Should you go with two, three, or five milligrams?

Advertisement

If you have ever struggled to get a good night's sleep, you likely know plenty about melatonin—both as a supplement and as a hormone in your body. Before you can understand how it works as a treatment, it's important to understand how it functions on its own. "Melatonin is made naturally in the brain's pineal gland each evening and throughout the night," explains Dr. Jeffery Durmer, Chief Medical Officer of Nox Health. It's known as the natural hormone of the dark, says Dr. Abhinav Singh, facility director of the Indiana Sleep Center. As the sun starts to set and you're around less light, your brain produces melatonin to regulate your body's circadian rhythms (or 24-hour internal clock), helping your body understand that it needs to sleep.

"Melatonin supplements became known as a safe alternative treatment for sleeplessness or insomnia by boosting the amount of melatonin in your body," Dr. Singh says. However, he continues, there have not been enough case-controlled studies or large trials to definitively understand how melatonin supplements impact sleeplessness. For example, the U.S. Food and Drug Administration (FDA) doesn't categorize it for medical use because we don't know enough about how it works. What we do already know is who is more likely to benefit from taking it.

"Individuals suffering from circadian rhythm disorders (like non-24 hour sleep-wake disorder), people who travel across time zones and experience jet lag, or folks who work night shifts can benefit from the proper use of melatonin to enhance their circadian rhythm," Dr. Durmer explains. "People with blindness are also most at risk for non-24 hour sleep-wake disorder, and over-the-counter melatonin is often helpful." With the existing information and research, what else do we know about effectively and safely using melatonin? What's the best dose of melatonin—and is there such a thing? We asked the experts.

woman sound asleep in bed night time
Credit: DedMityay / Getty Images

Is there a "best dose" of melatonin?

"Melatonin isn't a drug; it's a hormone released naturally in your own body. When you think about it in that way, the 'average dose' is all about finding the replacement or supplemental amount that helps your body get good quality sleep," says Dr. Mike Dow, Psy.D., Ph.D. From there, though, it's hard to narrow down an exact dosage. "The fact is that there is no 'good dose' that is recommended because, without more research, we don't have enough guidelines," Dr. Singh says. "But in the world of medicine, we have a saying: Start low, go slow." Generally, less than five milligrams is considered a safe place for adults to start taking melatonin to treat short-term sleeplessness and insomnia—like on nights when you're experiencing elevated stress and anxiety levels.

What's the most popular dose?

"Most individuals will do fine on a two to two-and-a-half milligram dose," says Dr. Chelsie Rohrscheib, Ph.D., neuroscientist and Head Sleep Specialist at Wesper. "Using more than five milligrams of melatonin per night isn't recommended unless you're working closely with your doctor." Typically, 10 milligram options aren't available over the counter and would only be recommended for those who suffer from blindness and non-24 hour sleep-wake disorder, explains Dr. Durmer. "Too much melatonin can actually disrupt the circadian rhythm and make sleep more difficult," Dr. Rohrscheib adds. When you first "start low and go slow," Dr. Rohrscheib recommends beginning with a half or one milligram one hour before bedtime, then "increasing in small increments until you find a dose that works for you."

Why do we all react different to melatonin?

Your weight, age, and other medications can affect melatonin's effectiveness, explains Dr. Rohrscheib. Specifically, the optimal melatonin dosage increases with weight, and the hormone can be less effective when you reach elderly ages. "If the patient has other medical conditions or takes other medications that might interfere," Dr. Singh says, "then the melatonin may not break down easily. You could end up feeling drowsy or nauseous."

How else can you improve your sleep quality?

"Melatonin works synergistically with other practices," says Dr. Dow. "You'll get the best results by combining a melatonin supplement with simple sleep hygiene strategies like keeping a consistent bedtime, exposing yourself to natural light first thing in the morning, and keeping the bedroom very dark and cool." That includes avoiding blue light, so no scrolling through your phone or staring at the clock.

Most importantly, you'll want to seek medical guidance to find the root of your insomnia. "As a sleep clinician, I first ask why is this person not sleeping?" Dr. Singh says. "That's the fundamental thing." Mental health and quality (or poor quality) sleep go hand-in-hand, and melatonin alone can't fix those kinds of issues—nor can it cure chronic, long-term insomnia. So, if you think you need to take melatonin everyday, don't. Instead, talk to your doctor about more effective strategies and treatments for long-term relief.

Comments (2)

Martha Stewart Member
October 16, 2021
How long should one take it I've got back pain so need it to get to sleep
Martha Stewart Member
October 16, 2021
How long should one take it I've got back pain so need it to get to sleep