Melatonin, Heart Headlines, and Reflux: What’s Real—and What’s Just a Link?

Why Everyone’s Talking About Melatonin Right Now

You may have seen headlines saying melatonin is linked to heart problems. A new analysis of health records found that people with long-term, prescription melatonin use (over a year) were more likely to develop heart failure, be hospitalized, or die than similar people with insomnia who didn’t use prescription melatonin. That sounds scary—but it’s very important to understand what this kind of study can and can’t prove. It shows a connection (an association), not that melatonin caused those outcomes. Reporters and the American Heart Association’s news brief both stressed this point and highlighted limits in the data (like who used OTC melatonin but wasn’t counted, dose differences, and how severe the insomnia was). 

Causation vs. Association

• Association means two things show up together. Example: when it rains, you also see more umbrellas.
  

• Causation means one thing makes the other happen. Example: rain causes people to carry umbrellas.
  
  In the melatonin study, researchers saw that people who used prescription melatonin long-term also had more heart problems later. That’s an association. But people who need long-term prescriptions often have more severe insomnia or other health issues to begin with, and those conditions are already linked to worse heart outcomes. So the insomnia or underlying illness may be the driver, not the melatonin itself. The study can’t prove cause and effect. 

What the New Study Actually Looked At

• Researchers reviewed electronic health records for >130,000 adults with chronic insomnia.
  

• They compared people who used prescription melatonin for ≥1 year with people who didn’t.
  

• Over about five years, the melatonin-prescription group had higher rates of heart failure, hospitalization, and death.
  

• Big caveats: it was observational (so it can’t prove causation), dosing and OTC use were unclear, and insomnia severity may explain the findings.
  
  

So…is melatonin unsafe?

Based on this single observational analysis, we can’t say melatonin causes heart problems. What we can say is:

Long-term, prescription-strength melatonin use is a flag that someone may have serious, ongoing sleep issues, and chronic insomnia itself is tied to worse heart health. That’s likely why experts say not to panic, but to talk with a clinician if you’re using melatonin regularly for long periods. 

If not melatonin for sleep, then what?

For chronic insomnia (trouble sleeping at least 3 nights per week for 3 months), major medical groups recommend Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first-line treatment. CBT-I teaches skills that improve sleep long-term and can be done in person or through evidence-based digital programs. Medications (including melatonin) are usually add-ons or short-term tools when CBT-I isn’t available or while you’re getting started. 

Bottom line:

• Occasional, low-dose melatonin can be reasonable for short-term sleep support for many adults.
  

• For ongoing insomnia, ask about CBT-I, which treats the root habits that keep you up. 
  
  

Where Reflux Fits—Night Symptoms vs. Sleep Problems

Nighttime reflux can wake you up with burning, coughing, or a sour taste. Poor sleep then makes reflux triggers (late snacking, bigger portions, stress) more likely the next day. It’s a loop.

Why we include 1 mg melatonin in RefluxRaft PM

Our product, RefluxRaft PM Midnight Berry, includes a low dose (1 mg) of melatonin. The goal is gentle sleep support, not heavy sedation. And there’s more: early research suggests melatonin may support the lower esophageal sphincter (LES)—the valve that helps keep stomach contents from flowing back up—by pathways that include gastrin-mediated effects on LES tone. Some small studies and reviews report improvements in reflux symptoms with melatonin or melatonin-based protocols. (The research isn’t massive yet, but the mechanism is promising.) 

Why alginates matter at night

The alginate in RefluxRaft forms a gentle “raft” that sits on top of stomach contents and blocks reflux from splashing into the esophagus—without reducing stomach acid production. That nonsystemic, mechanical action is a significant reason alginate products are widely used, including during pregnancy. 

Putting the Headlines in Context: How to Use Melatonin Wisely

• Match the tool to the job. If you’re dealing with occasional nighttime reflux that disturbs sleep, a low-dose melatonin paired with an alginate barrier can make sense.
  

• Chronic insomnia needs a plan. If sleep problems are frequent and long-standing, ask your clinician about CBT-I, and use supplements as short-term supports, not the whole solution.
  

• Keep doses low. More isn’t better with melatonin; start low and use the smallest effective dose for the shortest time.
  

• Talk to your clinician if you have heart disease, are on heart medications, or are considering regular long-term melatonin use—especially at doses higher than 1–3 mg. (The heart-failure study signals a connection but doesn’t prove harm; it’s still smart to check in.)
  

