How to Use Melatonin

Melatonin is a popular sleep promoting supplement which helps “reset” your body’s internal clock — but it’s not without risks. Here's what you should know.

Being slow in the morning may not mean you are depressed or apathetic about your day. Natural night owls tend to feel more energetic as the day goes on. When other people begin to nod, they’re getting their second wind and having trouble quieting down.

Genes are part of this story, but they needn’t rule. Most of us can’t sleep as late as we’d like, so if you’ve fallen into a night owl pattern and can’t tear yourself away from the glowing light of your computer or TV at 1:30 a.m., you’re probably sleep-deprived.

Many people say they’re resigned to being fatigued or feel fine despite fewer than six hours of sleep most nights. But it’s important to understand that chronic sleep deprivation isn’t a minor annoyance. Lack of sleep increases your risk of obesity, depression, and accidents behind the wheel, among many dangers.

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How to use melatonin to help you sleep

You can adopt good habits to change your body clock — which include ample exercise and staying away from electronic devices and your TV, for at least an hour before bedtime. During the transition, you can help the process by getting extra sunlight and, if you need extra help, possibly taking melatonin supplements.

Melatonin is a hormone our bodies produce in response to light. After a week of natural light only (including the glow of a campfire), our bodies release melatonin near sunset, and levels decline around sunrise. Under modern conditions, the amount of melatonin in your blood typically rises 2 hours before you fall asleep and declines as you awaken.

It’s common for people using melatonin to take the supplements just before getting into bed. That’s much too late. People vary in how soon they fall asleep after the rise in natural melatonin. The best time for taking a supplement, research suggests, falls in a range of 4.5 hours, depending on the individual. This means that if you usually go to bed at 1:30 a.m., you might need to take a supplement as early as 9 p.m. to push your body clock earlier.

Once you’re regularly getting to sleep at your desired bedtime — let’s say midnight — you might take melatonin 2 hours before getting in bed.

What you should know about melatonin supplements

You’ll likely hear different recommendations about how much to take. To complicate matters even more, according to the National Center for Complementary and Integrative Health (NCCIH), you often can’t rely on a supplement’s label about how much melatonin is actually in tablets and gummies. The NCCIH explains melatonin supplements are regulated less strictly by the Food and Drug Administration than prescription or over-the-counter drugs. That means you often don’t know exactly what is in supplements labeled as melatonin.

For example, the NCCIH points out a large study tested 31 different melatonin supplements bought from drug and grocery stores in the U.S. Researchers found that most of the products didn’t contain the amount of melatonin listed on the label.

Another worrisome finding was that 26 percent of the supplements tested contained serotonin, a hormone your body produces to regulate sleep, among other functions; too much serotonin can cause health problems.

Talk to your doctor before you take supplements, at least on a regular basis. Your healthcare provider may have experience with a specific brand of melatonin and can recommend specific dosages to help you reset your sleep cycle, if needed.

Another way to push your body clock earlier is to expose yourself to sunlight in the morning. In one study, researchers tested the effect of taking .5 mg of melatonin 5.75 hours before usual bedtime, exposure to 3 hours of 3,000 lux broad spectrum white light beginning an hour before the normal rising time — and the two combined.

As it turned out, the melatonin and white light worked about equally well to move the body clock earlier. But the combination did the best job of all.

You might try this strategy to minimize jet lag when you travel east or when you start a new, earlier work or school schedule. Begin taking your supplement several days beforehand.

If you need to push yourself towards falling asleep later — perhaps after traveling west — try taking melatonin after you awake and exposing yourself to sunlight late in the day.

If you are expecting a baby or trying to become pregnant, it’s a good idea to try to get your sleep-wake cycle under control with exposure to light and dark, not melatonin. The NCCIH notes there are safety concerns about the use of melatonin in pregnant and breastfeeding women. Research into how melatonin might impact the unborn and newborn is lacking, so it makes sense to skip the supplements for now.

What parents should know about children and melatonin

Helping children and teens get to sleep is complicated. Because melatonin is widely available in many forms — including liquids and gummy formulations aimed at youngsters — and touted as a “natural” supplement to aid sleep, it’s no surprise sales have skyrocketed over the past several decades.

But reports of youngsters being hospitalized and suffering serious health outcomes from ingesting melatonin have also soared. While many hospitalizations involve teens who took overdoses, the largest increase in melatonin-linked health problems has been in kids 5 years old and younger, according to the American Academy of Pediatrics (AAP).

While it’s true some youngsters downed melatonin — especially gummies — that was not kept out of their reach because they thought it was candy, others were sickened when their parents gave them supplements, hoping to get their youngsters to sleep. In addition, parents may give kids accidental overdoses because labels are not always reliable.

While melatonin plays a role in sleep, it is not a harmless “sleeping pill” for kids and should be used only after a discussion with your child’s pediatrician. When it comes to medical uses for kids with sleeping problems, melatonin in low dosages may help children with neurodevelopmental disorders such as autism or attention deficit hyperactivity disorder. A pediatrician, however, should carefully monitor a child taking melatonin for such purposes, the AAP emphasizes.

The rise in serious problems from melatonin overdoses in children and adolescents prompted the  American Academy of Sleep Medicine (AASM) to release a health advisory urging parents to talk to a healthcare professional before giving melatonin or any supplement to youngsters for any reason.

“While melatonin can be useful in treating certain sleep-wake disorders, like jet lag, there is much less evidence it can help healthy children or adults fall asleep faster,” said M. Adeel Rishi, MD, vice chair of the AASM Public Safety Committee and a pulmonology, sleep medicine, and critical care specialist. “Instead of turning to melatonin, parents should work on encouraging their children to develop good sleep habits, like setting a regular bedtime and wake time, having a bedtime routine, and limiting screen time as bedtime approaches.”

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