Why Melatonin for Tinnitus Works
Melatonin tinnitus therapy is a powerful, natural way to help your brain recovery from loud ringing. Beyond sleep support, melatonin for tinnitus plays a role in neuroprotection, inflammation control, and neurotransmitter balance, all of which influence tinnitus severity. In this article, I’ll explain why I routinely recommend melatonin for tinnitus, how it works, and the best way to use it.
Here, I outline what you need to know about melatonin and tinnitus:
- How does melatonin help sleep?
- How much melatonin should you take for tinnitus?
- Tips for Sleeping with Tinnitus
- What are melatonin’s side effects?
What is Melatonin?
Melatonin, a hormone produced by the pineal gland in the brain, plays a crucial role in regulating the sleep-wake cycle. Beyond its well-known function as a sleep aid, recent studies have explored the potential benefits of melatonin for ringing ears.
As my patients know, I strongly stress the importance of sleep optimization for tinnitus relief. For this reason alone, melatonin is a good supplement to include in the treatment of tinnitus, especially in cases where tinnitus patients have insomnia (difficulty going to sleep).
However, as we learn more about the neurological benefits of melatonin, it’s becoming clear that using melatonin to treat tinnitus may have benefits far beyond its impact on restoring sleep. Here, I cover what you need to know about melatonin for tinnitus.
How does sleep affect tinnitus?
Improved sleep quality is crucial for tinnitus relief due to its profound impact on various physiological and psychological aspects of overall health. Here are key reasons why adequate and restful sleep and tinnitus relief go hand-in-hand:
| Sleep Parameter | Description |
|---|---|
| Stress Reduction | Quality sleep helps regulate stress hormones, such as cortisol. Elevated stress levels are associated with increased tinnitus perception and annoyance. |
| Neurotransmitter Balance | Sleep influences the balance of neurotransmitters in the brain, including serotonin and dopamine. Imbalances in these neurotransmitters are linked to mood disorders and can contribute to tinnitus distress. |
| Cognitive Function | Adequate sleep enhances cognitive function, including attention and memory. Improved cognitive abilities can contribute to better coping strategies for dealing with tinnitus, reducing its cognitive impact. |
| Immune System Support | Sleep is essential for a well-functioning immune system. Tinnitus may be linked to inflammation, and a robust immune response can help manage inflammatory processes in the body, potentially mitigating tinnitus symptoms. |
| Emotional Health | Sleep plays a critical role in emotional regulation. Lack of sleep can lead to irritability, mood swings, and heightened emotional responses. |
| Hormonal Balance | Sleep influences hormone regulation, including melatonin. Disruptions in melatonin production can impact sleep quality and may be associated with tinnitus severity. |
| Overall Health | Chronic sleep deprivation is linked to various health issues, including cardiovascular problems and metabolic disturbances. Addressing these broader health concerns contributes to tinnitus recovery. |
Tinnitus patients are particularly susceptible to the effects of poor sleep. This is because sleep disturbance can activate a migraine-like process in the brain, making the tinnitus intensity worse. When indicated, we always screen our patients for sleep disorders.
Many tinnitus patients suffer from dysfunctional sleep wake cycles (called circadian rhythm disorder) or insomnia. These sleep problems tend to amplify their ringing loudness and intensity. For this reason, melatonin supplementation is a powerful complementary therapy in the treatment of tinnitus.
How does melatonin help sleep?
Melatonin plays a crucial role in regulating the sleep-wake cycle, also known as the circadian rhythm (the brain’s 24 hour clock system). Melatonin hormone helps synchronize various physiological functions in the sleep-wake cycle, acting as a “biological clock” that signals the body when it's time to wind down and prepare for sleep.
Plasma melatonin hormone produced by the pineal gland reaches its peak plasma levels at night. This is because it's production is inhibited by light. The peak wavelength that suppresses melatonin production is 480 nanometers, which happens to be the blue light spectrum. That's why blue light from screens can cause insomnia at night; it suppresses the effects of melatonin.
At night, melatonin prompts physiological changes, such as a drop in body temperature and an increased propensity for sleep. Conversely, exposure to light, especially natural sunlight or artificial blue light, inhibits melatonin production, signaling wakefulness and alertness.
Given the importance of good sleep for tinnitus patients, melatonin tinnitus therapy makes good sense.
