A melatonin dosage guide: How much do I need to sleep?

What is melatonin? | Benefits of melatonin | Melatonin dosage | Melatonin safety

If you’re one of the 70 million people living with a sleep disorder, you’ve probably struggled to find a safe and effective way to get better sleep at night. Over-the-counter sleep aids, like ZzzQuil and Unisom, don’t always work. Meanwhile, taking the plunge into prescription sleep medications, such as Ambien or Seroquel, carries a risk of dependence (creating another problem instead of a solution!). On top of that, it’s likely your difficulty catching zzz’s has gotten even worse since the start of the COVID-19 pandemic.

For many people with sleep problems, taking a melatonin supplement before bed seems like the best option. In fact, a 2021 sleep survey by SingleCare found that 20% of respondents reported taking a natural supplement like melatonin to sleep better. Because supplements aren’t medications, per se, they’re available OTC and often considered a “natural” or safer way to find relief from sleeplessness. But is melatonin safe to take? And how do you know what’s the right dose for you? Here’s how to figure it out.

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What is melatonin?

The sleep hormone melatonin comes from a small gland in the brain called the pineal gland, whose primary job is melatonin production. Natural melatonin regulates your body’s circadian rhythms, or the “clock” that tells your body what time of day or night it is and what it’s supposed to be doing every day at those times, according to the Society for Endocrinology. (This is why you generally feel sleepy around the same time every night.) 

Normally, melatonin levels increase at night. Secretion of the hormone begins after darkness and peaks between 2-4 a.m., decreasing gradually from there. Infants produce only small amounts of the hormone, but melatonin production is highest between the ages of 1-3 years. From there, production decreases about 10% to 15% every decade. In young adults, daytime peak values of melatonin are 10 picograms (a picogram is 1 trillionth of a gram) per milliliter, and nighttime peak values are 60 pg per milliliter.​

But many people don’t produce these higher levels in the evenings, which means their body clocks aren’t sending them the right signals. The reasons why are varied; some people struggle to sleep well when they have certain medical or mental health conditions, like anxiety or depression, while others can trace their sleeplessness to situational or environmental causes.

“The natural release of melatonin can be altered by cell phone screens, TVs, and bright lights throughout the house,” says Anjali Kohli, MD, internist at Houston Methodist Primary Care. “Other common causes include disturbances in the sleep wake cycle [like those] caused by jet lag or shift work.”

Nutritional factors also play a role in melatonin production, but less so than exposure to daylight and nighttime darkness. There are notable levels of melatonin in tomatoes, olives, barley, rice, walnuts, milk, and some varieties of grapes. Diets rich in vegetables, fruits, and grain products seem to contain considerable amounts of dietary melatonin, but their impact on overall melatonin production is minimal. 

Not making enough melatonin can lead to the occasional sleepless night, but it can also cause primary sleep disorders like insomnia, sleep apnea, circadian rhythm sleep disorder, and restless leg syndrome. When sleeplessness becomes persistent, many people choose to take a melatonin supplement to boost their body’s natural levels of melatonin.

Dr. Kohli says that melatonin doesn’t force you to sleep, but if you’re in the right environment—like a dark, quiet, comfortable room—it should help you feel drowsy and make it easier for you to drift off. Melatonin is a viable option for many people with sleep issues and, though it doesn’t work for everyone, is generally considered effective.

When should I take melatonin?

Melatonin may be used to improve sleep onset, sleep time, or sleep quality. There are several scenarios where you might benefit from taking melatonin for sleep, according to the National Center for Complementary and Integrative Health (NIH). These include:

• Experiencing jet lag during or after a long flight or after traveling through different time zones
• Performing shift work that disrupts your sleep cycle (such as overnight work shifts)
• Having temporary instances of anxiety related to events in your life
• Experiencing the occasional sleepless night
• Being diagnosed with delayed sleep-wake phase disorder

Some healthcare professionals also recommend that children who experience difficulty sleeping due to other health conditions, like autism spectrum disorder and attention deficit hyperactivity disorder, take melatonin—although experts are still unsure about the overall safety and effectiveness of this approach. The American Academy of Pediatrics (AAP) reminds parents to always discuss supplement use with their child’s pediatrician, especially since melatonin is a hormone and may affect the growth and development of a child who has not fully matured.

RELATED: Is melatonin safe for kids?

How much melatonin should I take?

Melatonin supplements are available in a wide range of dosages, from 1 milligram up to 10 milligrams, and can be taken in pill form, as dissolvable tablets, liquid drops, or even gummies. However you take it, the best time to use melatonin is about 30 minutes before bedtime.

If you’ve never taken melatonin before, start small and work your way up if needed. For adults, Dr. Kohli recommends beginning with a 1 to 2 milligram dose daily and increasing the dosage by another 1 to 2 milligrams at a time. For children, the AAP says the dose should remain low (between .5 and 1 milligram), capping out at no more than 3 to 6 milligrams of melatonin. The maximum dosage for healthy adults ranges from 5 to 10 milligrams. If that sounds like a wide spectrum of normal, it’s because the “right” dose of melatonin is very individualized. According to University of Missouri Health Care neurologist Pradeep Bollu, MD, while some people respond well to 3 milligrams daily, others may need more or less. If you feel like you need more than 5 milligrams, you should talk to your doctor first before trying a higher dose. The more melatonin you take the more likely you are to have side effects. Melatonin dosage is fixed according to age, and does not vary by body weight.

