The Truth About Taking Melatonin To Help You Sleep
Its been a rough day and you must wake up early tomorrow for a breakfast meeting, so you take a melatonin pill, brush your teeth and crawl into bed. Then you stare at the ceiling. And stare. And stare.
Neurologist and sleep medicine specialist John Andrefsky, MD isnt surprised.
Melatonin decreases sleep latency by about six minutes, which is not a lot of time considering people sometimes cant fall asleep for 45 minutes, an hour or two hours, he says. Melatonin affects when you fall asleep, not how quickly.
Dr. Andrefsky says melatonin is more useful in mitigating jetlag than in curing chronic insomnia, so it can be an effective tool for people who travel leisurely or for business.
Melatonin In The Treatment Of Complications Of Sleep
The use of melatonin as a prophylactic helps to prevent cardiac remodeling due to hypoxia arising from obstructive apnea . Effects on the cardiovascular system are also realized due to the ability of melatonin and melatonin receptor agonists to inhibit bradykinin B2 receptors, as well as dimerization of angiotensin-converting enzyme I, improving therapeutic control of blood pressure . Another way of realizing the effects of melatonin is the stabilizing effect on angiotensin II receptors and ACE-B2R dimers, which increases the production of nitric oxide by endothelial cells, increasing tissue perfusion. The activation of the MT1 receptor promotes vasoconstriction and MT2 receptor vasodilation. Thus, melatonin can act as a therapeutic agent in the treatment of cardiovascular diseases and hypertension resulting from comorbid diseases in sleep-dependent respiratory disorders. These effects of melatonin in carotid-dependent respiratory disorders were found as a result of a few studies therefore, they do not have a sufficient recommended level.
How Do Doctors Use Melatonin
Sleep doctors may use melatonin to help patients with circadian rhythm disorders regulate their sleep-wake cycles. For example, during the pandemic, Dr. Avidan said, weve seen those people who become super night owls unable to fall asleep until 2 or 3 a.m.
Experts also suggest people use a bright light in the mornings to help them wake up, which has alerting properties and can suppress any remaining melatonin production, said Dr. Abbott.
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Can Melatonin Supplements Improve Sleep
It is well-established that melatonin produced by the body plays a fundamental role in getting quality sleep, so its natural to consider whether melatonin supplements can be used to address sleeping difficulties.
Research to date has shown that melatonin supplements may be useful in certain situations for both adults and children.
Melatonin For Sleep: Does It Work
Melatonin sleep aids are growing in popularity, with 3 million Americansusing them in 2012, according to a nationwide survey from the Centers forDisease Control and Prevention. If youre among them or are consideringmelatonin for sleep, its smart to understand exactly how melatonin works.
Your body produces melatonin naturally. It doesnt make you sleep, but as melatonin levels rise in the evening it puts you into a state of quiet wakefulness that helps promote sleep, explains Johns Hopkins sleep expert Luis F. Buenaver, Ph.D., C.B.S.M.
Most peoples bodies produce enough melatonin for sleep on their own. However, there are steps you can take to make the most of your natural melatonin production, or you can try a supplement on a short-term basis if youre experiencing insomnia, want to overcome jet lag, or are a night owl who needs to get to bed earlier and wake up earlier, such as for work or school.
If youd like to harness melatonins sleep-inducing effects, Buenaver recommends taking these steps.
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How To Use Melatonin For Jet Lag
Jet lag is an air travel problem that causes difficulty in sleeping, fatigue, trouble concentrating, constipation, and other symptoms. Jet lag is much more likely if you cross over several time zones, and can worsen the more time zones you cross.
Effective starting doses for jet lag range from 0.3 to 0.5 mg. Smaller doses may work for some while others may need a higher dose. It may be more difficult to fly east, when time is lost, rather than to fly west, when you gain it back. High doses, such as 20 mg pills are available for purchase on the Internet, but such high doses are not normally recommended or needed, and may greatly increase side effects.
- Eastbound: If you are traveling east, say from the US to Europe, take supplemental melatonin for sleep after dark, 30 minutes before bedtime in the new time zone or if you are on the plane. Then take it for the next 4 nights in the new time zone, after dark, 30 minutes before bedtime. If you are still feeling drowsy the day after using this medication, try a lower dose.
- Westbound: If you are heading west, for example, from the US to Australia, a dose is not needed for your first travel night, but you then may take it for the next 4 nights in the new time zone, after dark, 30 minutes before bedtime. Melatonin may not always be needed for westbound travel.
Given enough time , jet lag will usually resolve on its own, but this is not always optimal when traveling.
What Is The Dosage For Melatonin
Researchers arent certain which dose of melatonin is most effective. It has been studied at doses ranging from 0.3 mg to 10 mg. It is possible for a small dose to work better than a large dose. A dose of about 0.3 mg closely resembles the level of your bodys natural melatonin production. Larger doses cause the melatonin in your blood to peak at a much higher level.
Studies show that timing may be more important than dose. The most effective time to take melatonin is different for everyone and can vary depending on your sleep problem. In certain cases, melatonin may be even more effective when used as part of a treatment plan that also includes bright light therapy.