"I would definitely recommend this program to to others... This is the only time I found something that actually worked."
—Tobias I.
Are you a good candidate for our program?
Melatonin's Functions in the Brain
Beyond its critical role in regulating sleep, melatonin has numerous important functions in the brain and central nervous system. These additional features amplify the potential effectiveness of melatonin for tinnitus. Here are some of the benefits that melatonin has on the brain and inner ear:
| Melatonin Function | Description |
|---|---|
| Neurotransmitter Modulation | Melatonin can influence the release of neurotransmitters, such as dopamine, serotonin, and GABA, which are essential for communication between brain cells. This can also support neural plasticity. |
| Antioxidant Properties | Acting as a potent antioxidant, melatonin can protect against oxidative stress, reducing the risk of cellular damage. Its antioxidant properties can also boost inner ear immunity and protect against drug mediated ototoxicity. |
| Neuroprotection | Melatonin has a protective effect on neurons by scavenging free radicals and reducing inflammation, which may contribute to the prevention of neurodegenerative conditions. |
| Mitochondrial Support | Melatonin has been shown to support mitochondrial function, enhancing energy production within neurons and promoting cellular resilience. |
Melatonin has powerful effects beyond helping with sleep or insomnia. By exerting antioxidant. anti-inflammatory, and neuroprotective effects, melatonin serves as an excellent complementary treatment for auditory system health.
Migraine, Melatonin, and Chronic Tinnitus
Research from my academic clinic in the past 5 years has shown that tinnitus is amplified by a migraine-like process in the brain. This can happen even if you never have a headache. In many people, the sole symptom of this migraine reaction is loud tinnitus.
Studies have shown that people with migraine headaches have a statistically significant decrease in melatonin levels compared to healthy people. Further, melatonin supplementation in migraine patients has been shown to be effective as an adjuvant therapy. Finally, melatonin has been shown in clinical trials to decrease calcitonin gene related peptide (CGRP), a key inflammatory mediator that drives the migraine process in the brain [1].
Melatonin levels can change with age, often decreasing as people grow older. This decline may also be connected to menopause, as hormonal changes during this time can further disrupt melatonin production and sleep patterns.
Something else important for tinnitus sufferers to know: melatonin protects against noise induced hearing loss. Further, it helps prevent hearing loss from ototoxic drugs like aminoglycoside antibiotics.
Given that melatonin has been successfully used as a complementary therapy for migraine management, we've used it effectively for tinnitus as part of a comprehensive tinnitus management program. For all of these reasons, melatonin as a supplement for tinnitus relief shows great potential.
Review of Melatonin Tinnitus Clinical Trials
Clinical trials for melatonin and tinnitus have shown promising results. In the pioneering trial by Rosenberg et al., melatonin's efficacy for tinnitus was assessed through a randomized, double-blinded, placebo-controlled study. The study found that individuals with elevated Tinnitus Handicap Inventory (THI) scores or sleep difficulties experienced improvement with melatonin [2]. Note that randomized, double-blind, placebo-controlled studies produce the highest quality medical evidence we have.
In another notable study, Abtahi and team compared melatonin to sertraline (Zoloft). In this study, 3mg melatonin (3 mg nightly for 3 months) led to a significant reduction in THI scores compared to sertraline. Notably, melatonin showed effectiveness with minimal side effects [3].
These are extremely positive results. We are currently working on further high-quality clinical trials to validate these findings conclusively, considering melatonin's recognized efficacy in improving sleep and overall quality of life for individuals with tinnitus.
How much melatonin for tinnitus should I take?
Melatonin dosages can vary, and it's advisable to start with lower doses (typically 1-3 mg) to assess individual tolerance and effectiveness. Most insomnia clinical trials for use a 3 mg dose of melatonin, a standard adult dose. Older adults should start at lower doses. There doesn't appear to be an issues with extended use.
What is the best form of melatonin to use? It can be confusing because there are multiple different formulations of melatonin, from standard pills, to gummies, to sublingual strips and drops. In addition, some melatonin products are marketed as fast-acting or quick-release formulas.
In my view, the most important thing is to get a high quality formulation of melatonin. There is wide variation in the actual dosage in many low-quality manufacturers that do not do quality control testing. As long as you have a high quality product, the effects will be consistent and you’ll figure out with experience when the best time is for you to take your melatonin.
