Melatonin: Much More Than You Wanted to Know (2018)

> the correct dose

A single correct dose is a myth.

The author even sort of notes that with the differences between teenagers, 25 year olds and the elderly.

There's also a wide variety of sleep disorders which are touched on in the article.

I've suffered with 2.5mg before for long enough to understand that it doesn't work for me, no matter how many studies you have with 95% CL that the dose is much lower. The 5mg tablets work much better for me.

If you get results at a lower dose, that's fine, I won't tell you to try using more.

I'm a 49 year old though with moderately severe DSPD and at least used to have non-24 hour disorder and would be happiest letting my schedule shift 1-2 hours every night during college for a few years. If you're a 25 year old and you've never quite had sleep that fucked up which wasn't entirely self-inflicted due to partying then you're not me (most young people who think they have bad sleep disorders are just actively doing things to fuck up their sleep and when they stop doing those things they're magically cured -- and then they turn into the most insufferable assholes because they think they understand sleep disorders when they don't).

And one thing to understand about melatonin is that its not really an anxiolytic and if stress/anxiety is keeping you up it may not work (it will not make the pandemic go away). I also find that I need to take it about an hour before bedtime, and rather than making me tired, it more allows me to get tired. I still need a nighttime ritual to unwind.

I've had this experience lately of waking up around 3 or 4 AM and having a hard time falling back asleep for 30 mins or so. Nothing catastrophic, but a bit annoying.

To address this, I've tried a couple of different things to help sleep: melatonin; and valerian root extract.

The valerian root worked great, until one night it gave me the worst sleep paralysis night terror of all time. Sleep paralysis is nothing new to me. Getting it once every other month or so, it's a bit unpleasant, but far from terrifying. Sometimes I can even leverage it to induce a lucid dream. But this was on a whole other level, with a full blown out-of-body hallucination and a demonic face across room that locked me in a state of raw horror and doom. Also, it made me feel mildly hung-over in the morning.

Never taking that stuff again!

Melatonin on the other hand, perfectly fine. I take a 3mg supplement with L-Theanine 1 hr before I want to sleep. Makes me nice and drowsy, and I sleep like a baby through the night. Can't speak to how it affects dreams because I have dreams every night anyway even without it. But overall really good experience.

I used to work 7pm - 7am night shift. 3 days on, 4 days off one week and 4 days on, 3 days off the next. With lots of melatonin, exercise and careful adherence to my bizarre schedule I was able to train my body into a diurnal inversion cyclical sleep schedule. As soon as my 3/4 day work week was over I would -- over the course of one day -- inverter myself back to being awake during the day. When my weekend was over I would invert back to sleeping during the day. I did this for years.

Work day 1: wake up 12pm, sleep 7am

Work day 2: same

Work day 3: same

Day off 1: wake up 12 pm, sleep at 10pm

Day off 2: wake up 8am, sleep 10pm

Day off 3: wake up 8 am, sleep 1am

Day off 4: wake up 12pm, sleep 3am

Repeat.

Melatonin was literally the only way I managed that.

I started to gradually notice some tossing and turning throughout the night in my mid 30s. I began taking one 100mg capsule of magnesium citrate right before I attempt to go to sleep. Has worked exceptionally well for about seven years now. Knocks me out, with no negative reaction to the magnesium (some people apparently have a negative stomach and or bowel reaction to magnesium supplements; I haven't attempted high doses). If I don't take it, I go right back to not sleeping soundly. The sleep feels high quality as well, I'm never groggy in the morning. And it's inexpensive, sub $2 per month. For something in the realm of more mild or typical restful sleep problems, definitely try it.

Amazed at the dosages of melatonin that people will take without thinking about it. It seems that the side effect profile is a lot greater than most people let on.

https://impossible.co/blogs/health/melatonin-side-effects

I've found a magnesium + l-theanine combo works wonders without any hormone interference or dependency issues to worry about.

Melatonin is not like a sleeping pill where more will necessarily make you more drowsy. It is a hormone that signals to your body that it is time to sleep. I can't find it right now, but there was a study of different doses in a large number of people that determined that just 0.2mg was more effective than larger doses for most people. And I've found that's true for me too. When I use melatonin, I use 0.2mg, and I fall asleep within half an hour, sleep a full night, and wake up feeling refreshed. If I use a larger dose, I sleep even less well than I would without a supplement.

I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.

Melatonin helped me with my sleep a bit, but never a lot. What did help is much brighter light during the day (on a timer, so the lighting would become dark in the evening) and adding to the basically-useless blue-light filters on my devices some automatic timed screen brightness changes.

