> There are few to no side-effects to melatonin use in adults (there is uncertainty about the risks & benefits in children & adolescents28), and it is not addictive or habit-forming like caffeine is. The usual dose for a night is 0.5-3 mg and I take 1.5mg [29]; my dose is highly likely to be too high. High doses may well be responsible for why some people try melatonin and report that it does nothing or hurts them, since in one study, the best dose for old people was 10x smaller (0.1mg or 0.3mg) and for one blind person, 0.5mg [30 31 32] . Zhdanova et al 1996 found 0.3mg & 1.0mg to affect sleep onset similarly. A study of delayed-release melatonin found with their high dose of 4mg (but not 0.4mg) elevated melatonin levels 10 hours after bedtime ( Gooneratne et al 2011) - potentially interfering with waking time.
It is difficult to find doses as small as 1mg sublingual (dissolve under the tongue) in my area. Everyone is trying to sell you 5-30mg chewables. And, I expect everyone is buying them under the assumption that more is better. But, here it explicitly is not.
The way melatonin works well for me is to wait until I'm already settled into bed and should be asleep, but I'm not. Do a couple body scans to relax for real. Try to think about something mindless. Then if I'm still awake, pop 1mg under my tongue. I'll usually wake in the morning with half of it drooled on my pillow :P
It usually takes 15-30 minutes before I get noticeably drowsy, but I feel no more groggy the next day than if I slept sober.
I've always had insomnia since I was a kid and I just chalked it up to "being a night owl." As a teenager, I mostly solved this by living in a permanent fog during the week and "catching up" by sleeping in on the weekend. As an adult, I was suffering greatly from chronic sleep deprivation because adults (mostly) don't have much control over when they can wake up to start the day.
Around 10 years ago, I started taking 5mg melatonin. It's going to sound like I'm overselling it, but it changed my life. It _very reliably_ makes me sleepy 1-2 hours after I take it. If I forget to take it, I am fully awake until the wee hours of the morning. Is it important to note that (for me), after I take it, I have to engage in some passive activity like (calm, non-shouty) YouTube repair videos or reading. Also, the "window of sleepiness" is at most about 30 minutes and if I decide to power through it, I will come out the other side fully awake again. Melatonin does not "force" me to sleep, only highly encourages it.
I was skeptical of melatonin for the longest time. Generally, I rarely see much if any positive effect from supplements. But (for me!) this stuff really works. If anyone reading this is on the fence, I highly recommend giving it a try. (With the acknowledgement that it takes about a week to get into a solid sleep schedule if yours is currently disorganized.)
Also, I don't take melatonin often, only when I seem to need to reset my sleep cycle, and I only take about 200-300 micrograms.
Why do you take so much? 5mg is a lot, according to the studies.
I started with 5mg arbitrarily because that seemed to be the most common dosage sold at the time. I think about lowering the dosage sometimes but at the end of the day, I know 5mg works well for me. I don't notice any side effects, and it's not any cheaper.
I also started with the special "slow release" formulas but couldn't tell any difference from the normal generic stuff.
- a long uninterrupted night cycle and a short (20-60 mins) afternoon nap. Around 2pm. - a night cycle split into two halves. With a 1-2h break (maybe up to 3h) starting around midnight to 2am.
The former is still very common, and imho stretching the definition of multiple cycles. The latter is more historical (more common when there are long winter nights and no electricity).
Also making it a “Western” problem is kinda weird? There are other cultures where single cycle sleep has existed. Even hunter-gatherer groups with little to no contact with the west. And alternatively afternoon naps are still quite common is some western areas. I guess the main thing that prevent it would be the classic work day schedule.
As someone who has never been a regular coffee consumer, I really didn't want to end up with the dual dependence of melatonin at night and then caffeine in the morning.
This thread is stimulating me to want to get my magnesium checked, but barring that I've found the most effective sleep interventions are the basic ones: get some exercise earlier in the day, and don't do screens for the last few hours before bed.
The usual suggestions from doctors for first line treatment are more mild medications that have drowsiness as a side effect, prescribed at low dose. I would actually prefer many of these low dose options over some of the high dose melatonin supplements. Melatonin is a hormone and taking it can throw off natural production
Modern orexin antagonist sleep medications are not addictive and can be taken long-term.
The reason diphenhydramine Is associated with a slight increase in dementia risk is the anticholinergic properties. This risk increase is from correlational studies on other medications with anticholinergic medicines being taken for many years by elderly people, so the risk of taking Benadryl occasionally is low to none.
The prescription alternatives like doxepin have the same antihistamine properties without the anticholinergic properties when used at the prescribed dose.
This is an example where people can get themselves into the wrong outcome by assuming anything their doctor prescribes is a last resort quick fix, but anything they can source by themself is safer and superior.
It’s not a good idea to take Benadryl for many years, but occasional use or even for months while going through a difficult period isn’t going to cause dementia.
Tramadol is routinely prescribed long term where I live. I know someone with a massive bottle good for something like 6 to 12 months of daily use. (I don't know if that's a good thing but it is certainly a thing.)
It has opioid effects and can cause drowsiness but would never be prescribed for sleep.
It’s also typically a controlled substance. I don’t know where you live but I’d be surprised if anyone was handed a 12 month supply in a bottle.
for people getting 7 hours of sleep you're good. Improve your sleep hygiene, ok, but artificial interventions to get 8 may not be worth it for you.
But I don't think it does anyone any favors to oversell the idea that it has "few" or "no" side effects -- it has mild side effects, most commonly reported in the literature are daytime fatigue, headaches and GI symptoms, and also nightmares. Mild doesn't mean it isn't a nonstarter for some people.
It's also important to remember that there are major gaps in what we know about melatonin; notably the effects of chronic supplementation are not well-studied, but earlier final awakening has been documented and this is quite commonly reported in anecdata -- I can contribute a datapoint there, as can most people in my circles who have used it.
To be clear, melatonin is great and useful, but as someone with a rare lifelong chronic sleep disorder who is intimately familiar with this substance, I think it's most useful when we're clear on what we know, what we don't know, and what actually are the limitations on a substance.
Just because downing a bottle of it probably won't cause systemic organ failure or otherwise any kind of medical emergency in most people doesn't mean there aren't tradeoffs to consider when using it, especially if you are sleep-challenged
I can easily sleep 8+ hours. Today slept 10.5.
I'm either not convinced screens are an issue, or they simply are not an issue for me personally, but if thats true -- WHY?
Man, were these the worst nights of my life! I’d get 2-3 hours of shut-eye and then be FULLY awake. Ready to go, couldn’t sleep the rest of the night. I was dead tired by day 7 and gave up.
Tried 0.3mg. Tried 5mg. Nope. There’s some evidence that melatonin can mess you up if you’re sensitive to cortisol/have too much of it. I’m not touching it again. No side effects? Sure.
N=1, but if it’s not working for you, don’t push it. My doctor instead prescribed a bit of therapy (CBT-i) and my sleep went back to normal after a couple of sessions.