Falling asleep these days can be difficult for many reasons, such as burnout at work, wanting to raise happy children, and a never-ending to-do list. You’re not alone either, 12 percent of Americans suffer from chronic insomnia.
Sleep is so important for so many reasons, including its effects on your mood, energy levels, immune system, and even your eyes—you just can’t sacrifice it.
There is a supplement that has been a game changer for many of us who have trouble sleeping. It’s called melatonin, and it’s a hormone your body produces that stimulates your sleep-wake cycle. However, unfortunately, according to the large 2025 According to a review by the American Heart Association, long-term use of it can cause heart failure. Also, “long-term” in this study is defined as one year, which is obviously not that long. Pretty scary, right?
However, not addressing sleep issues or taking melatonin cold turkey is not a foolproof solution, especially when it comes to heart health. After all, consistent sleep patterns can reduce the risk of heart disease. Some cardiologists would even say that sleep is the most overlooked habit for heart health, and for many, melatonin helps.
Related: Cardiologists say that this time to sleep is associated with a lower risk of heart attack
The research data and possible explanations add additional complexity, therefore Parade turned to cardiologists for better understanding. Ahead, these cardiologists share how long-term melatonin use can increase the risk of heart failure, what to worry about, and their recommendations.
đź©şSIGN UP for Parade’s health newsletter with expert-approved tips, healthy eating, exercise, news and more to help you stay healthy and feel your bestđź’Š
How long-term use of melatonin can increase the risk of heart failure
To be clear, the study is a case of correlation, not causation. In other words, we don’t know for sure whether taking melatonin every day for a year directly increases the risk of heart failure.
That said, cardiologists note that the mechanism or relationship between the two, if any, is not fully understood, but they do have theories.
“It is possible that higher doses of exogenous melatonin may overstimulate specific cardiac chemical receptors, which may lead to abnormal cardiac remodeling and increase the risk of congestive heart failure,” the report said. Dr. Bradley Server, MDinterventional cardiologist and Chief Medical Officer of VitalSolution. “We can speculate that there are circadian rhythm changes or unstable blood pressure issues due to additional medications.”
There are three other possible explanations. One is a confounding variable. “People with severe chronic insomnia (and often stress, depression, pain, or sleep apnea) use more melatonin and are already at increased cardiometabolic risk,” the report said. Dr. Sam Setareh, MD Staff cardiologist at Cedars-Sinai Medical Center, Senior Clinical Research Fellow at the National Heart Institute, and Director of Clinical Cardiology at Beverly Hills Cardiovascular.
Related: One daily habit silently increases the risk of heart disease, according to cardiologists
The second possibility he mentions is that taking melatonin at suboptimal times or in higher doses may impair circadian rhythms, autonomic tone, and blood pressure patterns. Overdosing may also be more common than we think, as the dosage and purity of over-the-counter melatonin can vary widely.
Last but not least, “Interaction with undiagnosed sleep apnea is common, increases the risk of heart failure, interferes with sleep, and may lead to supplement use,” says Dr. Setareh.
That’s a lot of big words to basically say: Heart health and sleep health are closely related in a number of ways, and melatonin use may or may not be affected.
If you take melatonin, how worried should you be?
Yes, the finding sounds bad, but remember this is a case of correlation, not causation. What level of concern is felt exactly? “Preoccupied enough to reevaluate the routine [and] for nighttime use, but don’t panic,” Dr. Setareh replies.
He adds that the size and consistency of the study warrants caution, especially in people with other risk factors for heart failure, such as hypertension, diabetes, obesity, kidney disease or other conditions.
There is also the fact that drugs and supplements have real effects on health, even if this is not one of them. “This study raises several clinical issues,” says Dr. Server. “We must always consider that every drug we use has risks and benefits.
Related: Can you get infected with melatonin? Experts share the truth about this popular supplement
Cardiologists’ recommendations for melatonin use
Given these insights, what do cardiologists suggest people do?
Dr. Serwer encourages non-pharmacological treatments for insomnia, such as meditation, exercise, avoiding caffeine, bright lights before bed and addressing any mental health issues. He adds that short-term use of melatonin has not yet been shown to have adverse effects, so taking it less often or less frequently may be a safer option.
Dr. Setareh’s suggestion is similar: “I advise many users to transition from continuous nighttime dosing to short-term, situational use (jet lag, transitions) and, if still needed, use the lowest effective dose—often one milligram taken two or three hours before bed—with periodic attempts to reduce the dose.”
When it comes to melatonin use, snacking on one of those gummies every night can be harmful in the long termand you don’t have to give it up completely. The data found is discouraging, but it’s just the beginning. It is very important to remember your usage.
“Melatonin is not a ‘sleep vitamin,'” says Dr. Setareh. “Until we have peer-reviewed, prospective data with accepted results, treat this as short-term relief, keep doses low, and focus on durable, evidence-based strategies that improve sleep and heart health without increasing risk.”
Next:
Related: 13 Weird Ways Your Body Is Telling You You Need More Sleep
Next: “I Have Chronic Insomnia – Here’s What I Do When I Can’t Sleep”
Sources
This story was originally reported by Parade in 2025. on Nov. 13, where it first appeared in Health & Wellness. Add the parade as a preferred resource by clicking here.