I used to have circadian rhythm disorders. The most common pattern for me was the pattern of delayed sleep-wake disorder i.e. night owl disorder. I also experienced non-24 hour sleep-wake disorder, where you go to bed at a different time every "night", offset by an hour or two. At my worst, I experienced irregular sleep-wake disorder, which consists of many short naps throughout the day, with no pattern from day to day. Comorbid with depression, of course. Even the most mild (delayed sleep-wake disorder) is like 50% comorbid with depression.

Fortunately I'm now mentally healthy and free from sleep issues, and I attribute that mostly to the lighting changes I've made to my apartment. I've also heard these kinds of changes can help with SAD if the lights are bright enough. Look up how bright the sun is, and try to get your apartment to at least 10% of that. (100% is still too expensive, and 10% seems to work fine.) Note that most indoor lighting is usually closer to 1%.

P.S. this is essentially "light therapy" which they prescribe with those pathetic little light boxes, but if you look up the amount of light they give off, it's not nearly enough (and not for a long enough period). Hence why the stupid light boxes had no effect, but my own lighting setup changed my sleep dramatically. Here is a setup similar to my own: https://arbital.com/p/lumenators/

P.P.S Another thing you can try if you have circadian rhythm issues is to exercise hard in the morning right at your desired wake-up time. I never had to try it, but I did see a promising study in mice that showed it could reset their circadian rhythm more dramatically than anything else.

P.P.P.S If your sleep issues are not circadian in nature, don't bother with melatonin. You develop a tolerance to the sedative effects of melatonin pretty quickly, in my experience.

Does anyone have any tips/advice to solve the inverse problem which is waking up on a regular schedule?

I mostly follow sleep best practices - no phone before sleep, sleeping at a regular time, meditation, blackout curtains, no caffeine after noon, etc and am able to fall asleep. But however I have a problem with waking up. I either need 9+ hours of sleep or I’m awake in just 5 hours - almost a bimodal distribution. The lack of consistency makes it very frustrating to plan the day. Considering I got to bed around the same time each day, not being to able to wake up on the same time is quite puzzling to me.

> 5. I try to use melatonin for sleep, but it just gives me weird dreams and makes me wake up very early

Story of my life. I just noticed because of this article that I have more weird dreams since I'm taking melatonin. Yesterday I took one and woke up at 4am after having a super weird dream.

My wife can only sleep during regular night hours with Melatonin. It improved her quality of life so much. We even blind tested her three times with identical pills at night and the nights with placebo melatonin had no sleep each time.

> What is the right dose of melatonin? 0.3 mg. "But my local drugstore sells 10 mg pills!..."

The article goes into depth about debates about the right dose. What I was told is that you just have to experiment yourself.

I've personally found for myself, when I have to shift my bedtime/schedule a few hours earlier:

- The 3 mg tablets (smallest I could find at my drugstore) get me to sleep no problem... but them I'm groggy the next day until late afternoon. The melatonin is clearly still in my system, the whole day I just want to nap. So way too much

- The supposedly "correct" 0.3 mg (1/10th of a tablet) gets me to sleep basically just as well... but then I wake up constantly throughout the night and sleep really lightly. I have to assume the melatonin wears off, and I don't have enough naturally produced to fully compensate

- A quarter-tablet (0.75 mg) is just right. Sleep like a log, but not groggy in the morning.

The right dose for you may be different, but I hope that maybe helps people identify the signs of too much or too little. And it's not too hard to cut the tablets as well with just a paring knife or something.

I've also heard that the actual strength of drugstore melatonin tablets is not necessarily even remotely consistent across brands, I don't know if that's true or not. But it might be a good reason, once you've determined your optimal dose with a brand, to stick to it.

I take ~6mg Melatonin regularly 1hour before I decide to sleep. It also has another important use, i.e. reducing inflammation in the body. Helps with autoimmune along with Vitamin D3.

I wonder how many folks that are taking Melatonin are coffee drinkers?

I spent years trying to crack my sleep issues. Blackout curtains, magnesium malate / citrate, no electronic devices for an hour before bed, CBD oil, even stronger CBD oil, different doses of Melatonin, 5-HTP, valerian extract, sleep apnea tests.

It never really significantly occured to me that it would be coffee as I believed I had ruled this out. I was already stopping coffee at 12pm and tried to limit to two cups. I also enjoyed coffee a lot, I spent good money on artisan roasted beans, a grinder and an aeropress (including one for travelling). Coffee is good for you right, antioxidants etc! Everyone drinks coffee and I can get it anywhere 24/7.

I decided it must be worth trying to drop it as an elimination test to see if it might help. I came across a reddit comment from a google search, where someone had quit caffeine and had a lot of success.

First few attempts failed, but eventually managed to get a day one out of the way (the stuff is addictive).

