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Melatonin for sleep linked to 90% higher risk of heart failure, study finds
(www.sfchronicle.com)
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Here's the original press release for anyone interested: https://newsroom.heart.org/news/long-term-use-of-melatonin-supplements-to-support-sleep-may-have-negative-health-effects
The most important sentence: "They were matched with peers in the database who also had insomnia but never had melatonin recorded in their health records. People were excluded from the analysis if they had previously been diagnosed with heart failure or had been prescribed other sleep medications." There are a few other sentences describing how well the control group was matched. I think it was a well-designed study.
I think there is still a risk of bias present, though, because people who decide to take melatonin might have more severe insomnia compared to people who just decide to just "live with it" and are not using sleep aids.
The next step should be a randomized clinical trial looking at heart failure rate in patients with insomnia dosed with melatonin versus placebo and/or a different medication. Until then, correlation does not mean causation. I don't think such a study will be done in the US because melatonin is considered a dietary supplement and is not subject to the same degree of regulation as medicine. Maybe in the UK, since melatonin is prescription only?