{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:17:58Z","timestamp":1790363878482,"version":"4.1.0"},"reference-count":78,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clocks &amp; Sleep"],"abstract":"<jats:p>Melatonin occupies a paradoxical position in contemporary sleep medicine: despite its physiological role as a regulator of circadian timing, it is frequently used and perceived as a nonspecific \u201cnatural\u201d hypnotic. Although melatonin demonstrates modest benefits for sleep initiation and clearer efficacy in circadian rhythm sleep\u2013wake disorders, its clinical use is often undermined by diagnostic imprecision, inappropriate dosing, mistimed administration, inconsistent formulations, and inadequate patient counseling. Circadian disorders can be misclassified as primary insomnia, leading to symptomatic treatment approaches that fail to address the underlying phase misalignment. At the same time, supraphysiological doses and reflexive bedtime administration have become normalized despite evidence that melatonin acts primarily as a chronobiotic whose effects depend more on timing than dose. Regulatory inconsistencies and substantial variability in over-the-counter preparations further complicate safe and reproducible use. These factors contribute to avoidable treatment failure, inaccurate labeling of nonresponse, and persistent misconceptions regarding melatonin\u2019s mechanism of action. Therefore, melatonin should be approached as a pharmacological intervention requiring the same diagnostic rigor, individualized dosing, and longitudinal assessment expected of other sleep therapeutics, particularly when integrated with behavioral and circadian interventions.<\/jats:p>","DOI":"10.3390\/clockssleep8030038","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T03:20:21Z","timestamp":1782357621000},"page":"38","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Melatonin in Clinical Practice: Grey Zones Between Chronobiology, Insomnia and Consumer Supplementation"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1740-6782","authenticated-orcid":false,"given":"Alexandros","family":"Kalkanis","sequence":"first","affiliation":[{"name":"Department of Pulmonology, Leuven University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium"},{"name":"Laboratory of Respiratory Disease and Thoracic Surgery (BREATHE), KU Leuven University, Herestraat 49, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliki","family":"Karkala","sequence":"additional","affiliation":[{"name":"Laboratory of Respiratory Disease and Thoracic Surgery (BREATHE), KU Leuven University, Herestraat 49, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3252-6694","authenticated-orcid":false,"given":"Athanasia","family":"Pataka","sequence":"additional","affiliation":[{"name":"Respiratory Failure Unit, General Hospital of Thessaloniki \u201cG. Papanikolaou\u201d, Aristotle University of Thessaloniki, Exochi, 57010 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.clinthera.2022.03.008","article-title":"Melatonin: Translation of ongoing studies into possible therapeutic applications outside sleep disorders","volume":"44","author":"Leelawiwat","year":"2022","journal-title":"Clin. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Minich, D.M., Henning, M., Darley, C., Fahoum, M., Schuler, C.B., and Frame, J. (2022). Is melatonin the \u201cnext vitamin D\u201d?: A review of emerging science, clinical uses, safety, and dietary supplements. 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