First 3-4 days were tough to put it mildly, constant pumping headaches and extreme fatigue. However around day 5 something wonderful happened. I had one of the most deep satisfying sleeps I had in years, it was like the sort of sleep a child has. Deep R.E.M level sleep with a vivid dream. I work up with a feeling of being deeply nourished. I actually cried as I was so happy I had found an answer.

I am now caffeine free for 10 months and I can still feel myself healing and the layers of the onion being peeled away. I very rarely get anxious now and my productivity at work is back at where it was when drinking coffee, but the difference is my focus is much better. On coffee I was like a scatter gun, whereas now it's more of a less manic focus.

I continue to sleep great, all night, no more 3 am wake ups. On the rare occasion that I do wake, I don't find myself in this delirium / anxious state where I proceed to toss and turn, instead I feel really at ease and drop off again.

Caffeine really gets played down as harmless (and perhaps for some it may be), but there are so many folks around that are suffering with sleep issues that could solve this by quitting. Caffeine binds to your adenosine-receptors. When adenosine binds to its receptors, neural activity slows down, and you feel sleepy. Adenosine facilitates sleep and dilates the blood vessels, probably to ensure good oxygenation during sleep. Caffeine blocks these receptors thereby removing the feeling of being sleepy. Studies are limited, but I wonder if the long term impact of playing with your biochemistry day after day for years has a bigger impact than we know of. It also increases cortisol the stress hormone, so this is where the anxiety comes from, cortisol is akin to 'fight or flight'.

I only intermittently used melatonin, mostly to help me normalize when on the you’re-in-your-20s-and-working-hard-and-playing-hard Bay Area lifestyle (that so was deleterious)! The last couple of times I used it (now years ago), was to help get me back on schedule after jet lag.

For my body, it was a prime example of less-is-more: a soft, minuscule dosage would soothe me to sleep when sunlight diminished; more would give me terrifying dreams. The flip side is the moment the sun rises, — boom — involuntarily awake!

I think it affected my light sensitivity permanently, even years after stopping. I am extremely thankful to be living in a part of the world these days (D-A-CH), where good blackout shutters are commonly built into residential windows.

Webber Super Sleep (melatonin, 5-HTP, L-Theanine) changed my life for the much, much better

Hmmph... I'm taking 20mg most nights. One 10mg at bedtime, then another 5 hours later if I wake up again.

Even that isn't enough to really put me to sleep if I'm stressed out.

For me, "more is more" seems to be true...

Melatonin is a hormone, and is contraindicated for those with existing or predisposition to mental health conditions. In fact, that used to be a warning on the label in NY state.

It's not something to play with.

> I think you could make an argument for anything up to 1 mg. Anything beyond that and you’re definitely too high

So, should I take the whole 1 mg pill or divide it into smaller doses?

I often found that small doses of Melatonin worked much better for me and didn't give me headaches the next day. I buy the smaller dose available (3mg at my store though some places have 1mg too). I split the 3mg into half. So I take around 1.5mg which works good enough for me.

I also found the fancier "Melatonin Plus with L-Theanine and 5-HTP" to be not just expensive but also gave me severe headaches next day.

I used melatonin for about 7 years before i stopped it because it gave me vertigo. I am not 100% sure that melatonin was direct contributor to my vertigo, but my vertigo did get better after i stopped using melatonin.

Please research the side effects before you try this. It is not completly harmless because its 'natural'/ otc ect , i think its even regulated in some countries like the UK.

> Most existing melatonin tablets are around ten to thirty times the correct dose

I wonder how common this is in pharmacology.

> I've suffered with 2.5mg before for long enough to understand that it doesn't work for me, no matter how many studies you have with 95% CL that the dose is much lower. The 5mg tablets work much better for me.

Well, have you tried 0.5mg and lower? That was the point of the article, I think.

I read this sst post when it originally came out and decided to experiment with taking 0.3mg melatonin every evening. I started to get heart flutters that literally lasted all day. Stopped as soon as I stopped taking melatonin.

Melatonin is also the most powerful known antioxidant:

https://www.mdpi.com/2076-3921/9/11/1088/pdf

What I liked about melatonin was the YEAH READY TO GO when waking up.

Useful when my schedule was working on the car before work.

But I really try not to take it anymore. The blue light glasses are sufficient.

I have found melatonin supplements very effective for jet lag but I am hesitant to take any sleep supplement for more than a day or two in a row for fear of dependence.

https://news.ycombinator.com/item?id=17632668 266 comments

I don't think his "What is the right dose of melatonin?" is correct.

My doctor told me to take 3mg. 3mg really works well for me. Anything less and I don't sleep.

> I am not a sleep specialist.

Then you shouldn't be writing an article about sleep as if you were an expert. Why on Earth should I trust anything this man says if the first line of the article is about how he's not qualified to give the advice he's giving?