High Dose Melatonin for Tinnitus
There is no data on the utility of high dose melatonin for tinnitus (i.e. doses higher than the pineal gland normally produces). However, a 2020 meta-analysis (summary of multiple studies) of high dose melatonin reported that there were increased reports of drowsiness, headache and dizziness [4].
I recommend avoiding high dose melatonin for ear ringing relief. This is because sleeping too much can worsen tinnitus just as much as not enough sleep.
How to Take Melatonin for Ear Ringing at Night
Melatonin should be taken around 30-60 minutes before bedtime. When used for tinnitus, melatonin therapy should be combined with other non-invasive interventions that can help foster better sleep. These are sometimes called “sleep hygiene” techniques and they can help with insomnia related to tinnitus.
Sleeping with Tinnitus
Sleep disturbances are extremely common for people who suffer from tinnitus. It's important to follow simple guidelines that will help optimize your ability to sleep. These should be used in parallel with melatonin tinnitus therapy for best results.
| Recommendation | Description |
|---|---|
| Consistent Sleep Routine | Establish a regular bedtime routine for better sleep quality. |
| Blue Light Reduction | Minimize exposure to blue light before bedtime, especially from screens. Blue light actually blocks melatonin release. |
| Sleep Environment Optimization | Create a sleep environment to enhance rest that is cool, dark, and comfortable. |
| White Noise or Sound Generators | Use white noise or sound generators to help mask tinnitus sounds while you are falling asleep. |
| Mindfulness Techniques | Practice mindfulness exercises like progressive relaxation and deep breathing as you prepare to go to sleep. |
| Stimulant Avoidance | Steer clear of stimulants in the evening for a calmer bedtime experience. |
| Hydration Timing | Refrain from drinking water three hours before bedtime for uninterrupted sleep. |
| Avoid Email/Social Media | In the 1-2 hours before going to sleep, don’t look at your email or social media. Excitement/stress caused by reading or seeing something on email/social media will cause suppression of sleep. |
What are the common melatonin side effects?
Melatonin for tinnitus is generally considered safe for short-term use, but some individuals may experience side effects. Common side effects of melatonin may include:
| Melatonin Side Effect | Notes |
|---|---|
| Daytime Sleepiness | Some individuals (older adults in particular) may feel drowsy during the day, especially if melatonin is taken in larger doses. If this happens, reduce the dose. |
| Headache | Melatonin use has been associated with headaches in some cases. This can occur if you sleep too much. |
| Dizziness | A feeling of lightheadedness or dizziness has been reported by a small number of individuals. This will happen if you take melatonin and don’t go to bed and continue walking around the house. |
| Nausea | Melatonin supplementation may uncommonly cause nausea or stomach discomfort in some users. |
| Irritability | Mood changes, including irritability, have been reported in rare instances. |
| Vivid Dreams or Nightmares | Some people may experience vivid dreams or nightmares when taking melatonin. |
| Sleep Disruptions | Paradoxically, melatonin can affect sleep patterns negatively in rare individuals, leading to difficulty falling asleep or staying asleep. |
If you get any side effects, try going to a lower dose before completely giving up on melatonin. You should not take melatonin if you have untreated sleep apnea, as this can make your apnea worse. Some advise against taking melatonin if you’re pregnant or suffer from depression. Also, combining melatonin with blood-thinning medications or anticonvulsants may pose risks.
Can melatonin cause tinnitus?
Melatonin is very rarely linked to tinnitus and I found no official reports of this in the literature. While it's not impossible, any increase in tinnitus is more likely due to manufacturing impurities or as a secondary reaction to one of more common side effects (like headache). If you do notice an increase in tinnitus, simply stop taking it and consult a healthcare provider for guidance.
The Importance of Multimodal Tinnitus Care
While melatonin has clear benefits for sleep and brain health, it is not a standalone solution for tinnitus relief. Tinnitus is driven by complex neurological and inflammatory processes, particularly migraine-like brain activity and neural sensitization. Addressing these underlying factors requires a multimodal treatment approach—melatonin alone is often not enough.
