More than 300 million people have sleep disorders, is it safe to eat melatonin?

Screenshot of a brand of melatonin.

"Eating melatonin feels like psychological comfort, but it's better than taking tranquilizers." Xiao Cheng, who is preparing for the re-examination of graduate students at an affiliated hospital of Beijing University of Traditional Chinese Medicine, said that he has recently been "stressed" and often cannot sleep at three o'clock in the middle of the night, at this time he often gets up to eat a melatonin.

The "2021 White Paper on Exercise and Sleep" jointly released by the Chinese Sleep Research Society and other institutions shows that more than 300 million Chinese have sleep disorders, and the incidence of insomnia in adults is as high as 38.2%. The "China Sleep Research Report (2022)" jointly released by the Institute of Sociology of the Chinese Academy of Social Sciences, the Social Science Literature Publishing House and other institutions shows that in the past 10 years, the average chinese people's sleep time is more than two hours late, and the wake-up time is also 37 minutes late. 64． 75% of those surveyed actually slept less than 8 hours a day.

"Drinking coffee during the day to refresh the mind, eating melatonin at night to help sleep", I don't know when it began, the above ridicule has become a true portrayal of many people's lives. Melatonin products from major e-commerce platforms and offline pharmacies also continue to sell well.

Behind the popularity of melatonin products is the increasingly prominent sleep problem of contemporary people. However, there are also some people who take melatonin without much effect, and some people who have some side effects.

Relevant experts told Shell Financial Reporter that melatonin is mainly effective for some insomnia problems related to biological clock disorders. Melatonin products cannot be considered a panacea. "If used, because its formulations are different, individualized choices need to be made. Also pay attention to its possible side effects. ”

The average Chinese person sleeps more than two hours late

"Every time you eat melatonin, you can fall asleep after half an hour," more than a dozen students mentioned in a WeChat group of more than 100 college students who had eaten or were eating melatonin products. Several students have said that eating melatonin has an effect on them.

Melatonin products are also common in the workplace population. 26-year-old Xiaoling also had a period of time because of the pressure of examination, coupled with emotional problems leading to insomnia, after taking a melatonin for a few days, she felt that there was not much effect. Later, a friend recommended another melatonin fudge, and she felt that the effect was better.

David, who is engaged in the investment industry, has had sleep problems since high school and has been more than 10 years now. "At that time in the third year of high school, I was stressed, I couldn't sleep, and I tried many methods, but the effect was not obvious." Later, during his studies and work, he often had difficulty falling asleep at night. He also started eating melatonin two years ago.

Shell financial reporters searched on major e-commerce platforms and found that many melatonin products were hot. According to the hot selling list of an e-commerce company's "Selected Improved Sleep List", a melatonin tablet that ranked first showed that 1.478 million people had bought it and sold more than 20,000 pieces in the past 30 days; the second place was a melatonin capsule, which showed that 2.971 million people had bought it and sold more than 10,000 pieces in the past 30 days; a melatonin gummy in the United States ranked third, showing that 369,000 people had bought it and sold more than 10,000 pieces in the past 30 days. In another e-commerce international direct sales area, this melatonin fudge is also in the top position. Its 2-bottle specification currently sells 18,595 pieces per month.

Behind the hot sales of melatonin is the increasingly prominent sleep problem of the Chinese people. Recently, the "China Sleep Research Report (2022)" released by the Institute of Sociology of the Chinese Academy of Social Sciences and other institutions shows that the average sleep time of Chinese people in the past 10 years has decreased from 8.5 hours in 2012 to 7.06 hours in 2021, and the time to fall asleep is more than two hours late, the time to wake up is also 37 minutes late, and the sleep time is reduced by nearly 1.5 hours. In addition, 64. 75% of those surveyed actually slept less than 8 hours a day. Among them, the sleep problems of new mothers, students, and professionals are particularly prominent.

Long-term sleep deprivation can lead to a series of negative effects, such as affecting work efficiency, reducing cognitive judgment, disturbing emotions and mental minds, and may also damage physical health. Sleep problems immediately gave birth to the sleep economy.

According to the "2021 China Sleep Economy Industry Research Report" (hereinafter referred to as the "Industry Report") previously released by Ai Media Consulting, the overall market size of China's sleep economy has increased from 261.63 billion yuan to 377.86 billion yuan, an increase of 44.42% between 2016 and 2020. According to the data of the "Industry Report", the market size of China's sleep health products exceeded 13 billion yuan in 2020. Among them, exogenous melatonin is an important part of the sleep supplement industry.

"Melatonin products are effective for mild, occasional insomnia." Ji Lianmei, a well-known pharmacist and founder of "Ask a Pharmacist", told Shell Financial Reporter that if he encounters some patients with insomnia symptoms that are not very serious, he will recommend them to try health care products such as melatonin.

According to the research report "Medical and Health Series: What is the Prospect of the Melatonin Market under the Trillion Sleep Market" (hereinafter referred to as the "Melatonin Market Prospects" report) previously released by the Leopard Research Institute, China's market size in 2019 is about 493 million yuan, the compound annual growth rate from 2015 to 2020 is 12.15%, and it is speculated that the compound annual growth rate of 2020-2025 will be 8.35%, and it is expected that the size of China's melatonin market will exceed 800 million in 2025.

Why can't melatonin be used as a medicine?

It is not that eating melatonin will definitely get the ideal sleep. David, who works on investments, has tried a total of three melatonin brands in the past two years, and only one of them has made him "a little easier to fall asleep", and he is not sure whether it is "psychological or drug effect". His sleep has not improved much so far.

