Melatonin has not been shown to quiet tinnitus itself, but it may help people whose tinnitus disturbs their sleep: in a placebo-controlled trial, 46.7% of that group improved on melatonin against 20.0% on placebo.
Unlike ginkgo biloba, where the trial evidence is clearly negative, melatonin has a mixed and moderately encouraging research picture for tinnitus — particularly for the sleep-disruption side of the condition rather than tinnitus loudness itself.
Why melatonin might do more than just help you sleep
Most people know melatonin only as a sleep hormone, but the proposed mechanism for tinnitus is more specific than "it helps you sleep, and better sleep helps tinnitus." Melatonin is present in the cochlea itself, following its own circadian rhythm with higher concentrations at night, and researchers have identified two separate, direct mechanisms that could plausibly affect tinnitus independent of sleep:
Antioxidant activity. The cochlea generates oxygen free radicals and reactive oxygen species as a normal byproduct of its metabolic activity, and oxidative stress from these free radicals is increasingly implicated as a contributor to inner ear damage and dysfunction. Melatonin is a potent free radical scavenger — among the more effective antioxidants identified in the body — and researchers have proposed it may help neutralize this cochlear oxidative stress directly, distinct from any effect on sleep.
Dopamine and GABA interaction. Melatonin has been found to inhibit dopamine signaling in the auditory system, suppressing the neurotransmitter's peak response by a substantial margin in laboratory research, through a pathway that appears to involve GABA (the brain's primary inhibitory neurotransmitter). Since dopamine and GABA both play a role in auditory neural activity, this offers a second, sleep-independent pathway through which melatonin could theoretically influence tinnitus-related neural signaling.
Both mechanisms are plausible and biologically grounded, but plausible mechanisms don't guarantee clinical benefit, which is exactly why the trial data below matters more than the theory alone.
What the trials found
The placebo-controlled trial. A 1998 randomised, double-blind, placebo-controlled crossover trial gave 30 patients 3 mg of melatonin nightly for 30 days and a placebo for 30 days, in either order. On its main scale, the Tinnitus Handicap Inventory, the two ended almost level: an average of 26.09 after melatonin against 26.43 after placebo, not a significant difference. The encouraging result was in a subgroup. Among patients whose tinnitus was disturbing their sleep, 46.7% reported overall improvement on melatonin against 20.0% on placebo, and those who improved on melatonin tended to have had higher Tinnitus Handicap Inventory scores to begin with. That points to a targeted benefit for a specific group rather than a general tinnitus treatment.
The comparison with sertraline. A 2017 randomised trial gave 70 patients either melatonin 3 mg or sertraline 50 mg daily for three months. Sertraline is an antidepressant sometimes used for tinnitus distress, covered in drugs for tinnitus. Both groups improved: average Tinnitus Handicap Inventory scores fell from 45.02 to 30.29 with melatonin and from 44.85 to 36.96 with sertraline, and the authors concluded melatonin was the more effective. There was no placebo group, though, so the trial can say melatonin did at least as well as sertraline, but not how much of either group's improvement came from the drug rather than time and expectation.
The review. A 2015 review of the clinical evidence found five studies — three of melatonin alone, two combining it with other drugs — with designs ranging from single-arm to randomised, placebo-controlled crossover, all with methodological weaknesses. Its conclusion is that melatonin's effectiveness for tinnitus cannot be confirmed given the biases in the evidence, but that melatonin seems to improve the sleep disturbance linked to tinnitus. That narrower finding is more consistent than any claim about tinnitus severity.
Reading the evidence honestly
The pattern across the research is fairly consistent: melatonin's clearest benefit is for sleep, not for making tinnitus itself quieter. Given how tightly tinnitus and sleep disruption feed into each other (see sleeping with tinnitus), improving sleep can plausibly reduce how distressing tinnitus feels day to day even without changing the tinnitus directly — which may explain why some trials show improvement on tinnitus handicap scores despite the mechanism being sleep-related rather than auditory.
Practical considerations
Melatonin is available over the counter in the US and generally considered to have a favorable safety profile compared to many alternatives, including few significant side effects at the doses commonly used in these trials. That said, "available without a prescription" isn't the same as "no reason to check with a doctor first" — melatonin can interact with certain medications (including blood thinners and some diabetes medications) and isn't well-studied for long-term daily use over years. If tinnitus-related sleep trouble is significant enough to consider melatonin, it's worth a conversation with a doctor or pharmacist about your specific medication list first, rather than starting on your own.
If poor sleep is the main problem, CBT for tinnitus has far more trial evidence behind it than any supplement, and the 2024 VA/DoD guideline notes some evidence that it improves sleep as well as distress; CBT for insomnia, tested directly in tinnitus-related insomnia, is the more targeted version.
Where it fits in
Melatonin is a reasonable, low-risk option to discuss if your tinnitus is closely tied to sleep disruption specifically — best thought of as a sleep aid with some tinnitus-adjacent research support, rather than a targeted tinnitus treatment in its own right. It pairs naturally with general sleep strategies rather than replacing them.
Where the professional guidelines land
Melatonin is named directly. The American Academy of Otolaryngology–Head and Neck Surgery's clinical practice guideline on tinnitus issues a recommendation against ginkgo biloba, melatonin, zinc and other dietary supplements for persistent, bothersome tinnitus. The 2024 VA/DoD guideline suggests against ginkgo biloba, dietary or herbal supplements, and nutraceuticals for tinnitus management (weak against).
That is worth weighing against the sleep-specific reasoning above rather than treating the two as unrelated. The guidelines' position is about melatonin as a treatment for tinnitus. Melatonin's use for sleep is a separate question with a separate evidence base, and tinnitus that is mainly a sleep problem is a different target from tinnitus itself.