Does melatonin help older adults sleep?

Melatonin does (!) help older adults sleep.  It has been shown that melatonin preparations help people fall asleep faster, increase total sleep time, and slightly improve sleep efficiency.  Prolonged-release melatonin like ramelteon is thought to be helpful AND it does not increase traumatic accidents (head injuries, falls or motor vehicle crashes).

What are the guidelines?  American Academy of Sleep Medicine and the Choosing Wisely campaign both state that cognitive behavior therapy should be the primary treatment for chronic insomnia in adults.  This includes winding down before bed, only having sex or sleep in the bed, no blue lights or tv 30 minutes before bed.  The 2017 ASM guidelines gave a weak recommendation for starting ramelteon 8 mg nightly to help with chronic sleep-onset insomnia that did not respond well to cognitive behavior therapy.  Medications like Lunesta and ambien should be tried as a last resort.

I hope this helps.