Melatonin for Sleep: How the Help Works

“The effects on our sleep depend on the time of day you take it,” said Dr. Martin, who is also a spokesperson for the American Academy of Sleep Medicine. “If you took a sleeping pill in the middle of the day, you would feel sleepy. If you take melatonin in the middle of the day, it doesn’t really have that effect.”

Hypnotics like Ambien or Benadryl generally cause people to feel sleepy right away, and the sedative effects of these drugs “far exceed what you get from melatonin,” said Dr. Alon Y. Avidan, professor of neurology and director of the Sleep Disorders Center at UCLA

In an analysis published in PLOS One in 2013, which combined results from 19 studies involving 1,683 men and women, people who took melatonin supplements fell asleep seven minutes faster and increased total sleep time by eight minutes. That might not sound like much, but there were many individual differences, and the researchers found that melatonin also improved general sleep quality, including people’s ability to wake up refreshed.

But there is no guarantee that melatonin will work for you.

dr Sabra Abbott, assistant professor of neurology in sleep medicine at Northwestern University Feinberg School of Medicine, said the most common complaint she hears from patients is, “I’ve tried melatonin and it didn’t work.” Many feel the same the next morning hungover or dazed.

dr Martin said that melatonin doesn’t work any better than a placebo in many studies, but added, “One caveat I always like to mention though is that placebos work pretty well for insomnia.”

We produce melatonin naturally in our brain, but only in picogram amounts, or a trillionth of a gram, which is what Dr. Rosen described as “a whiff of it coming out at dusk.” Over-the-counter melatonin supplements are available in much higher milligram doses, or thousandths of a gram. That’s a big difference, although the amount that eventually reaches the brain is closer to natural levels.

Many experts recommend starting with the smallest dose available — 0.5 milligram to 1 milligram, 30 minutes to an hour before bed — and seeing how you do from there. If this has no effect, the dose can be gradually increased.

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