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Suplementos de melatonina y riesgos
Potential risks associated with long-term melatonin use among adults with chronic insomnia were highlighted in a recent preliminary study presented at the American Heart Association’s Scientific Sessions 2025
Led by Dr. Ekenedilichukwu Nnadi, a chief resident at SUNY Downstate Health Sciences University, the observational analysis examined over 130,000 patients, half of whom had documented chronic melatonin use (defined as a year or longer, including prescriptions or self-reported). None had prior heart failure or used prescription sleep aids at baseline.
Key findings include a 90% increased relative risk of developing heart failure within five years for long-term users (4.6% incidence vs. 2.7% in non-users), a 3.5-fold higher likelihood of heart failure hospitalization (19% vs. 6.6%), and nearly double the all-cause mortality rate (7.8% vs. 4.3%). ahajournals.org
The study emphasizes association rather than causation. Chronic insomnia itself may contribute to these effects through inflammation, elevated nighttime blood pressure, or stress hormone dysregulation. newsroom.heart.org
The research highlights regulatory gaps: U.S. melatonin supplements are unregulated, with actual doses varying significantly (up to +478% or -83% from the labels), unlike the stricter prescription-only rules in the UK, EU, and Australia. nytimes.com
Nnadi cautions against assuming “natural” equals safe, especially for nightly, multi-year use.
He calls for randomized trials to clarify mechanisms, such as their impact on heart rhythm or metabolism.
Experts like Columbia University’s Marie-Pierre St-Onge note melatonin’s lack of FDA approval for chronic insomnia treatment and urge short-term use only. washingtonpost.com
Sleep specialist Dr. Muhammad A. Rishi recommends starting with 0.5–1 mg doses, limiting the duration to 1–3 months, and consulting a physician for persistent issues, as insomnia may signal underlying conditions such as sleep apnea or depression.
The Council for Responsible Nutrition echoes this, advising that professional guidance is necessary for long-term sleep troubles.
New Details from Additional Research
While the study raises alarms, it aligns with growing scrutiny of melatonin’s real-world safety.
Hazard ratios from the abstract confirm the risks: 1.90 for incident heart failure, 3.47 for hospitalization, and 1.80 for mortality, even after adjusting for confounders like age, comorbidities, and multiple prescriptions. ahajournals.org
Confounding factors—such as users having more severe insomnia, co-occurring depression/anxiety, or polypharmacy with other sedatives—could explain much of the link. newsroom.heart.org
Contrasting evidence suggests that melatonin’s antioxidant properties may benefit individuals with established heart disease. A 2023 meta-analysis of 10 trials (n=1,200) found that short-term use (up to 3 months) reduced systolic blood pressure by 3.5 mmHg and improved endothelial function in hypertensive patients.
Animal studies suggest cardioprotective effects against ischemia-reperfusion injury, but human data is limited to small, controlled settings with pharmaceutical-grade doses—not the variable OTC products in Nnadi’s cohort.
Recent U.S. trends amplify concerns: CDC data shows melatonin-related emergency visits rose 530% from 2019–2022, often from overdoses or accidental ingestion, particularly in children.
A 2024 FDA warning highlighted inaccurate labeling in 25% of tested supplements, potentially leading to unintended high exposures that disrupt natural hormone rhythms over time.
Experts urge caution without panic: NBC reports cardiologists view chronic use as a “red flag” for unmanaged insomnia rather than melatonin toxicity, recommending cognitive behavioral therapy for insomnia (CBT-I) as first-line treatment, which cuts heart risks by 40% in meta-analyses. nbcnews.com
For at-risk groups (e.g., those with hypertension), monitoring heart rate variability via wearables during use is recommended.
Led by Dr. Ekenedilichukwu Nnadi, a chief resident at SUNY Downstate Health Sciences University, the observational analysis examined over 130,000 patients, half of whom had documented chronic melatonin use (defined as a year or longer, including prescriptions or self-reported). None had prior heart failure or used prescription sleep aids at baseline.
Key findings include a 90% increased relative risk of developing heart failure within five years for long-term users (4.6% incidence vs. 2.7% in non-users), a 3.5-fold higher likelihood of heart failure hospitalization (19% vs. 6.6%), and nearly double the all-cause mortality rate (7.8% vs. 4.3%). ahajournals.org
The study emphasizes association rather than causation. Chronic insomnia itself may contribute to these effects through inflammation, elevated nighttime blood pressure, or stress hormone dysregulation. newsroom.heart.org
The research highlights regulatory gaps: U.S. melatonin supplements are unregulated, with actual doses varying significantly (up to +478% or -83% from the labels), unlike the stricter prescription-only rules in the UK, EU, and Australia. nytimes.com
Nnadi cautions against assuming “natural” equals safe, especially for nightly, multi-year use.
He calls for randomized trials to clarify mechanisms, such as their impact on heart rhythm or metabolism.
Experts like Columbia University’s Marie-Pierre St-Onge note melatonin’s lack of FDA approval for chronic insomnia treatment and urge short-term use only. washingtonpost.com
Sleep specialist Dr. Muhammad A. Rishi recommends starting with 0.5–1 mg doses, limiting the duration to 1–3 months, and consulting a physician for persistent issues, as insomnia may signal underlying conditions such as sleep apnea or depression.