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For Primary Sleep Disorders
Researchers have conducted many studies on melatonin supplements for various health conditions. Most studies have been conducted in sleep disorders, such as jet lag, shift work sleep disorders, delayed sleep phase disorder, and insomnia. Studies are often not consistent in their results and questions still remain about its usefulness, dosage, length of treatment and long-term safety for some sleep conditions.
Melatonin can be effective for jet lag for many people when dosed at the appropriate time. Studes measuring the effectiveness of melatonin for the treatment of insomnia show a slight reduction in the amount of time needed to fall asleep, but melatonin may not increase the overall quality of sleep. This medication does appear to be safe for short-term use for primary insomnia .
Melatonin Dosage For Children
Short-term use of melatonin in small doses appears to be safe and well-tolerated by most children. The effective dosage for children ranges from 0.05 milligrams per kilogram to 5 milligrams of melatonin. When children experience side effects from taking melatonin, theyre typically mild and may include:
Medical professionals may recommend melatonin for children with conditions that affect their sleep, such as insomnia, autism spectrum disorder, or attention-deficit hyperactivity disorder. Several studies have shown melatonin supplements can significantly improve overall sleep times by 25 minutes to 48 minutes, on average, for children with these conditions.
However, there havent been enough studies of melatonin in children for experts to determine an official recommended dosage or any potential long-term safety risks. Since melatonin is a hormone, its possible that taking supplemental melatonin could affect other aspects of hormone development in children, but further research is needed.
If your child is having sleep problems, experts recommend consulting your doctor before giving them melatonin. Research indicates that for half of the cases where melatonin was used to treat pediatric insomnia, better sleep habits were just as effective at relieving the childs sleep problems.
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When To Take Melatonin
Melatonin plays a critical role in regulating your sleep-wake cycle. So it should be taken at the right time of day. Your brain naturally makes melatonin from sundown to sunrise. These supplements take about 30 minutes to reach peak levels in your blood.
Most people take melatonin about an hour before going to bed.
However, there are certain conditions when it helps to take it at other times.
- For trouble falling asleep: Take melatonin 30 minutes before bedtime.
- For night owls: People with delayed sleep phase syndrome may want to take melatonin several hours before the desired bedtime. For example, if you usually fall asleep at 2 a.m., but you want to go to bed at 11 p.m., try taking melatonin as early as 9 p.m.
- For early birds: If you have symptoms of advanced sleep phase syndrome, where you fall asleep very early and wake up early, treatment is usually bright light timed to delay sleep onset. Melatonin may be used either closer to the desired bedtime or after about a half-sleep period. This should be discussed with a sleep specialist.
You Should Only Take Melatonin As Agreed With Your Doctor
Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.
Take your melatonin one to two hours before you go to bed, and after some food. This can be a small snack before bedtime, like a biscuit or two, if you have your evening meal more than two hours before you go to bed.
Do not break or chew the modified-release tablets. This is because they have a special system in them to deliver the medicine into your body slowly, over a few hours. Swallow the tablet whole with at least half a glass of water while sitting or standing.
You should make sure that you do not watch TV or use a computer or mobile phone at least an hour before going to bed, as light from these can stop your body from making its own melatonin.
Can You Overdose On Melatonin
While melatonin is generally considered safe, it is possible to take too much. There is no official recommended melatonin dosage, and people can have different sensitivities to melatonin, so finding an appropriate dose can be challenging. Moreover, because melatonin is not regulated in the U.S., the actual melatonin content of supplements can vary significantly. Studies have found that some melatonin products can have nearly five times as much melatonin as their label claims, or much less.
The first sign that youve taken too much melatonin is that youll continue feeling its soporific effects the following day. You may feel especially drowsy or groggy. Doses of 10 milligrams or higher can cause side effects like drowsiness and headache. Other symptoms of melatonin overdose include:
- Changes in blood pressure
- Vivid dreams or nightmares
Safety Of Melatonin For Insomnia
Over the short and long-term, studies have shown that melatonin treatment:
- is not associated with dependence
- does not lead to melatonin tolerance
- wont cause rebound insomnia
- is not associated with withdrawal symptoms.
That means melatonin is not habit-forming and the effects wont gradually decline with use. It also means that if you take melatonin and then stop, your sleep wont regress.
Negative effects associated with melatonin use are rare and mild.
Studies also showed positive carryover effects, which simply means that after the melatonin treatment period, some of the benefits of the treatment were still enjoyed.
Age is a consideration in the use of melatonin, and we tend to err on the side of caution. Melatonin is, after all, a hormone. Thats not something you want to tamper with lightly when it comes to children. That said, studies with children and young adults also found no adverse effects during the study periods.
Its a tough call, and if youre thinking of using melatonin with a child or adolescent, wed recommend speaking with a trusted health practitioner.
If youre pregnant or breastfeeding, the question of safety is more complex. As with most natural products, there are very few studies on humans during pregnancy. Most of the research comes from animal studies. Those studies are surfacing some potential protective benefits on the fetus from melatonin supplementation, but its likely too early to say for certain.