• Kids & pregnancy. Alginate-only reflux products have supportive safety data in pregnancy; melatonin use in pregnancy or in children should be discussed with a clinician to tailor the approach for you. 
  
  

Lifestyle Changes That Help Reflux and Sleep (And Your Heart)

• Earlier, lighter dinners. Aim to finish eating 2–3 hours before bed; keep portions smaller.
  

• Head-of-bed elevation. Gravity helps reduce nighttime reflux.
  

• Trigger check. Tomato sauces, chocolate, peppermint, fatty or spicy foods, alcohol, and late caffeine can stoke reflux, and disrupt sleep.
  

• Weight & movement. Even small weight changes and regular activity can reduce reflux and support heart health.
  

• Consistent wind-down. Keep a set sleep/wake schedule; dim lights in the hour before bed, keep devices out of reach.
  
  

Your Action Plan

Don’t let headlines alarm you. The new study shows a link, not proof that melatonin causes heart problems. If you take melatonin regularly, have a quick conversation with your clinician.

Aim for root-cause sleep care. For chronic insomnia, ask about CBT-I; for occasional nighttime reflux, a low-dose melatonin + alginate strategy can help.

Try a gentle, targeted option. RefluxRaft PM Midnight Berry (1 mg melatonin) offers sleep support and alginate-based reflux control—a one-two approach for nighttime symptoms that doesn’t reduce stomach acid. See how it fits into your routine.

Keep learning. Check out our other blog posts for diet and lifestyle ideas that calm reflux and support better sleep—and visit our site to learn more about our alginate-based products like RefluxRaft.

About the Author

Dr. Spencer C. Payne, MD, is a board-certified otolaryngologist specializing in Rhinology, Sinus, and Endoscopic Skull Base Surgery. With nearly 24 years of medical experience and 18 years at UVA Health, Dr. Payne is a recognized leader in his field. His approach combines cutting-edge surgical techniques with a deep interest in functional medicine, emphasizing nutrition and lifestyle modifications for long-term patient wellness. He has coauthored national guidelines on sinusitis,nosebleeds, and balloon sinuplasty and frequently contributes to professional forums and thought leadership platforms. Passionate about improving patient outcomes, Dr. Payne is known for his curiosity, problem-solving mindset, and ability to translate complex medical concepts into actionable insights.

 

References:

• American Heart Association newsroom summary of the melatonin study (preliminary; association, not causation). https://newsroom.heart.org/news/long-term-use-of-melatonin-supplements-to-support-sleep-may-have-negative-health-effects

• Reporting on the same dataset with expert commentary on limitations and insomnia as a confounder. https://www.washingtonpost.com/health/2025/11/03/melatonin-heart-failure-sleep-aid/
     

• ACP and AASM guidance that CBT-I is first-line for chronic insomnia in adults. ACP Clinical Practice Guideline (Annals of Internal Medicine, 2016):https://www.acpjournals.org/doi/10.7326/M15-217. AASM Guideline on behavioral/psychological treatments (J Clin Sleep Med, 2021; full text) https://pmc.ncbi.nlm.nih.gov/articles/PMC7853203/
  

• Reviews/trials on melatonin & GERD, including possible LES support and symptom improvement. 

• Kandil et al., 2010 (BMC Gastroenterology; full text): https://pmc.ncbi.nlm.nih.gov/articles/PMC2821302/

• Bang et al., 2019 (Medicine/Baltimore; full text): https://pmc.ncbi.nlm.nih.gov/articles/PMC6358381/

• Evidence for alginate “raft” therapy and safety profile (including pregnancy). 

• Leiman et al., 2017 (Dis Esophagus; systematic review & meta-analysis; full text): https://pmc.ncbi.nlm.nih.gov/articles/PMC6036656/

• Strugala et al., 2012 (BMC Gastroenterology; open-label study in pregnancy; full text): https://pmc.ncbi.nlm.nih.gov/articles/PMC3503308/

Review of heartburn management in pregnancy (BMC Gastroenterology, 2022): https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02287-w

Disclaimer

This article is for educational purposes only and isn’t medical advice. If you have ongoing sleep trouble, heart disease, are pregnant, or are considering long-term supplement use, talk with a qualified health professional to find the safest plan for you.