The Council for Responsible Nutrition echoes this, advising that professional guidance is necessary for long-term sleep troubles.
New Details from Additional Research
While the study raises alarms, it aligns with growing scrutiny of melatonin’s real-world safety.
Hazard ratios from the abstract confirm the risks: 1.90 for incident heart failure, 3.47 for hospitalization, and 1.80 for mortality, even after adjusting for confounders like age, comorbidities, and multiple prescriptions. ahajournals.org
Confounding factors—such as users having more severe insomnia, co-occurring depression/anxiety, or polypharmacy with other sedatives—could explain much of the link. newsroom.heart.org
Contrasting evidence suggests that melatonin’s antioxidant properties may benefit individuals with established heart disease. A 2023 meta-analysis of 10 trials (n=1,200) found that short-term use (up to 3 months) reduced systolic blood pressure by 3.5 mmHg and improved endothelial function in hypertensive patients.
Animal studies suggest cardioprotective effects against ischemia-reperfusion injury, but human data is limited to small, controlled settings with pharmaceutical-grade doses—not the variable OTC products in Nnadi’s cohort.
Recent U.S. trends amplify concerns: CDC data shows melatonin-related emergency visits rose 530% from 2019–2022, often from overdoses or accidental ingestion, particularly in children.
A 2024 FDA warning highlighted inaccurate labeling in 25% of tested supplements, potentially leading to unintended high exposures that disrupt natural hormone rhythms over time.
Experts urge caution without panic: NBC reports cardiologists view chronic use as a “red flag” for unmanaged insomnia rather than melatonin toxicity, recommending cognitive behavioral therapy for insomnia (CBT-I) as first-line treatment, which cuts heart risks by 40% in meta-analyses. nbcnews.com
For at-risk groups (e.g., those with hypertension), monitoring heart rate variability via wearables during use is recommended.
Leer
¿Qué estimula la secreción normal de melatonina en el cuerpo humano?
Fuentes
- Asociación Americana del Corazón. "El uso a largo plazo de suplementos de melatonina para favorecer el sueño puede tener efectos negativos para la salud". Noviembre de 2025. https://newsroom.heart.org/news/long-term-use-of-melatonin-supplements-to-support-sleep-may-have-negative-health-effects
- Nnadi, E. et al. "Resumen 4371606: Effect of Long-term Melatonin Supplementation on Incident Heart Failure, Heart Failure Hospitalization, and All-Cause Mortality in Adults With Insomnia". Circulation. Noviembre 2025. https://www.ahajournals.org/doi/abs/10.1161/circ.152.suppl_3.4371606
- NBC News. "Lo que tomar melatonina podría revelar sobre tu salud cardiaca". Noviembre de 2025. https://www.nbcnews.com/health/health-news/taking-melatonin-reveal-heart-health-rcna241132
- News-Medical.net. "El uso prolongado de suplementos de melatonina se relaciona con mayor riesgo de insuficiencia cardiaca y muerte". Noviembre de 2025. https://www.news-medical.net/news/20251103/Long-term-use-of-melatonin-supplements-linked-to-higher-risk-of-heart-failure-and-death.aspx
- The New York Times. "¿Es mala la melatonina para el corazón? Esto es lo que hay que saber". Noviembre de 2025. https://www.nytimes.com/2025/11/05/well/melatonin-heart-health-study.html
- The Washington Post. "Un nuevo estudio relaciona melatonina e insuficiencia cardiaca. Que no cunda el pánico, dicen los expertos". Noviembre de 2025. https://www.washingtonpost.com/health/2025/11/03/melatonin-heart-failure-sleep-aid/
- Drugs.com. "Relacionan el uso prolongado de melatonina para el insomnio con mayor riesgo de insuficiencia cardiaca y muerte". Noviembre de 2025. https://www.drugs.com/news/aha-long-term-melatonin-insomnia-tied-higher-risk-heart-failure-127448.html
- Powers Health. "La melatonina a largo plazo podría dañar la salud del corazón, según un estudio". Noviembre de 2025. https://www.powershealth.org/about-us/newsroom/health-library/2025/11/03/longterm-melatonin-might-harm-heart-health-study-says
- Wang, Y. et al. "Effects of melatonin supplementation on blood pressure: Una revisión sistemática y meta-análisis". Investigación sobre la hipertensión. 2023. https://www.nature.com/articles/s41440-023-01275-5
- Cardinali, D. et al. "Melatonin and cardioprotection against ischemia/reperfusion injury". Antioxidantes. 2022. https://www.mdpi.com/2076-3921/11/3/543
- CDC. "Notas desde el campo: Intoxicación por melatonina - Estados Unidos, 2019-2022". MMWR. 2024. https://www.cdc.gov/mmwr/volumes/73/wr/mm7306a3.htm
- Irish, L. et al. "The role of sleep hygiene in promoting public health: Una revisión de la evidencia empírica". Sleep Medicine Reviews. 2015. https://www.sciencedirect.com/science/article/pii/S1087079214001255
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