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Does Food Contain Melatonin
A study published in Food and Nutrition Research notes that certain food products do contain various amounts of melatonin as measured by immunological and chromatographic laboratory techniques. How consumption of these various foods might affect endogenous production sleep or was not evaluated:
- Wine, beer
- Cows milk
Research finds that melatonin synthesis depends upon availability of the essential amino acid tryptophan, a needed component of the diet. If intake of tryptophan is severely restricted, synthesis of melatonin is significantly reduced in humans.
In the Nurses Health Study, no link was found between the consumption of various nutrients, such as folate, vitamin B6 and zinc and increased urinary excretion.
Diets rich in vegetables, fruits and grain products will contain considerable levels of dietary melatonin. The overall effect of dietary consumption on nighttime levels of melatonin is very limited. Melatonin production is primarily driven by the effects of light and darkness and by age, declining as we get older.
When To Steer Clear
Certain people should be more cautious about melatonin use, particularly if it triggers a negative reaction, including those with:
- Chronic insomnia. Having trouble falling asleep or staying asleep that lasts a month or more shouldn’t be managed with melatonin, according to the American Academy of Sleep Medicine and the American College of Physicians. These groups recommend other more proven remedies , noting that there is not enough evidence that melatonin is safe and effective for long-term use.
- Restless Legs Syndrome . The tingling or “creepy-crawly” feeling in the legs that often keeps people awake could be worsened by melatonin. The supplement can intensify RLS symptoms because it lowers the amount of dopamine in the brain, according to the Restless Legs Syndrome Foundation. If you’ve been diagnosed with RLS or suspect that you have the condition, talk to your HCP about lifestyle changes or medications that could help.
- Dementia. This progressive cognitive deterioration is often associated with insomnia, which can tax both patients and their caregivers. But melatonin may do more harm than good among those with dementia since the condition causes people to metabolize the supplement more slowly, resulting in daytime drowsiness. In people with moderate or severe dementia, melatonin supplementation may increase the risk of falls, according to 2015 guidelines from the American Academy of Sleep Medicine.
If you’ve been drinking alcohol, it’s also not safe to take melatonin.
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Why You May Be Low In Melatonin
As we age, our natural production of the sleep hormone, melatonin, declines. Thats one reason older people have difficulty sleeping.
Today, many of us are suppressing our natural melatonin production by exposure to light in the evenings. Youve no doubt heard this in the news. Melatonin release is triggered by low light conditions, so sitting in front of a screen or under artificial lights delays that release.
There are also circadian rhythm disorders to contend with, like jet lag, shift work and social jet lag.
Havent heard of social jet lag? Its when we keep a significantly different schedule from weekdays to weekends and our bodies have trouble keeping up. If you turn into a night owl on your days off, only to suffer when you get up for work or school, you know exactly what I mean.
Some medications such as beta blockers can also affect melatonin production and lead to insomnia.
For these reasons and more, some people need extra sleep support. So, lets talk about the science behind melatonin for insomnia and sleep disorders.
Best Way To Take Melatonin
Melatonin isnt like a drug, where a higher dose is more effective, says Grandner. If anything, lower doses tend to be more effective. He recommends 0.53 mg per day, although some people may benefit from larger amounts.
Timing is equally important. If you take melatonin as your body is starting to naturally produce it, you can potentially jumpstart the system and get it to start producing melatonin a little faster, Grandner says. Your whole clock is going to shift. Melatonin generally starts to rise about two hours before you go to sleep, although the exact time varies from person to person. When taking a melatonin supplement:
- Start with 0.5 to 3 mg. If you experience side effects, such as grogginess or a headache, reduce the dose.
- Take melatonin about two hours before you want to go to sleep. If it doesnt work as you hoped, try taking it a bit earlier or later.
- If you tend to wake up during the night, try a sustained-release melatonin supplement.
- Enhance your own nighttime melatonin production by getting morning light, which has a more beneficial effect on your body clock than daylight later in the day.
- For about two hours before bedtime, stay away from digital screens and other bright lights, which suppress melatonin production.
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When To Talk To Your Doctor About Melatonin
To ensure safe usage, it is always a good idea to consult your doctor before taking any over-the-counter sleep aid, including melatonin. They know your personal medical history and can best advise you on the appropriate melatonin dosage for your needs. They will also know whether melatonin might interact with any other medications you may currently be taking.
Certain health conditions and medications may increase your risk of side effects when taking melatonin. If you take any of the following medications, be sure to talk to your doctor before taking melatonin:
- Pregnant or breastfeeding women
- Shift workers
The research into melatonins potential benefits and use cases is still evolving, and its long-term effects are still unknown. For many people, melatonin offers mild improvements to sleep problems when used on a short-term basis. For others, it may cause side effects or not impact sleep at all.
If you find your sleep problems persist after trying melatonin, it may be time to talk to a doctor. They can recommend other strategies for improving your sleep, such as better sleep hygiene, changes to diet and exercise, or cognitive-behavioral therapy for insomnia. They can also evaluate other possible causes for your sleep problems.
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