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 Natural Hormones: Take Two Melatonins and Call Me in the Morning 

Wayne, a 24 year old computer programmer from Seattle, asserts, "I have severe chronic insomnia and I've used melatonin twice. Neither time did it seem to improve my sleep. (My body is amazingly good at resisting sleep.) Both were 3 mg doses taken just a few minutes before bed."

Keep in mind that melatonin is subtle compared to the effects of prescription sleeping pills. It doesn't have their knockout punch. Matthew, a 26 year old teacher, tells me, "I am impressed at the similarity between melatonin and natural sleep. As someone who has suffered periodic bouts of insomnia, melatonin provided natural sleepiness without the drowsiness of some prescription medicines that I've taken in the past." Heather, a 24 year old massage therapist, nods, "Sleep comes on naturally and peacefully."

Some individuals do very well with small doses. A survey respondent wrote, "I'm 57 years old and have been taking melatonin regularly for insomnia for a year. Previously, I would sleep 4 or 5 hours, then wake up and not be able to go back to sleep. With 1 mg of melatonin I sleep through the night. If I do happen to wake up, I am able to easily fall back asleep. I've had no side effects at all and wake up refreshed."

For most people melatonin is effective the very first night. Some of my patients report feeling an effect after the first week. However, some may take up to a month before noticing a difference. MacFarlane and colleagues also noted this: "Improved sleep is in evidence from the first treatment night, but an increased efficacy is observed with repeated treatments."

When is the Best Time to Take Melatonin?
People vary widely in their response times. Pills are effective for most people when swallowed about half an hour to 90 minutes before bed. Lozenges dissolved in the mouth seem to work more quickly. You may take them between 10 minutes and an hour before going to bed. Most people notice a natural yawn within half an hour of dosing.

I, personally, do well with 0.25 mg taken 45 minutes before bedtime. When I put my head on the pillow, I'm out! I have found that a low dose is more effective when taken at least an hour or two before bed while a high dose can be taken closer to bedtime. One of the most common mistakes people make with melatonin is taking it too close to bedtime. This is not a prescription sleeping pill and doesn't work as quickly. For the most part, a good hour is required for best results. Let's also keep in mind that tablets and lozenges from different manufacturers may be absorbed at different rates.

Leona, a 42 year old social worker, tells me, "I took a 1 mg lozenge right before bed. I didn't feel any effects from it and had trouble falling asleep. I tried it again a few nights later right before bed. Still no effect. I was almost going to give up on melatonin until you suggested I try it at least 1 hour before bed. This seemed to make all the difference; I went to sleep within a couple of minutes of putting my head on the pillow."

One survey respondent wrote that he has chronic insomnia and takes 10 mg of melatonin an hour before bed. He wakes up at 3 or 4 am and takes another 10 mg. This works for him; he feels fine the next day. Another user noted that he once woke up at 3 am and couldn't fall asleep. He hadn't taken any melatonin the night before. After an hour of tossing in bed, he took two 3 mg pills at 4 am and had trouble getting out of bed the next day. He felt groggy most of the morning. It's best to take melatonin to accentuate our natural sleep rhythm avoiding the use at a late hour where it could shift our cycle to an undesired time.

(Excerpted from Melatonin: Nature's Sleeping Pill ISBN: 0963975579)
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 About The Author
Ray Sahelian MDRay Sahelian, M.D., is a popular and respected physician who has been seen on numerous television programs including NBC Today, Dateline NBC, and CNN, and quoted by countless major magazines such as Newsweek He......more
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