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Now considered one of the most popular natural sleep aids in the world and available over the counter, melatonin is incorporated into the daily lives of millions of people in order to improve their sleep. As more people take melatonin supplements, questions about how much one should take, especially when taking a high dose of melatonin, for example, 10 mg, have also become of interest among both researchers and the general public.
10 mg is well above the recommended dosage of melatonin, and while there may be potential benefits to taking a 10 mg dose every night, there are also potential risks that you may not be aware of.
Melatonin is a hormone synthesized in the brain, particularly in the pineal gland. As darkness approaches in the evening, the melatonin-making process within the pineal gland begins, typically around 9 PM, and peaks between 2 AM and 4 AM. This natural rhythm is essential for entraining sleep-wake cycles as well as regulating your circadian biological rhythms.
We spoke with Dr. Michael Grandner, Sleep Expert and Associate Professor of Neuroscience & Physiology, about the science surrounding melatonin as a sleep supplement. He says: "Melatonin is primarily a chronobiotic, which means it helps to reset biological clocks, it isn't a sedative as a classical sleep medication."
Melatonin binds to the melatonin receptors in the brain, specifically those in the suprachiasmatic nucleus (SCN), which is essentially the master biological clock in your body. Research in the Journal of Clinical Medicine has suggested that melatonin supplementation can help restore normal circadian rhythms that have been disrupted. Thus melatonin may be helpful for jet lag or shift work sleep disorder.
Importantly, it is not necessarily true that more melatonin is more effective. Unlike other medications, which tend to increase the effects with an increased dose, melatonin has a more complex relationship that many people do not grasp.
Clinical studies examining melatonin's effective dose typically report doses from 0.5 mg to 5 mg, and many studies have found effective results much lower than the average dose sold on the market. An extensive review in Sleep Medicine Reviews examined melatonin sleep studies and found doses of 0.5 mg to 3 mg were often as effective as higher doses to improve sleep onset.
The American Academy of Sleep Medicine recommends initiating melatonin supplementation with the lowest effective dose, and that most people are likely to need 1-3 mg of melatonin for 1-2 hours before desired sleep time. The recommendation is based on the idea that melatonin should mimic the body's natural production of this hormone and not exceed it therein.
Dr. Suzanne Gorovoy, Sleep Expert, Clinical Psychologist, and Behavioral Sleep Medicine Specialist, states: "Lower melatonin doses often work better because they closely resemble the body's natural melatonin curve; using higher doses can disrupt the normal sleep architecture."
Disruptions caused by excess melatonin can lead to what researchers have coined "melatonin hangover," where individuals feel dazed or groggy the following day. Studies published in the European Journal of Clinical Pharmacology show doses greater than 5 mg increase the risk of feeling groggy in the morning.
Taking 10 mg of melatonin every night is still 3-10 times more than optimal doses reported in the literature. Melatonin is regarded as safe and low in toxicity for most people, but more melatonin is not better.
At 10 mg of melatonin you are taking 10-100 times more melatonin than your body would produce at night. Research in the Journal of Pineal Research suggests melatonin at this amount can:
Dr. Areti Vassilopoulos, Sleep Expert, Pediatric Health Psychologist and Assistant Professor of Child Psychology, states: "High doses of melatonin can even paradoxically impair sleep quality initially by shifting how our stages of sleep ebb and flow naturally."
In addition to the issues with sleep quality, possibly the most concerning aspect of nightly high-dose melatonin use is its potential effects on your endocrine system. Studies found in Frontiers in Endocrinology have found that chronic melatonin use at high doses could desensitize melatonin receptors and impair other hormone production, including reproductive hormones.
Even though melatonin is readily available in stores and considered safe and well-tolerated, using 10 mg nightly can cause many side effects that most people do not anticipate. A significant study reported in the journal Sleep Medicine documented the side effects of melatonin dosage greater than 5mg. These side effects include:
A nightly dosage of melatonin at 10mg is particularly concerning when combined with certain classes of medication. An article published in Drug Safety listed some important interactions that users should consider:
Dr. Samantha Domingo, Sleep Expert and Clinical Health Psychologist, states: "High-dose melatonin is not simply a sleep aid – melatonin is a hormone that affects several biological systems, and can interact with a multitude of other medications."
One of the most highly influential studies regarding optimal dosing of melatonin was conducted at MIT and published in the Journal of Clinical Endocrinology & Metabolism. This study compared multiple doses of melatonin with doses of 0.1mg, 0.3mg, and 3mg. 0.3mg of melatonin was as effective at reducing sleep onset time while producing fewer side effects the next day than 3mg.
Most importantly, researchers found that at higher doses, melatonin is often less effective than lower doses, which greatly challenges the prescriptive view of "more is better" that many people possess about melatonin. This research has fundamentally changed the way that sleep medicine specialists think about melatonin dosing; it is not a dose-dependent intervention, but smaller doses often yield better results with fewer side effects.
Melatonin does not create the same type of physical dependence as prescription sleep medications, but using high doses nightly could result in psychological dependence and/or physiological changes that make it difficult to sleep without melatonin.