Successful tinnitus management most often requires an integrative medicine approach. This includes:
✔ Medical Management – Targeting neurotransmitter imbalances and neurological stability
✔ Anti-Inflammatory Nutrition – Reducing neuroinflammatory foods and supporting brain health
✔ Behavioral Sleep Therapy – Optimizing sleep habits to improve tinnitus resilience
✔ Cognitive Behavioral Therapy (CBT) – Reframing negative thought patterns and emotional responses
The Role of a Medical Team
A tinnitus-trained medical team does more than prescribe medications—they provide personalized supplement guidance, optimize dosing, and ensure safe, evidence-based interventions. Without proper direction, supplement use can fall short or, in some cases, worsen symptoms. For lasting tinnitus relief, melatonin should be part of a strategic, integrative plan, not a one-size-fits-all remedy.
Conclusion: Melatonin and Tinnitus Relief
Melatonin tinnitus therapy is an important treatment tool, especially for those seeking a natural approach. While individual responses may vary, melatonin's multifaceted benefits on sleep, neural function, and overall well-being make it a compelling option in the holistic management of tinnitus.
However, as with any supplement for tinnitus, beware of expecting a quick fix. Melatonin tinnitus therapy is an important intervention, but it must be combined with other structured therapies that address the fundamental neural mechanisms that cause and perpetuate tinnitus.
Schedule a call today to create a personalized, medically-guided plan for lasting tinnitus relief.
Melatonin Tinnitus FAQs
Can melatonin cause your ears to ring?
It’s very unlikely. There are no strong studies showing that melatonin causes ear ringing. If someone notices increased tinnitus after taking melatonin, it may be due to other ingredients in the supplement or a rare side effect like headache. Simply lowering the dose or switching brands often helps.
Is it harmful to take melatonin every night?
For most people, no. Melatonin is considered safe for nightly use, especially at lower doses like 1–3 mg. Studies show it does not lead to dependence or disrupt your natural sleep cycle when used properly. Still, it’s best to use high-quality melatonin and talk to a healthcare provider if taking it long term.
How much melatonin should I take for tinnitus?
Start with 1–3 mg about 30–60 minutes before bedtime. This is the dose used in most clinical trials for tinnitus. If you're older or sensitive to medications, start even lower. There’s no proven benefit to high doses, and they may cause unwanted side effects like drowsiness or dizziness.
Can low melatonin cause tinnitus?
Low melatonin levels can disrupt sleep, increase inflammation, and worsen stress, all of which can make tinnitus louder or more annoying. This is especially true in older adults or those with poor sleep habits. An observational study found that elderly patients with tinnitus had significantly lower plasma melatonin levels than those without.
Does melatonin affect your ears?
Yes—in a good way. Melatonin has antioxidant and anti-inflammatory effects that may protect the inner ear from damage caused by loud noise or certain medications. It also helps regulate neurotransmitters that influence how the brain processes sound, including tinnitus.
Does melatonin affect hearing?
Emerging research suggests it might. Melatonin may help prevent noise-induced hearing loss and protect hearing cells from oxidative stress. Some studies even show it can support better hearing outcomes in people exposed to loud environments or ototoxic drugs.
Does taking melatonin help with tinnitus?
Yes, especially if you struggle with sleep. Clinical trials show melatonin can reduce tinnitus severity in people who also have insomnia. It’s most effective when combined with other treatments that target the brain's response to tinnitus, such as lifestyle changes and neural retraining.
Melatonin Tinnitus Therapy References
[1] Zduńska A, Cegielska J, Domitrz I. The Pathogenetic Role of Melatonin in Migraine and Its Theoretic Implications for Pharmacotherapy: A Brief Overview of the Research. Nutrients. 2022 Aug 15;14(16):3335.
[2] Rosenberg SI, Silverstein H, Rowan PT & Olds MJ Effect of Melatonin on Tinnitus. The Laryngoscope 108, 305–310 (1998).
[3] Abtahi S, Hashemi S, Mahmoodi M & Nilforoush M Comparison of melatonin and sertraline therapies on tinnitus: A randomized clinical trial. Int J Prev Med 8, 61 (2017).
[4] Menczel Schrire Z, Phillips CL, Chapman JL, Duffy SL, Wong G, D'Rozario AL, Comas M, Raisin I, Saini B, Gordon CJ, McKinnon AC, Naismith SL, Marshall NS, Grunstein RR, Hoyos CM. Safety of higher doses of melatonin in adults: A systematic review and meta-analysis. J Pineal Res. 2022 Mar;72(2):e12782.
