Melatonin – should you ever take it?

Melatonin is much over-hyped for sleep problems. Its usefulness for insomnia is limited. However, it is clearly useful for disorders of the sleep-wake rhythm. It is useful in delayed sleep phase syndrome, shift work disorder, jet lag syndrome.

For delayed sleep phase syndrome, along with behavioral treatment and bright light in the morning, melatonin 1-3 mg in the evening (not at bedtime) is helpful. For jet lag syndrome, melatonin is helpful when traveling eastwards. 1-3 mg melatonin should be taken at the destination’s evening time as soon as travel begins. It is not so useful for westward travel. Luckily, the body adapts more easily to travel westwards than eastwards. For night shift work, melatonin 1-3 mg taken before going to bed in the morning may be helpful, along with bright light upon waking up.

Melatonin is also useful in some cases of poor sleep. For example, beta blockers (often used for blood pressure) reduce melatonin production and cause insomnia. Melatonin supplementation controls the insomnia caused by beta blockers. Melatonin may be helpful in sleep disorders related to blindness. It may also help people who go to bed later and get up later on weekends, then have trouble falling asleep Sunday night. A short course of melatonin may help students and teachers get back on a school schedule after going to bed later and getting up later during the summer break.

The correct dose is 1-3 mg nightly for adults, and probably 0.3 to 1 mg nightly for children. There really should be no reason to take doses higher than 3 mg a day.

Melatonin probably does no harm once you are past child-bearing potential. Because of its effects on sex hormones, particularly in males, it should be used cautiously in children and in adults of child-bearing potential.

As a supplement, melatonin is not adequately controlled by the FDA. Earlier research has shown that many melatonin products do not contain the amount of melatonin claimed on the bottle. This is particularly true of products that contain melatonin along with other supplements. Products that contain melatonin only are more likely to have what they claim to have. Consumer Labs tests supplements. Their lowest cost approved product for each dose is:

3 mg: Well at Walgreens Quick Dissolve Melatonin 3 mg – Cherry Flavor

1 mg: Swanson Melatonin 1 mg

0.3 mg: Life Extension Melatonin 300 mcg (0.3 mg)