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Melatonin 101 - Dosing, Timing, and What to Do When Melatonin Isn't Working

Melatonin 101 - Dosing, Timing, and What to Do When Melatonin Isn't Working

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More Americans are using melatonin for sleep than ever before, but is this supplement actually safe or effective? This post covers how melatonin works, considerations for use, and alternatives to help you make an informed decision and get some ZZZs. 

Disclaimer: Consult your medical provider if you are considering starting any dietary supplement, including melatonin. This article is for informational purposes and does not constitute medical advice.

Alarm clock

What is melatonin?

Melatonin is a key hormone that is involved in your sleep-wake cycle, also known as your circadian rhythm. Your brain naturally ramps up melatonin production in response to darkness, which promotes sleep. Melatonin levels start to naturally decrease in the morning.

Supplemental melatonin is typically made synthetically and can be purchased over the counter in tablets, sprays, liquid tinctures, and even gummy form. 

Who is melatonin for?

Melatonin has been shown to be an effective sleep aid when taken on a short-term basis and is well-tolerated by most people. Research on melatonin as a sleep aid shows modest benefits, including falling asleep faster and a small increase in total sleep time. There is some evidence to suggest that melatonin can be helpful for shift workers, people with sleep-wake phase disorder, or those struggling with jet lag.

It is important to note that these benefits can vary based on individual responses to melatonin, which can be influenced by age, dose, timing, and existing sleep patterns. 

Per Cafer’s psychopharmacology:

  • Melatonin is not an FDA approved treatment for any condition
  • Melatonin is possibly effective for insomnia, jet lag, neuroprotection, stimulation of the immune system, and headaches
  • There is no clear evidence on melatonin and sundowning/delirium or manic episodes

Who is melatonin NOT for?

Since melatonin is a naturally occurring hormone, it should be safe to consume it in supplement form, right? Unfortunately, natural does not always mean safe. 

Taking too much melatonin can cause mild side effects like headache, nausea, and dizziness.

You should avoid or use caution when taking melatonin if you:

  • Are taking certain medications, including antidepressants, benzodiazepines, prescription sleep aids, anti-seizure drugs, immunosuppressants, oral contraceptives, and blood thinners 
  • Struggle with chronic insomnia: There is not enough evidence to conclude that long-term melatonin use is the most safe and effective solution for chronic insomnia.
  • Are pregnant or breastfeeding: Researchers do not have enough evidence to say if melatonin is safe for these populations.
  • Are an older adult (55 years or older):  Melatonin levels decline as you age, so older people may be more sensitive to melatonin supplements. You may require a smaller dose and notice that melatonin’s effects last longer.
  • Have dementia: Melatonin is not recommended for this group according to the 2015 American Academy of Sleep guidelines.
  • Are drinking alcohol: Since alcohol disrupts your melatonin levels and the way supplemental melatonin works in your body, it is best to avoid mixing melatonin and alcohol. 

Can you get addicted to melatonin? 

Melatonin is not considered habit-forming and some research suggests that its effects on sleep do not change over time. In other words, you don’t need to increase your melatonin dose over time to get the same sleep benefits.

Is melatonin safe?

The actual amount of active ingredients in dietary supplements like melatonin can also be higher or lower than what’s listed on the label, as these products are not regulated by the US Food and Drug Administration (FDA).

Woman sleeping using melatonin

Melatonin dosing

The amount of melatonin in over the counter supplements can vary widely. Standard doses range are typically 3 mg, 5 mg, and 10 mg, but some supplements are sold in higher or lower doses.

There are no universally accepted safe ranges for melatonin dosing.

After checking with your medical provider that it’s safe for you to take melatonin, start with the smallest dose possible (3 mg is typically recommended) and gradually increase your dose as needed until you find the right amount for you. 12 mg is considered the maximum daily dose. You can cut tablets into smaller doses (half or even quarters) to help you fine-tune your melatonin dose.

Melatonin timing

You may be wondering, how long does melatonin stay in your system? For most people, the effects of melatonin set in after 30-60 minutes and last 4-8 hours, depending on the dose. Melatonin supplements work best for sleep when given 3-5 hours before your bedtime

Keep in mind, melatonin’s effects can also vary based on your age, weight, lifestyle, and whether you take certain medications or consume caffeine. It may take up to two weeks for the melatonin to work.

Melatonin not working? Here’s what could be going on.

