The Clay Travis and Buck Sexton Show – "Wellness Unmasked: New Melatonin Study Raises Red Flags"

Date: November 18, 2025
Guest Host/Speaker: Dr. Nicole Saphier

Main Theme and Purpose

This episode of "The Clay Travis and Buck Sexton Show" (Wellness Unmasked segment) features Dr. Nicole Saphier diving into a newly released study that suggests a strong link between extended melatonin use and significantly increased risks of heart failure and all-cause mortality. Dr. Saphier unpacks the findings, questions some of the study's methodology, and provides evidence-based context to help listeners understand both the risks and the nuances. The episode shifts into a broader exploration of sleep health, highlighting both the dangers of poor sleep and practical strategies for better rest, especially during the holiday season.

Key Discussion Points and Insights

1. Introduction to the Melatonin Study (03:06–05:15)

• Dr. Saphier shares how she came across the new melatonin study due to messages from friends and her own scientific curiosity.
• The study in question is a large-scale review of medical records from over 130,000 adults in the US and UK, focusing on those diagnosed with insomnia.
• The central finding: "Adults with insomnia who took melatonin for at least 12 months had a 90% higher chance of developing heart failure compared to the control group."
  – Dr. Nicole Saphier [04:00]

2. Key Findings of the Study (05:15–06:50)

• The melatonin group was nearly 3.5 times more likely to be hospitalized for heart failure and had almost double the risk of death from any cause over the study period.
• Dr. Saphier is upfront about the study’s impact:

  “They're not mincing words here. They're not saying, oh, it’s like a 2% increase, a 5% increase. They're like, nope, nearly 100% increased risk of death from any cause in the people who were taking melatonin. I mean, this is mind blowing..."
  — Dr. Nicole Saphier [05:45]

3. Critical Examination of the Study’s Methodology (06:50–11:03)

• Prescription vs. Over-the-Counter Melatonin: The study only considered those with a prescription for melatonin as "users," which is crucial because in the US, melatonin is mostly obtained over the counter, whereas it's prescription-based in the UK.
  • This introduces major confounding and possible misclassification.
  • Many "non-users" in the US arm may have actually taken OTC melatonin without a prescription, blurring distinctions between groups.
• Difference in Formulation:
  • Prescription melatonin (especially in the UK) is often extended-release, while US over-the-counter versions are mostly immediate-release.
  • Dr. Saphier asks, “Is it this extended release version that’s causing some sort of alteration in not only our brain chemistry, but is that actually having a role in our cardiovascular health? …That’s one question I had.” [09:20]
• Dosage Uncertainties: No mention of exact doses taken, which could dramatically change risk profiles.
  • “Are they taking 1 milligram for one year or are they taking 20 milligrams for one year? I mean, that kind of makes a difference, doesn’t it?” — Dr. Nicole Saphier [10:05]
• Underlying Severity and Lifestyle Confounders:
  • All participants were diagnosed with insomnia, but those who sought prescriptions might have had much more severe sleep issues, which in and of themselves increase cardiovascular risk.
  • The study didn't control for lifestyle factors like smoking, obesity, or preexisting heart disease.

4. Cautious Interpretation and Media Hype (11:03–12:25)

• Despite dramatic headlines, Dr. Saphier warns against alarmism:

  “I’m not really sure that’s the message here. In fact, I think we need to peel back those layers a little bit.”
  — Dr. Nicole Saphier [12:20]

• Suggests that what the data most likely exposes is risk associated with specific prescribed formulations, not necessarily all types or dosages of melatonin taken by the public.

5. The Biology of Sleep and Its Health Impacts (16:24–22:50)

• Dr. Saphier transitions to emphasize why sleep itself is so vital:
  • Poor sleep is linked to elevated risks for cardiovascular disease, high blood pressure, dementia, depression, anxiety, and even cancer.
  • The neurohormonal axis is disrupted with sleep deficits, elevating stress hormones (cortisol, norepinephrine) and lowering serotonin.
  • Chronic sleep deprivation can shrink the hippocampus (memory formation) and prefrontal cortex (personality, self-control), potentially altering behavior or increasing the risk of dementia.
  • Memorable analogy: "It’s kind of like if you’ve had too much alcohol...well, that part of your brain that tells you...‘that’s not a good idea’—that’s your prefrontal cortex. When you lose volume in there, you lose the ability for your body to say...what’s right, what’s not right.” — [19:25]

