Lifestyle

America’s Top Sleep Medicine Group Says Stop Taking Melatonin for Insomnia

By Mike Harper · April 26, 2026

The sleep aid sitting in your medicine cabinet probably isn’t doing what you think it’s doing — and the country’s leading sleep medicine organization has said so, in writing.

The American Academy of Sleep Medicine, the professional body that sets clinical standards for sleep disorder treatment in the United States, recommends against using melatonin, diphenhydramine, and valerian to treat chronic insomnia in adults. These are three of the most popular over-the-counter sleep products in the country — and according to the AASM’s evidence review, none of them produce clinically significant improvements in the time it takes to fall asleep, total sleep time, or sleep quality for people with chronic insomnia.

Melatonin is the most striking entry on that list, because the supplement has become so culturally embedded in American bedtime routines that most people assume it has been validated by science. The AASM’s review of the clinical trial data found that melatonin reduced time to fall asleep by only about nine minutes compared to placebo — an improvement the organization concluded does not rise to clinical significance. It found no meaningful effect on total sleep time or sleep quality.

Diphenhydramine — the active ingredient in products like Benadryl, ZzzQuil, and Unisom SleepTabs — fared similarly. The evidence showed it reduced time to fall asleep by about eight minutes compared to placebo, with no improvement in total sleep time. What the evidence did show: diphenhydramine carries real risks, particularly for older adults, including next-day grogginess, impaired driving, dry mouth, urinary retention, and an association with cognitive impairment at higher doses over time.

Valerian, the herbal supplement often marketed as a natural sleep remedy, also received a “not recommended” designation from the AASM, with the task force finding insufficient evidence that it meaningfully improves any sleep outcome variable.

So what does the AASM recommend?

The organization’s strongest position is that cognitive behavioral therapy for insomnia — known as CBT-I — should be the first treatment tried for chronic insomnia, before any medication. CBT-I is a structured program, typically delivered over six to eight sessions with a trained therapist, that addresses the thought patterns and behavioral habits that perpetuate sleeplessness. Clinical trials consistently show it produces durable improvements — not just while the treatment is ongoing, but after it ends. Unlike medication, it addresses the underlying problem rather than masking the symptom.

For people who cannot access CBT-I or who still have symptoms after completing it, the AASM does recommend several prescription medications. Eszopiclone, zolpidem, and suvorexant are among those the organization considers appropriate for specific insomnia types — sleep onset, sleep maintenance, or both — when prescribed by a physician who can weigh the risks and benefits for an individual patient.

The AASM is clear that its guidelines apply specifically to chronic insomnia — defined as difficulty sleeping at least three nights per week for at least three months, with daytime consequences. People with occasional sleeplessness are in a different category, and the evidence landscape there is different.

The practical takeaway for most adults is this: if you’re reaching for melatonin occasionally before a red-eye flight or after a stressful week, the AASM’s guidance is not necessarily aimed at you. If you’re taking it nightly for months hoping it will fix a persistent sleep problem, the evidence suggests it probably isn’t working — and talking to a doctor about CBT-I or appropriate prescription options is likely a better use of your time and money.