If you’re taking melatonin at a fairly high dose and still having trouble sleeping, you may be tempted to up your dose, but this may not be helpful or safe.

Consult with your medical provider to rule out other issues that could be interfering with your sleep. Chronic insomnia may require additional treatment, such as cognitive behavioral therapy or prescription sleep aids.

Alternatives

Melatonin is naturally found in certain foods, so adding these to your evening meal or snack can be a worthwhile alternative to over-the-counter melatonin supplements. Melatonin-rich foods include:

  • Cherries
  • Nuts
  • Eggs
  • Milk and other dairy products
  • Fish

Cherries high in melatonin

If you’re struggling with insomnia, first-line treatments often include behavioral changes such as improving your sleep hygiene, working on relaxation techniques, or CBT-based approaches.

When behavioral or nutritional approaches aren’t helping with your sleep, your medical provider may suggest a supplement like melatonin or a prescription sleep aid. 

Reviewed by: Kathy Hunter, PMHNP-BC

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With Cerebral, you can connect with a mental health provider who can work with you on a personalized action plan to help you stop overthinking and equip yourself with strategies to use when you’re feeling like life is out of control. 72% of Cerebral clients reported feeling less anxiety after just 3 months of treatment.* Join Cerebral today! *Based on Cerebral clients with moderate to severe anxiety and/or depression from 2020-2023. Image by freepik
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Do Affirmations Really Work? Yes! Here’s the Science
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Decreases stress Focusing on calming and empowering thoughts during affirmations activates the body’s relaxation response, reducing stress. Redirecting mental energy away from worries promotes a sense of inner peace and balance. How to make affirmations more effective To fully unlock the benefits of affirmations, follow these practices: Commit to a routine Consistency plays a key role in making affirmations effective. Incorporating them into a daily practice, such as during your morning routine or right before bed, strengthens their impact. The more frequently they are practiced, the deeper they become embedded in your subconscious, reshaping mental patterns for long-term change. Set them in the present Affirmations are most powerful when framed in the present tense. Speaking to yourself as if the positive change is already happening makes the statements feel more tangible. Instead of saying, "I will be confident," say "I am confident." This approach strengthens the connection between thought and reality. Make them personal to you Affirmations that speak directly to your unique needs and challenges resonate more deeply. Crafting statements that feel authentic boosts their emotional impact, which makes the practice feel more genuine and effective. Avoid toxic positivity Affirmations should be realistic and grounded in compassion, not a denial of real challenges. Balancing positivity with authenticity keeps affirmations from feeling forced or disingenuous. Instead of glossing over difficulties, focus on affirmations that offer hope while acknowledging real feelings. Focus on what’s achievable Starting with small, manageable goals ensures that affirmations feel achievable rather than overwhelming. Building confidence from these small successes creates momentum, allowing for larger goals over time. This approach keeps the practice grounded and effective. Pair your affirmations with action Affirmations become even more powerful when they are followed by concrete actions. They should act as a catalyst for positive change, not a substitute for it. After repeating your affirmation, take tangible steps toward your goals, and celebrate each achievement along the way. 5 affirmations to start your practice Here are a few affirmations that can serve as starting points for building a healthier mindset: I am a strong, capable person This statement reinforces self-confidence and serves as a reminder of your inner strength, especially in moments of doubt. I am loved and accepted Affirming that you are worthy of love cultivates a deep sense of belonging, even in the face of external challenges. I am doing my best and that is enough Emphasizing self-compassion, this affirmation encourages acceptance of imperfections and honors the effort being put in. I can handle whatever comes my way This promotes a sense of resilience, reminding you that challenges can be met with strength and adaptability. I trust in my ability to navigate uncertainty Strengthening trust in your ability to handle unknowns builds confidence in managing life’s uncertainties with grace. When positive affirmations don’t work, try speaking with a mental health professional While affirmations can support mental health, not everyone finds success using them and some require  professional therapy, especially  when feelings of depression, anxiety, or hopelessness persist for an extended period.  A qualified therapist can offer personalized guidance and support based on your unique issues. If you would like expert help in taking better care of yourself, join Cerebral and work with someone who has experience caring for persons exactly like you. Positive mental effects from affirmations are possible. If they are used frequently, conveyed openly, and combined with constructive action, they may effect long-lasting change. Try powering up your thoughts to inner strength and positivity if you begin employing affirmations right away.
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