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Finding the appropriate amount of melatonin can be the difference between sleeplessness and waking up feeling truly refreshed. With such a wide range of dosages available—from 0.5 mg to 20 mg on store shelves—determining a reasonable dose requires relying on science and understanding individual sleep needs and patterns.
The American Academy of Family Physicians (AAFP) lists melatonin as a first-line pharmacological agent for insomnia; however, the FDA does not approve any standard doses. So, that means you HAVE to be aware of evidence-based recommendations for the safe and effective use of melatonin.
A recent meta-analysis has indicated melatonin ultimately increased total sleep time and led to a reduction in sleep onset latency over time with an effect size peaking at 4 mg/day. But of course, that does not mean you should go ahead and take 4 mg every day. While there is still important individual optimization, this will be very gradual, so you need a systematic approach, primarily if sleep disorders are being considered.
Clinical Recommendation: 0.5-1mg, increasing by 1mg weekly as needed.
The recommendation for most adults is to start with 0.5 to 1 mg of melatonin and increase the dose if necessary. The "start low and go slow" method is advantageous as it minimizes possible side effects, takes time to find your minimum effective dose (if applicable), and maximizes the prevention of tolerance—we do this with sleep hygiene too.
The physiological rationale behind this recommendation is quite simple: peak concentration after oral dosing of melatonin is reported to be, in many examples, considerably higher in older adults—e.g., 240% more than in adults under 45 years of age. This illustrates that the metabolism of melatonin varies widely as you get older, have liver function issues, and have varying baseline metabolic rates; all factors that may influence your natural sleep patterns.
We asked Dr. Michael Grandner, Sleep Expert and Professor of Neuroscience and Physiological Sciences, what his experience tells us about melatonin dosing. He says: "Many people assume that more melatonin equals better sleep, but research shows that lower doses are often more effective. Starting with 0.5-1mg allows your body to respond naturally without overwhelming your melatonin receptors."
Clinical Recommendation: Take melatonin 1-3 hours before your desired bedtime, not right before sleep.
Advancing the timing of administration (3 h before the desired bedtime) and increasing the administered dose (4 mg/day), as compared to the exogenous melatonin schedule most used in clinical practice (2 mg 30 min before the desired bedtime), might optimize the efficacy of exogenous melatonin in promoting sleep.
This timing principle reflects melatonin's role as a circadian rhythm regulator rather than a sedative. As night time comes, this clock helps our body make melatonin, a sleep-promoting hormone, while continuing to emit signals that help us stay asleep. Taking melatonin too close to bedtime can disrupt this natural rhythm progression, much like how blue light exposure affects sleep timing.
Clinical Recommendation: Match your melatonin approach to your specific sleep challenge.
For sleep onset difficulties (trouble falling asleep), immediate-release formulations work best. The FR melatonin formulations were more effective than the slow-release formulation. The 5-mg FR formulation significantly improved the self-rated sleep quality, shortened sleep latency, and reduced fatigue and daytime sleepiness.
For sleep maintenance issues (frequent nighttime awakenings), extended-release formulations may provide better results. The clinical rationale: different formulations target different phases of the sleep cycle, with immediate-release helping initiate sleep and extended-release maintaining sleep architecture.
We asked Dr. Suzanne Gorovoy, Sleep Expert, Clinical Psychologist, and Behavioral Sleep Medicine Specialist, about personalizing melatonin approaches. She says: "Understanding whether you struggle with falling asleep or staying asleep determines your optimal melatonin strategy. Sleep onset issues respond better to immediate-release formulations taken earlier, while sleep maintenance problems may benefit from extended-release versions."
This approach aligns with personalized sleep strategies that address individual sleep patterns and challenges.
Clinical Recommendation: Adjust expectations and dosing based on age-related physiology.
Doses of melatonin between 1 mg and 6 mg appear to be effective for improving sleep in older adults; however, further studies are needed to find the optimal minimum effective dose. Age affects both melatonin production and metabolism significantly.
For Adults 18-65: Standard 0.5-3mg range applies, with most finding effectiveness at 1-2mg, similar to recommendations for healthy sleep habits.
For Adults 65+: It is reasonable to expect that the same dose administered to an older individual would have more pronounced effects. Start with 0.5mg and increase cautiously, especially when considering sleep changes with aging.