For melatonin Dawei can now eat without eating. "Personally, I don't feel very useful." During his "ongoing struggle" with sleep problems, he took the exam as a counselor, "Peace of mind is more important than anything else." ”

Xiao Wu, who works in an investment bank, also has a period of time to eat melatonin in order to adjust her work and schedule, and at first this product still has some sleep aid effect on her, and then it no longer has an effect. "It's not as good as exercising before going to bed, pulling muscles or something."

Professor Guo Xiheng, director of the Sleep Medicine Center of Beijing Chaoyang Hospital, told Shell Financial Reporter that eating melatonin has a certain effect on strengthening sleep. But at the same time, we need to pay attention to several problems, the first is to clearly realize the difference in the role of endogenous melatonin and exogenous melatonin.

"Endogenous melatonin is produced by the brain, and there is a blood-brain barrier between the brain and the body. After exogenous melatonin is eaten, the body's digestive system may destroy a part, the blood-brain barrier may block a part, and then the melatonin that enters the brain through the blood-brain barrier may only play a part, so some people feel that the effect is better, and some people feel that there is no effect, which is related to the amount of melatonin that can really work in the end. Guo Xiheng also mentioned that the supplementation of exogenous melatonin may, in turn, inhibit the melatonin produced by the body itself, thereby indirectly affecting sleep.

Professor Han Fang, secretary general of the World Sleep Society and director of the Sleep Center of Peking University People's Hospital, said, "Everyone's absorption of it is different, the concentration of action is not the same, when to play a role, how much role to play, how much can be absorbed, this is no way to evaluate, individual differences are relatively large, there is no standard, which is also the reason why melatonin products can not be used as drugs, but can only exist as health care products." ”

"When you choose, you choose a suitable type and a suitable dosage according to your actual situation, and if it is really useful, you can eat it." However, it should be noted that it is only for certain types of insomnia, not a sleeping pill, just used to adjust the rhythm, and may be useful for insomnia caused by jet lag, night shift, etc. Han Fang said.

Experts do not recommend taking melatonin in large amounts for a long time and in large quantities

Some melatonin products have experienced side effects in some consumers.

Xiao Yang, 24, told Shell Financial Reporter that when he first ate melatonin, he could indeed improve his sleep habits, but after eating for about half a month, he would often feel "dizzy", "nausea", "headache" and so on the next day, so he could only stop using it. On the black cat complaint platform, a consumer said that his mother had previously taken a certain melatonin, and then there were problems such as increased blood pressure, dizziness, and drowsiness.

The U.S. Center for Disease Control and Prevention has issued an announcement that a 2017 analysis of Melatonin products in Canada found that the content of melatonin in each product varies greatly, ranging from -83% to 478% of the label label content. And there are also big differences between batches and batches.

In this uncertain situation, Ji Lianmei said that it should try to avoid taking melatonin in large quantities for a long time, "If you need to take it, it is recommended to choose domestic products." Choose the brand of overseas purchasing carefully, because it is likely to be too large. ”

Han Fang reminded that melatonin and all sleep aids actually have the effect of placebo. He said long-term melatonin consumption may have an impact on blood pressure, such as increased blood pressure, or some people have symptoms such as headaches.

As the director of the Sleep Medicine Center of Beijing Chaoyang Hospital, Guo Xiheng usually encounters a variety of sleep disorder patients in the clinic, he said that the clinical characteristics of different sleep disorders are different, and the reasons behind them are also very complicated. "Some are mental and psychological factors, some are regular problems with sleep rhythms, some are sleep disorders caused by systemic diseases, and some are the influence of social environment, genetics and other factors on sleep." People with long-term sleep disorders must go to a sleep specialist for treatment, do not blindly deal with it themselves. ”

Ji Lianmei has also encountered many people with sleep disorders in her daily counseling, and she also stressed that sleep disorders have never been a simple physiological problem, and she usually encounters some people with more serious sleep disorders, and she usually recommends that patients go to the psychiatric department.

How should ordinary people judge whether their sleep is healthy?

It can be comprehensively judged by three dimensions: sleep timing, sleep duration, and feelings after waking up. Guo Xiheng said that the first is the timing of sleep. Normal adults sleep from 10 p.m. to 11 p.m. The second is the length of sleep. The average adult sleep time is 7 to 8 hours, too short and too long may mean that sleep is problematic. Another is the feeling of waking up. If you wake up feeling refreshed, quick to react, optimistic, strong work and learning ability, good memory, etc., it means that sleep is good and of high quality. On the contrary, it means that the quality of sleep is not good.

"If one or two of the above points are not matched, in fact, it is not necessary to go to the hospital to see a doctor, but you need to adjust your life and work style first, and if you can't solve it after adjustment, then find experts in this area to help treat." Guo Xiheng said.

Asked about the advice for people taking melatonin, Han Fang said that melatonin products are not a panacea, and not all insomnia problems can be used to deal with it.

Ji Lianmei said that on the one hand, do not exaggerate the side effects of melatonin, on the other hand, do not rely solely on melatonin to improve sleep problems. "For insomnia, we put more emphasis on non-drug treatment, that is, cognitive behavioral therapy, including adjusting the mentality."

"Melatonin is actually just a health care product, and more clinical experience shows that some people still have some effect when they just take melatonin, but there is no effect after a long time." Others have no effect at first, indicating that its role itself is limited. Guo Xiheng suggested that if you want to temporarily adjust your sleep and do not want to take sleeping pills, you can use this way, and if there is no effect, you still have to use a more scientific method to deal with it, and it is not recommended to take melatonin for a long time and in large quantities, especially young people.

Beijing News shell financial reporter Sun Wenxuan Editor Xu Chao Proofreader Fu Chunyan