let’s dive in and review the relevant research evidence about the melatonin migraine connection and see if this supplement makes sense for you to consider.
* While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.
What is melatonin?
Melatonin is a hormone naturally produced in the pineal gland. This small, reddish gland is located deep in the brain and is responsible for controlling our circadian rhythm. Circadian rhythm describes our body’s clock and how we naturally feel awake or drowsy over the 24 hour cycle of the day.
Our circadian rhythm is not just important for our sleep patterns. It also regulates other essential bodily functions like body temperature control, hormonal regulation and eating habits.
Melatonin gets us ready for sleep when darkness falls. Conversely, sunlight and artificial lighting suppresses melatonin, while stimulating the activity of serotonin – which makes us feel awake during daylight hours.
Melatonin levels can be suppressed by being in bright settings as well as being close to device screens that emit a lot of blue light. This is one reason why sleep experts suggest avoiding screens before bed if getting a good night’s sleep is a problem.
Melatonin supplements are widely available in the United States and most frequently used as a sleep aid.
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What the research says about the melatonin migraine connection
Curiosity may have been sparked by these 2 interesting studies that looked closer at the melatonin-migraine link. One study showed that melatonin levels are lower during migraine attacks. (2)
The second study showed that melatonin levels were lower in people with chronic migraine (3) and several comorbidities like depression and fatigue.
The information from the above studies was compelling enough for others to look for a more direct relationship.
The migraine-melatonin summary studies
In 2016, two very well-respected headache specialists, Amy Gelfand, MD and Peter Goadsby, MD, summarized the published research on melatonin and primary headache disorders (3). They concluded that it was likely helpful in a few primary headache disorders. Migraine and cluster headache showed the most favorable results.
In one of the highlighted studies (4) the participants were in three groups. One group received 3 mg of immediate release melatonin, a separate group received 25 mg of amitriptyline and the third group received a placebo. The participants took their medication each night for 3 months. The researchers concluded that the melatonin was as effective as the amitriptyline and more tolerable. It was superior to the placebo.
Contrarily, when looking at a smaller study that used 2 mg of sustained release melatonin compared to a placebo, there was no measured benefit from the melatonin. That study was conducted over 2 months.
The authors suggested the possibility that the smaller study was under-powered. Perhaps 3 mg of immediate release melatonin is the better dose and type to get the benefit of melatonin for migraine.
Three years later, a review of the above randomized control studies (5) plus 5 others studies concluded the following: Melatonin is very likely to be a promising alternative for migraine prophylaxis. Current literature examining melatonin’s efficacy in migraine prevention is growing, but still limited.
A very recent (2022) published review of the migraine and melatonin connection had similar conclusions.
Possible reasons melatonin may help migraine
The importance of sleep in migraine prevention
Maintaining a regular sleep schedule can be a challenge when you have migraine symptoms. Heck, it can be a challenge when we feel perfectly well. Establishing a more beneficial circadian rhythm with melatonin supplements in addition to the natural hormone may support the melatonin-migraine mechanism.
Most neurologists emphatically agree that poor and irregular sleep are significant problems for people with migraine. Prioritizing quality, consistent sleep is universally high on their list of recommended lifestyle modifications. Knowing this, we have this helpful article on sleep strategies for those with migraine. Sleep can also be especially challenging when you have profound dizziness or a sense of disequilibrium. We included more specific tips for improving sleep with vestibular migraine.
Reduction in pain and inflammation
Melatonin has been shown to be helpful in certain types of procedural pain (6). It has also been shown to reduce pain in fibromyalgia (7). Additionally, melatonin has known anti-inflammatory effects (8). Even if quality sleep is not a specific challenge for you, melatonin may be helpful as an effective analgesic and/or anti-inflammatory to discuss with you doctor.
How much melatonin should I take for migraine?
A 2017 study (9) states an estimated 38% of patients with migraine are good candidates for preventative treatment, yet less than 13% actually take preventive medications. As mentioned above, this same study found melatonin to be as effective as the preventative medication amitriptyline (25mg) in reducing headaches.
If you are looking for a bump in relief, melatonin may be worth a try. Johns Hopkins Headache Center recommends taking 3-6 mg an hour or so before bedtime. Some members of our community who use melatonin recommend starting a lower dose and bumping up to 3mg if needed. You can find many melatonin supplements for a discounted price in our supplement dispensary.
Possible side effects of taking melatonin
Melatonin supplements can help bring on drowsiness and lull us into a deep sleep. This is why people who struggle with insomnia often turn to this neurohormone in order to get their much-needed rest at bedtime. Conversely, taking melatonin too close to bedtime could end up making us feel groggy instead of well-rested in the morning. This makes the dose and timing important.
Additionally, there are 2 side effects that may discourage people with migraine- headache and dizziness. Keep in mind that these side effects are listed for many supplements and over-the-counter medications. You won’t know if side effects are a problem for you unless you give it a try.
In our private Facebook group, I was surprised to see how many people reported vivid dreams or nightmares after trying melatonin. Quite a few people found the dreams disturbing enough to avoid the potential migraine relief from this inexpensive supplement. Those must have been some dreams! In all the studies I read, nightmares were only mentioned once.