For Children: The proposed dosage of melatonin to healthy children is 0.5 to 5 mg, approximately 30 min to 1 h before bedtime. However, pediatric use requires medical supervision due to potential effects on pubertal development, making behavioral sleep interventions often preferable.
Clinical Recommendation: Assess effectiveness after 1-2 weeks and consider other options.
In adults, trials have shown exogenous melatonin has only modest efficacy in primary insomnia: an increase in total sleep time of 12.8 minutes and a decrease in sleep latency of 4 minutes. Although beneficial, these findings are relatively modest compared to other sleep interventions such as cognitive behavioral therapy.
Signs melatonin isn't effective for you:
Many popular sleep medications such as Trazodone, Benadryl, and even melatonin, don't even show clinical evidence to increase total sleep time more than a couple minutes! When melatonin is ineffective, evidence-supported approaches such as comprehensive sleep programs would likely offer greater improvements than interventions such as sleep medications.
Clinical Recommendation: Monitor your response and watch for interactions.
Common melatonin side effects include: morning sleepiness, headaches, and vivid dreams. Interactions with commercial medications can be concerning. In one study, dosing 5mg of melatonin for four weeks in people taking nifedipine resulted in increases in blood pressure: systolic: 6.5 mmHg and diastolic: 4.5 mmHg.
Considerations for important interactions:
We also asked Dr. Areti Vassilopoulos, Sleep Expert, Pediatric Health Psychologist, and Assistant Professor of Child Psychology, about monitoring melatonin use: "Tracking the response of your sleep after using melatonin is important, but it is also critical to monitor how you are functioning during the day. If you find that you are groggy, experiencing changes in mood, or having problematic dreams, these may warrant a conversation with your healthcare provider."
You may want to consider some form of sleep tracking to help monitor your response.
A groundbreaking 2024 meta-analysis of randomized controlled trials looking at melatonin analyzed 26 randomized controlled trials published between 1987-2020, for a total of 1689 observations to determine the optimal melatonin protocols. The findings indicated sleep onset latency reduced and total sleep time increased with melatonin supplementation. The greatest effect occurred approximately with a dose of 3-4 mg, with an effect of taking it 3 hours before bedtime.
The meta-analysis challenges the conventional wisdom of taking melatonin 30 minutes before bed. Rather, taking melatonin 3 hours before bed would allow the body to use the melatonin with the natural circadian rhythm, instead of working against it, yielding a greater effect on both sleep onset time and sleep duration increases.
Beyond just taking a pill, using melatonin is best when it is part of a bigger plan for improving sleep. If you are not using these strategies, consider implementing them in conjunction with taking melatonin.
Bright light in the morning and avoiding light in the evening can help improve sleep timing and sleep quality.
Bedrooms should be kept cool (65-68°F), so create a proper sleep environment.
Consider using relaxation strategies and/or a form of meditation in the evening before time devoted to sleep.
Establish regular bedtimes and wake times, or regularity in your sleep schedule.
For those who want to avoid medication, there are also evidence-based sleep programs (utilizing cognitive behavioral therapy for insomnia) that have resulted in participants sleeping on average over 85 minutes longer compared to pre-treatment sleep, without taking medication or supplements. These programs are better able to address the underlying causes of insomnia compared to supplementation alone.
It is important to keep in mind how the quality of supplements is variable and poorly regulated, with melatonin being no exception. A study looking at melatonin gummies and melatonin content revealed that 88% of the gummies were significantly mislabeled with amounts ranging from 74-347% of the labeled amount of melatonin.
Consider using melatonin along with other natural sleep aids and dietary sleep-promoting foods to maximize your melatonin supplementation effectiveness.
Using melatonin effectively involves more than just grabbing a "high-dose" product off the pharmacy shelf. Start with 0.5-1 mg of melatonin taken 1-3 hours before your desired bedtime. Listen to your body and gradually adjust your dose when needed. And, in some instances, the timing of taking melatonin may be more important than the dosage. Ultimately, if after 2-3 weeks of taking melatonin you do not find improvements in your sleep, a comprehensive sleep plan and approach that takes your particular situation into consideration is warranted compared to only treating symptoms.
We can achieve quality sleep—it just might take different approaches to meet your individual needs.
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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