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

One friend has found that breaking a pill in small portions and taking about 0.2 mg 90 minutes before bed and taking another 0.2 mg 30 minutes before bed gives her a better sleep than taking it all at one time. This is a good option for some since melatonin is gradually produced by the pineal gland at night. One could therefore take small doses maybe 2 hours, 1 hour, and 30 minutes before bed. I tried this approach recently, using tiny doses, and it worked well. I must have taken a total of less than 0.3 mg.

These anecdotes indicate the importance of trial and error in finding out the best dose and the best time for your unique self. If melatonin doesn't work for you initially, don't give up. Experiment with varying doses and times. You may also try another brand if the first is not effective. As a rule, if you have trouble falling asleep, consider sublinguals. If you have no trouble falling asleep but wake up in the middle of the night or early morning, consider taking a pill just before bed with food, or the slow release form, which stays in your system longer. If you have difficulty in both falling asleep and staying asleep, you could combine low doses of sublinguals and the slow release.

Slow-release (also known as sustained, time, or controlled-release) melatonin will likely become more popular in the future. A 1995 study published in The Lancet found a 2 mg slow release pill to be very helpful in older insomniacs, especially after regular use for 3 weeks (Garfinkel). It is possible that smaller doses, such as 0.5 mg, may also be just as effective.

Those who are used to taking prescription sleeping pills may require a few days or weeks before noticing the subtler effects of melatonin.

Is Melatonin Addictive?
Since no studies in humans have yet been published specifically addressing this question, I can't make a definitive statement about melatonin's addictive potential. I can only state my own experience and the experience of my patients who feel melatonin not to be physically addictive. Those who take it for its anti-aging effects use it regularly and aren't concerned with addiction. The majority of users who take it for improved sleep only do so when they really need it. A few mentioned that they liked the improved quality of sleep so much that they wanted to use melatonin often— almost like a weak psychological addiction.

It is possible that for some insomniacs melatonin can be habit forming. Stuart, a regular user for 4 months, is one example: "I don't have a strong urge to take it but I can tell the difference in the quality of my sleep when I do use it. At night, when its getting close to bedtime, I sometimes think to myself, you know, I really want to sleep well tonight. So, often I pop a pill."

Dennis, who is 52, writes, "I have been a vegetarian and meditator for 20 years. Anything I take routinely I make a practice of not taking for 1 day a week, 1 week per month, and 1 month per year. With melatonin I have noticed no withdrawal, no feeling of addiction, and no noticeable effect other than natural restful sleep when I take it. Honestly, it feels like something my body is missing and should have, and welcomes it when I take it. I feel no 'impact' like I do with pharmaceuticals. Great stuff."

For the past year and a half I've taken about 1-5 mg of melatonin three or four nights a week. With time, I discovered that a lower dose, such as 0.25 mg, was also effective. My sleep has been extremely deep and restful. I recently stopped taking it for a week and have noticed no withdrawal symptoms. I personally find that there is a slight habit forming tendency, and, as Stuart reported above, it is tempting to use melatonin regularly since the sleep it provides is so soothing.

(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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