Research reported in the Journal of Sleep Research suggests that repeated use of melatonin can suppress your body's own natural melatonin production. When you take external melatonin regularly, especially high doses, your pineal gland may suppress its production of melatonin through a negative feedback mechanism.
This can lead to a situation where stopping melatonin can result in rebound insomnia, where the sleep problems get worse for a temporary period of weeks while your body recovers its natural melatonin production.
If you're taking 10 mg melatonin every night and aren't tolerating it well or are concerned about using it long-term, there are several evidence-based alternatives to help improve sleep quality.
CBT-I is the gold standard treatment for chronic insomnia, and many studies have shown improvements in sleep quality that are more successful than sleep medications. Meta-analyses in Sleep Medicine Reviews show that CBT-I has lasting effects on sleep quality, with much less risk than ongoing sleep medicines.
Dr. Daniel Jin Blum, Sleep Expert, Clinical Psychologist, and Research Assistant Professor of Psychology, explains: "CBT-I works on addressing the root causes of sleep problems, not masking them, as high-dose melatonin often does."
The fundamental parts of CBT-I include sleep restriction therapy, stimulus control, cognitive restructuring, and education about sleep hygiene.
Before trying high-dose melatonin, here are some evidence-based techniques for better sleep:
Light Therapy: The Journal of Clinical Medicine has shown that properly timed light exposure regulates melatonin production in a natural way. In order to maintain healthy circadian rhythms, get fifteen to thirty minutes of bright light exposure within 30 minutes of waking.
Temperature Control: Studies suggest keeping your bedroom temperature between 65 and 68°F, as this temperature range will optimize your body's natural cooling process, which promotes sleepiness.
Magnesium Supplementation: Clinical trials published in the Journal of Research in Medical Sciences show magnesium supplementation improved sleep quality and reduced sleep onset time, and did not disrupt healthy hormonal balance.
If you prefer to take supplements instead of behavioral approaches, there are several safe alternatives to high-dose melatonin:
L-Theanine: Research from Nutrients reviews the effects of L-theanine and states that L-theanine promotes relaxation without sedation. Comparing L-theanine and melatonin, L-theanine provided a gentler effect and had fewer side effects.
GABA: Research from Food Science and Nutrition discusses adding GABA as a supplement to improve sleep quality by enhancing your brain's main inhibitory neurotransmitter. GABA vs melatonin studies indicated that GABA may be more beneficial for anxiety-based insomnia.
Some populations will have an increased risk from nightly melatonin use of 10 mg or more:
Pregnancy and Breastfeeding: Research in Reproductive Toxicology shows melatonin crosses the placenta and is present in breast milk. Melatonin at higher dosing during pregnancy may have negative effects on developing fetuses.
Children and Adolescents: Dr. Shiyan Yeo, Internal Medicine Physician and Sleep Medicine Expert, states: "Children's endocrine systems are still developing and are more vulnerable to disruption from high-dose melatonin supplementation." Studies in pediatric populations recommend maximum doses of 0.5-3 mg for children.
Autoimmune Conditions: Research has shown that high-dose melatonin may exacerbate autoimmune conditions by overstimulating immune systems.
If you have been taking 10 mg of melatonin every night before bed and want to shift to safer dosing, clinical guidelines recommend a gradual tapering approach:
Managing potential withdrawal symptoms may include optimizing timing of your melatonin use, light therapy, or additional stress management techniques.
You should see a professional medical provider for assessment when the following is true:
Studies show that people who receive a professional sleep evaluation are more likely to get better long-term outcomes compared to self-treatment with natural supplements alone.
While melatonin has a good safety profile, taking 10 mg every night is a higher dose than studies support for optimal dosing and poses unnecessary risks. Evidence reveals that lower dosing of 0.5-3 mg is sometimes more effective with fewer side effects, high dosing can negatively affect sleep architecture, and habitual melatonin use carries risk of dependency.
Instead of taking melatonin nightly at high doses indefinitely, use it as a temporary bridge in conjunction with sustainable sleep improvement strategies. Evidence-based treatments like CBT-I generally provide sustained improvement without the risk of nightly dependence.
The goal of a sleep supplement, including melatonin, is not just maintaining sleep, but consistently attaining restorative sleep that is essential to health. While melatonin is useful to aid sleep in some situations, the risk of dosing at 10 mg is often more trouble than it's worth. For personalized advice, consider comprehensive sleep programs to assess all dimensions of sleep health naturally and safely.
Dr. Shiyan Yeo
Dr. Shiyan Yeo is a medical doctor with over a decade of experience treating patients with chronic conditions. She graduated from the University of Manchester with a Bachelor of Medicine and Surgery (MBChB UK) and spent several years working at the National Health Service (NHS) in the United Kingdom, several Singapore government hospitals, and private functional medicine hospitals. Dr. Yeo specializes in root cause analysis, addressing hormonal, gut health, and lifestyle factors to treat chronic conditions. Drawing from her own experiences, she is dedicated to empowering others to optimize their health. She loves traveling, exploring nature, and spending quality time with family and friends.
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