6. Prioritizing Sleep Without Relying Solely on Melatonin (22:50–25:35)

• Emphasizes that consistency in sleep routine trumps sheer total hours—“Your body wants to follow the same rhythm. You want to try really hard to go to bed at a similar time every single night.” [23:00]
• Advises limiting screen time at least 90–120 minutes before bed to reduce blue-light interference with natural melatonin production.
• Advocates for regular physical activity, relaxation techniques (like evening showers or hot tea), and not overextending oneself during the holiday season.
• Encourages self-forgiveness around not making every social event, and pacing oneself to protect mental and physical health.
  • “Don’t power through anything...Pace yourself. It’s a marathon, not a sprint. You have to be enjoying every moment of your life because every day is a blessing and nothing is guaranteed.” — [25:00]

7. Her Take on Melatonin Supplementation Going Forward (25:35–26:40)

• Dr. Saphier is not wholly anti-melatonin but recommends caution, especially with prescription forms.
  • She uses (and includes in her own sleep aid) a very small, occasional (“microdose”) amount of melatonin (2 mg), alongside calming herbs such as lavender and chamomile.
  • Key advice: “…If you find yourself really not able to sleep without melatonin, take a look at the lifestyle and your bedtime routine, because maybe making some changes there are really what your body needs.” — [26:20]
• Invites listeners to share tips and reinforces that sleep is one of the single most important health choices we make.

Notable Quotes & Moments

• On the confounding in the study:

  "That's a huge confounding factor. So that's a really big deal for me. It's just a misclassification of non users."
  — Dr. Nicole Saphier [08:20]

• On media coverage:

  "The way that this study has been picked up by the media and just broadly blasted everywhere of 'oh my gosh, melatonin, you have almost 100% risk of all cause mortality and death if you take melatonin.' I'm not really sure that that's ... the message here."
  — Dr. Nicole Saphier [12:05]

• On sleep routine:

  "Me, my goal, I love being in bed by 9:30pm every night. Does that mean that I'm usually the first to leave a party? Yep. And you know what? I'm okay because I love my sleep and I prioritize it. I really do."
  — Dr. Nicole Saphier [23:24]

• On sleep, holidays, and health:

  “While we tell ourselves, ‘all right, we just need to power through these next two months and then we're going to recover in January,’ the reality is we don't recover in January…So please don't power through anything. Prioritize yourself.”
  — Dr. Nicole Saphier [24:55]

• On melatonin going forward:

  “I'm certainly going to avoid those prescription melatonins, I'll tell you that much. [But am I] opposed to microdosing of melatonin and taking it occasionally? No, I'm not…If you find yourself really not able to sleep without melatonin, take a look at the lifestyle and your bedtime routine.”
  — Dr. Nicole Saphier [26:37]

Key Timestamps

• 03:06 – Dr. Saphier introduces the melatonin study and its context.
• 04:00–05:45 – Alarming statistics from the study, initial reaction.
• 06:50–11:03 – Breakdown of study limitations and confounders.
• 12:05–12:25 – Media hype addressed.
• 16:24–20:45 – Dangers of chronic sleep deprivation.
• 22:50–25:35 – Holistic sleep improvement advice.
• 25:35–26:40 – Dr. Saphier’s melatonin takeaway and call for listener feedback.

Summary Takeaways for Listeners

• Don’t panic about the dramatic headlines: The alarming statistics around melatonin and heart health may not apply to over-the-counter forms most Americans use due to differences in formulation and methodology confounding.
• Prioritize sleep health above all—regular routine, reduced blue-light exposure before bed, daily physical activity, and mindful boundaries during stressful seasons.
• Use melatonin, if at all, in moderation and consider focusing on foundational lifestyle changes first.
• Consult your doctor if struggling with sleep consistently, and be wary of prescription options unless clearly indicated.
• Above all, protect your sleep—not just as an “extra,” but as a cornerstone of mental and physical wellness.

Dr. Nicole Saphier closes the episode with encouragement for listeners to share their own sleep tips and reiterates the importance of sleep for wellbeing, especially through life’s busiest and most stressful seasons.