Upon searching for more information specifically about nightmares and melatonin, it seems that it is a known complaint. Experts believe it has something to do with the increased time in REM sleep. While I’m certainly not an expert, my opinion is that it’s more likely due to some other effect of this neurohormone. I do not think people with longer, healthy REM cycles complain of disturbing dreams. Some resources suggested starting melatonin at a lower amount and giving your body time to adjust.
My personal experience
I have taken melatonin many times and have not had any negative side effects. I’m currently trying it again at the 3 mg dose to see if it will help my sleep and improve migraine control.
My father has vestibular migraine as well as trouble sleeping. A bad night of sleep makes him very likely to have a great deal of dizziness and disequilibrium. This leads to needing medication and daytime napping which then interferes with getting good sleep at night. It’s a vicious cycle. He started taking melatonin several months ago and has been getting good sleep ever since.
Who should not take melatonin?
Before you try using melatonin to find relief from migraine, it is important that you speak with your doctor. Melatonin has some known drug interactions. Some are significant. I suggest double-checking with your pharmacist. Many of us with migraine are on medications that could cause excessive drowsiness and/or changes in the effectiveness of the necessary medications if combined with certain supplements including melatonin.
This article has been updated since it’s original publication.
References
(1) https://americanmigrainefoundation.org/resource-library/migraine-facts/
(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3451944/
(3) https://pubmed.ncbi.nlm.nih.gov/19817880/
(4) https://pubmed.ncbi.nlm.nih.gov/27165014/
(5) https://pubmed.ncbi.nlm.nih.gov/30653130/
(6) https://pubmed.ncbi.nlm.nih.gov/26122244/
(7) https://bmcpharmacoltoxicol.biomedcentral.com/articles/10.1186/2050-6511-15-40
(8) https://www.sciencedirect.com/science/article/abs/pii/S0889159121000386
(9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432214/
I’ve always been curious about melatonin and whether it could have bigger implications (ie. other than for the commonly known associations like sleep) but I’ve never tried supplements. I do wonder whether more than 2mg is needed to make a difference. It seems like the link is more for the lower levels being associated with migraine rather than melatonin relieving migraine, but perhaps that’s just in the short term. Many medications and supplements can take several months for benefits and changes in the body to be seen, so it’d be good to see research look at it over, say, an 8 or 12m period.
Fab post, very thought-provoking! I suffer with chronic migraines that take up on average 5 or 6 days a week and it’s miserable. While mine seem to be inflammation-related, I’d be curious to know what my melatonin is like.
Caz xx
Hi Caz. Thank you for writing. The studies tend to suggest 3 mg being the preferred amount. I hope you find relief soon. -Danielle
I’ve been taking 3 mg for several years, but note that just in the past few days, Dr. Mauskop at the New York Headache Center, who I highly respect has, on his blog, said “a small dose of melatonin (300 mcg, or 0.3 mg) can help better than the usual 3 mg dose sold in most stores.” He has not steered me wrong, especially with a recommendation to monitor homocysteine and B-12, so I have ordered it and am going to try it.
Hi Bill- Thank you for commenting. I hold Dr. Mauskop in the highest regard. I have and recommend his book often. Yes, he recently wrote about melatonin noting the lower amount. The study he sited looked at melatonin for sleep rather than migraine. If I missed something, please let me know. As with many OTC supplements, the literature is sometimes conflicting. We cover these topics to help inform people about possible non-pharmaceuticals that can be helpful along side interventions prescribed by clinicians. Individual advice and changes to treatment plans should always be reviewed with a person’s doctor. So, yes, check with Dr. Mauskop. I hope you find the right combo for lasting relief. – Danielle
My apologies, Danielle, and thank you for the clarification. As a 73 year old who has contended with migraines since elementary school and tried just about everything, I will stay with the 3 mg dosage. I entirely overlooked the sleep vs migraine connection. I assumed he would always be referencing migraine. Thank you so much.
Is it possible that melatonin could act as an abortive as well?
Hi Susan. Thank you for your question. Based on the studies and clinical observation, melatonin is considered part of prevention. – Danielle
I tried a 3 mg dose of melatonin several years ago. The nightmares were so horrifying that I’m afraid to try it again. I had no idea that melatonin could cause nightmares, so I was surprised. My daughter had the same experience. Maybe it has to do with individual brain chemistry? I ordered a bottle of 0.3 mg sustained release melatonin, but haven’t yet worked up the courage to try it. In light of the study showing that you need 3 mg to get any benefit for migraine, maybe it’s not worth the risk. I will never take that much again!
Oh my gosh, I had horrible dreams, AND I woke up so depressed I had suicidal ideations. I thought it was a fluke so I tried it one more time (and this was on 1 mg, mind you) but the 2nd time no dreams that I recalled but I awoke and my mood was so low/doom sensation/scared/suicidal ideation that I will NEVER use it again
Sorry you had that experience. Unfortunately, no one intervention works for everyone. Some people swear by it. – Danielle
I have taken Melatonin for sleep for many years. The different brands vary tremendously. Some can cause vivid dreams and some don’t. They also wear out after time and you need to switch between brands. Melatonin is very safe and effective. You might want to try a smaller dose and a different brand. It comes in a 1 milligram dose. There is also a quick release as well as a slow acting formula available.
I take a 12mg dose for a sleep delay disorder without side effects. It’s never helped my intractable migraines but the sleep is really helpful.