Can You Take Melatonin Before Having Surgery?

For people who utilize melatonin as a supplement for sleep, it makes sense to take it in the evening hours before climbing into bed.

"Melatonin levels rise about two hours before bedtime," sleep expert Dr. Luis F. Buenaver tells Johns Hopkins Medicine. He adds that the effects of melatonin can be likened to a feeling of "quiet wakefulness that helps promote sleep." While our body can handle melatonin production by itself, supplementation may help support the natural production of the hormone in cases such as insomnia or jet lag.

Because melatonin can help ease us into a state of relaxation, is it possible that the supplement may also be useful in situations of heightened stress? The National Center for Complementary and Integrative Health reports that as many as 80% of patients feel anxious before and after undergoing surgery — so some may wonder if melatonin would be helpful and safe to take in this situation. As it turns out, there are both potential pros and cons to taking melatonin before surgery.

While research findings over the years have been mixed, some studies show that taking melatonin before surgery may be potentially beneficial for patients' physical and mental health.

In a 2013 scientific review published in the Indian Journal of Anaesthesia, researchers highlighted melatonin's immune-boosting, antioxidant, and anti-inflammatory properties. In addition, the study team analyzed a number of studies in which findings illustrated a link between perioperative melatonin usage and reduced levels of anxiety in patients.

In one such study, published in the British Journal of Anaesthesia in 1999, 75 women were given either 15 milligrams (mg) of midazolam, 5 mg of melatonin, or a placebo 100 minutes before anesthesia was administered in preparation for surgery. Measurements of patient levels of sedation, anxiety, orientation, and psychomotor performance revealed that melatonin and midazolam yielded the greatest reduction in patient anxiety. However, those who'd received melatonin had lower levels of impairment than those who'd taken midazolam. The researchers concluded that melatonin has the potential to be an effective tool for adult premedication by clinicians. 

While some of the research may look promising, many experts advise against the use of melatonin prior to surgery. Experts at Contoura Facial Plastic Surgery emphasize that any patient who regularly uses melatonin should stop taking the supplement two weeks before their procedure and continue to refrain from use for two weeks following the surgery. The reason is that melatonin can potentially exacerbate the effects of anesthesia or other sedating medications.

Furthermore, the anxiety-reducing effects of melatonin may not be universal. Rather, a 2009 study published in the scientific journal Anesthesiology found that children who took low doses of melatonin prior to surgery experienced greater preoperative anxiety than children who had been given the sedating drug midazolam.

Therefore, because the research surrounding the efficacy of melatonin to treat pre-operative anxiety isn't definitive, it's best to consult with your doctor ahead of your surgery and disclose if you take melatonin on a regular basis. The same is true for any other herbs, vitamins, or supplements you routinely use.