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Medically reviewed by Danielle Aberman, RD
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? Can melatonin treat and prevent migraine? Could melatonin be the answer for you?
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.
What the research says about melatonin and migraine
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.
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.
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