Melatonin is widely used as a sleep aid but is most effective for circadian rhythm issues rather than general insomnia. Melatonin for sleep requires proper dosing and timing for effectiveness. Lower doses often work better than higher.
What melatonin does
Hormone naturally produced by pineal gland that signals darkness/sleep. Levels rise in evening, peak overnight, decline in morning. Supplemental melatonin can:
- Shift circadian timing
- Modestly help sleep onset
- Help with jet lag, shift work
What melatonin doesn’t do well
- General insomnia (modest effect at best)
- Sleep maintenance
- Substitute for sleep hygiene/CBT-I
Dosing
Counterintuitively, lower doses often more effective:
- 0.3-1 mg often optimal
- 1-3 mg common
- 5-10 mg too high for most uses
- High doses can cause headaches and paradoxical effects
Timing
For sleep onset: 30-60 minutes before bed.
For circadian shifting:
- Delayed sleep phase: 5-7 hours before desired sleep
- Jet lag east: at destination bedtime
- Jet lag west: at destination bedtime
Quality concerns
OTC melatonin quality varies:
- Studies have found actual content from -83% to +478% of label
- Some products contain serotonin (concern)
- Look for USP-verified products
- Pharmacist-recommended brands
Side effects
- Headaches (high doses)
- Daytime sleepiness
- Vivid dreams
- Mild GI symptoms
- Generally well-tolerated
Frequently Asked Questions
How much melatonin should I take?
Start low (0.5-1 mg). Higher doses often less effective.
Is melatonin safe long-term?
Long-term safety data limited. Generally considered safe; lower doses preferred.
Should children take melatonin?
Specific medical situations only. Most pediatric experts recommend avoiding routine use.
Why doesn’t melatonin work for me?
Insomnia from non-circadian causes responds less. Other treatments may work better.
Can I become dependent on melatonin?
Not in classical sense. Some psychological dependence possible.
The bottom line on melatonin
Most effective for circadian issues (jet lag, shift work, delayed sleep phase). Modest effect for general insomnia. Lower doses often better. Quality matters.