Dose and timing are key to treat insomnia and circadian problems
By Brandon Peters, MD | Reviewed by a board-certified physician Updated September 06, 2018 (www.verywellhealth.com)
Melatonin is a naturally occurring hormone that is often taken in a pill form as an over-the-counter supplement to aid sleep. It is most helpful in circadian rhythm sleep disorders, but it is frequently taken to alleviate difficulty falling or staying asleep (characteristic symptoms of insomnia). If you are interested in using melatonin to help you to sleep, you may wonder how to safely take melatonin as a sleep aid to treat insomnia, as well as the appropriate dose and timing. Discover how to avoid side effects and reduce the likelihood of an overdose.
What Dose of Melatonin Should I Take?
Melatonin is believed to be relatively safe, and it is therefore available over-the-counter at many pharmacies and health supplement stores. It may be compounded in multiple ways, and it is sometimes even added to other products meant to aid sleep. Pure melatonin is most often sold as a pill or capsule, but you can also buy it in liquid or even spray form.
The advertised strength of the melatonin dose may range from 1mg up to 10mg or more. It is important to remember that melatonin is not regulated by the U.S. Food and Drug Administration (FDA). As such, production and quality standards are not enforced, so the dose may actually vary from the listed strength. It is recommended that it be purchased from a reputable source.
Research suggests that even very low doses of melatonin may be effective, especially in circadian rhythm disorders. The relationship between the dose and the perceived effect—a so-called dose-response relationship—does not appear to exist for melatonin. Therefore, it is difficult to determine the optimal dose for an individual. Given these limitations, it is probably best if you take the lowest possible effective dose. (This would mean taking 1mg or 2mg per day to aid sleep.) Higher doses may be used to treat sleep behaviors that occur as part of REM sleep behavior disorder.
The timing of the dose is very important and high blood levels at the wrong times may be a problem. Therefore, if you take too much, you may actually flood your system and the benefits will be counteracted. There are no reports of a fatal overdose on melatonin alone. Though it may cause morning hangover effects if the optimal dose is exceeded, as it wears off, these symptoms should relent.
When Should I Take Melatonin?
The role of melatonin in regulating our biological clock, or circadian rhythm, appears to be critical. Therefore, the timing of when you actually take it is just as important. It is normally produced in a part of the brain called the pineal gland and is released during the period of darkness from sundown to sunrise. When taken as an oral supplement, it reaches a maximum concentration in your blood after 30 minutes. However, the timing of administration may not be quite so simple.
Most people should take melatonin in the evening before going to bed, but—curiously—there are others who should actually take it in the morning. How do you know when you should take it?
If you have trouble falling asleep (especially if you want to stay asleep towards the morning), you should take it at night. It can be taken 30 minutes before bedtime. This is how most people use the medication.
People who are night owls (with delayed sleep phase syndrome) may want to take melatonin several hours before the desired bedtime. If you naturally fall asleep at 2 a.m., but you desire to go to bed at 11 p.m., you may consider taking it at as early as 9 p.m.
However, if you have symptoms of advanced sleep phase syndrome, in which there is a strong desire to fall asleep and wake up several hours too early, you should actually take it in the morning upon awakening. This condition is relatively rare (perhaps affecting less than 1 percent of people). If considering use in this way, consult with a sleep physician for guidance.
You should also ensure that you have ample light exposure at the opposite time, morning or night, from when you take your melatonin. This is especially important for night owls.
Now that you have figured out whether to take it in the morning or at night, how close should you take it to your desired bedtime (or after awakening)? If you decide to take it at night as a sleeping pill to induce sleep, you can take it up to 30 minutes before or at bedtime. If you are aiming to treat delayed sleep phase syndrome, you should take it 2 to 3 hours before your desired bedtime. Conversely, if you are falling asleep and waking too early, as occurs with advanced sleep phase syndrome, you may even take it upon awakening for the day.
Is It Safe to Take Melatonin Every Night?
As described above, melatonin is extremely safe. It is a hormone that your body makes naturally. Its use in a supplement form is also believed to be quite safe. It is not habit-forming, and you will not become "addicted" or dependent upon it. Therefore, if you find it to be helpful in improving your sleep, you may use it on a nightly basis without fear of adverse consequences. There is some caution advised in children and pregnant women due to its potential effects on other hormones. Side effects are not usually problematic, but these will resolve with discontinuation of the medication.
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