Overview
- Researchers analyzed five years of TriNetX records from nearly 131,000 adults with chronic insomnia, comparing about 65,000 recorded long-term melatonin users with nonusers.
- Recorded users had a roughly 90% higher five-year incidence of heart failure, with 4.6% developing heart failure versus 2.7% among those without recorded use.
- Secondary findings showed nearly 3.5 times higher hospitalization for heart failure and increased all-cause mortality among recorded long-term users.
- Experts stressed the observational design cannot prove causation and noted key limitations including OTC use misclassification across countries, unknown dose and adherence, and unmeasured insomnia severity.
- Clinicians advise caution with chronic, unsupervised use, urging patients to consult providers, while the American Academy of Sleep Medicine favors cognitive behavioral therapy over melatonin for treating chronic insomnia.