Overview
- The multicenter records review of nearly 131,000 adults with chronic insomnia found that those with at least 12 months of recorded melatonin use had about a 90% higher five-year incidence of heart failure than nonusers.
- Secondary results showed nearly 3.5 times higher hospitalization for heart failure and almost double all-cause mortality over five years among recorded users.
- Researchers analyzed international data from the TriNetX network and excluded people with prior heart failure or prescriptions for other sleep drugs, but they lacked dosing and adherence details and could not fully capture over-the-counter use.
- Clinicians and sleep experts emphasized potential confounding and reverse causation, noting that insomnia or undiagnosed conditions such as sleep apnea or early heart disease may explain the association and advising evaluation rather than abrupt discontinuation.
- The findings will be presented at the American Heart Association Scientific Sessions next week, and the team plans a full manuscript submission in early 2026, as guidance favors CBT‑I and cautious, short-term melatonin use when appropriate.