What to know about myasthenia gravis and melatonin

Last updated Sept. 3, 2025, by Agata Boxe
✅ Fact-checked by Joana Carvalho, PhD

 

Myasthenia gravis (MG) can cause muscle weakness, fatigue, and other symptoms that make it hard to fall or stay asleep.

While some people may consider supplements like melatonin to help with sleep, it’s important to talk to your doctor before using them, as they may carry risks for those living with MG. Fortunately, there are other ways to improve your sleep that may be safer and more effective.

Understanding MG sleep issues

Sleep issues are common in people with MG and can be caused by a combination of MG symptoms, medication side effects, and emotional stress.

  • Weakness affecting the muscles responsible for breathing can lead to nighttime breathing difficulties, and weakness in the muscles involved in swallowing may cause sensations of choking or the need to cough, both of which can disrupt sleep.
  • Some medications used to treat MG can cause insomnia, while other treatments can trigger muscle twitches that interfere with rest.
  • Anxiety or depression related to the condition can also make it challenging to get a good night’s sleep.

Because of these challenges, some people with MG may consider sleep aids — but not all options are safe for everyone with the condition.

MG and melatonin

Melatonin is a popular sleep supplement, but it can affect the immune system in ways that may worsen MG symptoms.

With MG, the immune system mistakenly attacks the neuromuscular junction, the location where a nerve communicates with a muscle. Melatonin can affect the immune system by influencing the production and activity of immune cells and chemical messengers that regulate immune responses. The increased stimulation of the immune system through melatonin could consequently worsen MG symptoms.

Additionally, many MG therapies aim to suppress immune activity, so taking melatonin might work against their intended effects.

Until more research is done, it may be best to be cautious about melatonin and avoid taking it unless your doctor prescribes it.

Alternatives to melatonin

MG symptoms, such as fatigue and breathing issues, can make it challenging to sleep well. One way to address sleep problems is through a holistic approach that involves multiple small adjustments.

You can try these tips to sleep better:

  • Try to conserve energy throughout the day to prevent nighttime fatigue.
  • Take your MG medication as scheduled to manage symptoms as well as possible.
  • Go to sleep and get up at the same time every day.
  • Keep your bedroom dark, cool, and as quiet as possible at night.
  • Establish a pre-bedtime routine with relaxing activities, such as reading or listening to music.
  • Avoid alcohol and heavy meals at least 2-3 hours before bedtime.

If sleep problems persist, talk to your doctor. Your healthcare provider may refer you to a sleep specialist or recommend other options.

Do not self-medicate with melatonin or other supplements because they can have unintended effects and worsen your symptoms.

Final thoughts

While melatonin is generally safe for people in the general population, this may not be the case for those with MG. Considering the limited research on the supplement and MG, exercise caution and consult a doctor to determine the best approach to addressing your sleep issues.

Your healthcare team can provide guidance and help you make the right decisions regarding your health and well-being.

Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.