Melatonin has long been my go-to for sleep during perimenopause and menopause. Like many midlife adults, I figured “natural” meant safe — especially when sleep was so hard to come by. But a recent preliminary study changes the conversation in a way I think we all need to hear.
What the 2025 Study Found
At the American Heart Association’s Scientific Sessions 2025, researchers examined health data from more than 130,000 adults with chronic insomnia. They compared people who used melatonin for at least one year with similar adults who didn’t. The results included:
- Adults taking melatonin long-term had about a 90% higher risk of developing heart failure over five years than matched non-users.
- Hospitalizations for heart failure were nearly 3.5× greater in melatonin users vs. non-users.
- People who used melatonin long-term had nearly double the rate of death from any cause over the study period.
Here’s the important nuance: this doesn’t prove melatonin caused these outcomes. It shows strong association, not direct cause and effect. Researchers stress that underlying sleep issues or other health conditions could also be part of the story.
Why This Matters Especially After 50
Melatonin use increases with age as natural production declines and sleep disturbances become more common. Studies show about half of adults over age 60 report significant sleep disruptions, and many reach for melatonin thinking it’s a low-risk fix.
Other research has shown that short-term melatonin use (like a few days to a few weeks) can help with sleep onset and jet lag, and side effects like headache or dizziness have been considered mild in many studies.
But here’s the gap: long-term safety data — especially in older adults — is limited or non-existent in peer-reviewed literature. One older review even noted that there’s simply not enough evidence to confidently judge long-term use beyond six months.
So is Melatonin Safe or Not?
Short-term use is still broadly considered generally safe by many clinicians when taken at low doses and for occasional sleep issues.
But the 2025 study’s findings raise two key points:
- Long-term nightly use — especially over a year — may not be as risk-free as commonly believed.
- Melatonin is an active hormone — not an inert supplement — and long-term supplementation could have effects we don’t fully understand yet.
And remember — supplements in the U.S. aren’t regulated like medications, so potency and purity can vary widely between brands.
My Personal Take (and What My Cardiologist Told Me)
I’ll be honest — I was a long-term melatonin user myself. I took it nightly for years to help with menopause-related sleep problems.
After reading this new study and having a detailed discussion with my cardiologist, I chose to stop taking it. My doctor didn’t say melatonin definitely causes heart issues — but they agreed that this study’s results are concerning enough to warrant caution, especially with year-after-year use. The advice I received was: more research is needed, but we shouldn’t ignore these findings either.
What You Can Do Instead
If you’re struggling with sleep — and many adults over 50 do — here are evidence-based approaches that don’t rely on long-term supplementation:
- Improve sleep hygiene: consistent sleep/wake times, cool and dark bedroom, limiting screens before bed.
- Watch caffeine and alcohol intake later in the day.
- Consider cognitive behavioral strategies (CBT-I), which studies show can be more effective than supplements.
- Speak with a healthcare provider if you rely on melatonin nightly — especially if you have heart or metabolic risk factors.
The Bottom Line
Melatonin isn’t inherently “bad.” But new research suggests that long-term nightly use — especially beyond a year — may not be harmless, particularly for midlife and older adults concerned about cardiovascular health. Short-term or occasional use may still be reasonable for many people, but if you’ve been taking it nightly for years, it’s worth reevaluating with your healthcare provider.
Sleep is vital — but so is heart health. Let’s make informed choices that support both.
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As someone with over 30 years of experience as a personal trainer and coach, I’m passionate about helping people age well through fitness and nutrition. I share tips and motivation on my Instagram, and I’d love for you to join my community there!
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