*Only under a doctor’s approval. Sources: Sleep Foundation, AJMC, SingleCare.

The dosage you take may also depend on your reason for taking melatonin. Its use in the treatment of some types of migraines and anxiety is still being studied, but many people find taking melatonin at different doses helps them with these other health issues.

• Sleep: While there is no official melatonin dosage recommendation for sleep, taking 1-10 mg an hour before going to bed appears to be safe in most adults.
• Adjusting circadian rhythm: Melatonin may be useful for people whose schedule doesn’t align with their body’s natural circadian rhythm—for example, night shift workers who go to bed very late or those who go to bed very early. Those who live with seasonal depression (SAD, also called winter depression), which is related to altered circadian rhythm caused by shorter days, may benefit from taking melatonin in the afternoon. In either scenario, it’s a good idea to work with a sleep specialist to determine dosage and duration.
• Jet lag: If you travel often—especially to new time zones—even minimal doses of melatonin may be helpful in minimizing the effects of jet lag. Try taking 0.5-5 mg 30 minutes before going to sleep until you adapt to the time zone. 
• Delayed sleep-wake phase disorder: Melatonin is a first-line treatment in individuals with this circadian rhythm sleep-wake cycle disorder, but it’s best to consult with a health care provider to determine a dose that’s appropriate for you. Research indicates that a very low dose is usually effective. 
• Premedication for surgery: According to research, melatonin may be helpful in reducing anxiety before surgery, but its effectiveness in reducing anxiety after surgery has not been established.
• Tardive dyskinesia: Melatonin may be helpful in controlling tardive dyskinesia, a condition marked by repetitive, uncontrollable movements that is common in individuals taking antipsychotic medication. A small study showed that 20 mg of melatonin decreased symptoms, but more research is needed. 
• COVID-19: In a study among patients who were hospitalized with COVID-19, melatonin administration resulted in improved sleep quality as well as blood oxygen saturation.  
• Cancer, adjunctive therapy: In cancer patients, melatonin given in high doses (orally or intravenously) may reduce the size of a cancerous tumor and improve a cancer patient’s survival rate, but this depends on the extent and type of cancer. Ask your healthcare provider for guidance.
• Chemo-related thrombocytopenia: Low platelet levels in the blood caused by chemotherapy may be remediated by melatonin. According to research, melatonin may enhance platelet and white blood cell recovery.
• Headache prevention: In a review of randomized, placebo-controlled trials, a 10 mg dose of melatonin taken at night was shown to help prevent cluster headaches, while a 3 mg dose was effective at preventing migraines. 
• Nicotine withdrawal: Insomnia is a clinically verified symptom of nicotine withdrawal. Older research indicated that taking lower-dose melatonin was effective at reducing mood-based withdrawal symptoms, but more current research is needed. 

“There are initial studies looking at melatonin as a therapy for certain headache disorders and anxiety, especially in relation to surgical procedures,” says Dr. Kohli, though she emphasizes that there is currently no consensus on using it for these issues and studies about the effectiveness are ongoing.

Is melatonin safe?

Even staying within the recommended range of melatonin could lead to long-term side effects or changes to your circadian rhythm. In other words, it might be healthier to look at melatonin as a short-term solution to your sleep troubles, used only occasionally, rather than as a permanent Band-Aid.

“It is always safest to allow your body to fall asleep naturally,” Dr. Kohli says. “Talk to your physician if you are having chronic trouble falling or staying asleep…insomnia is a very complex problem and can sometimes indicate underlying medical issues.”

Is it safe to take melatonin every night?

Unfortunately, there’s no straight answer here, which you’re probably hoping for. There isn’t any evidence proving conclusively that long-term use of melatonin is safe. Though the supplement is generally not associated with dependency, habituation, or hangover symptoms, Dr. Kohli says she doesn’t suggest taking melatonin every night because of the lack of long-term clinical trials  evaluating the safety of chronic use.

At the same time, there isn’t any evidence proving nightly melatonin use isn’t safe. Dr. Bollu points out that melatonin is a natural hormone that fluctuates in our bodies on a daily basis anyway, meaning it may be safer than taking a prescription drug.

RELATED: Is it safe to take OTC sleep aids every night?

Is melatonin approved by the FDA?

Because melatonin supplements aren’t medications, they aren’t regulated by the U.S. Food and Drug Administration (FDA). There’s no guarantee about the quality of the product you’re purchasing or the quantity of ingredients claimed on the label, unlike prescription drugs. A pharmacist or nutritionist may be able to help you find a product produced by a reputable manufacturer. 

Can you overdose on melatonin?

It’s difficult to assess just how much melatonin is too much. It appears to carry a low overdose risk; the National Poison Control website reports several cases where children and adults consumed extremely high doses of melatonin and had little or no unwanted side effects (other than acute drowsiness). It’s possible there is a lethal dose of melatonin, but no one knows what it is since there has never been a proven instance of too much melatonin causing death.

Who should not take melatonin?

Your provider will also assess your overall health profile when considering the safety of a higher dose. Per the NIH, the following populations should take low doses of melatonin under medical advice or none at all:

• Children: Before turning to melatonin, work on improving your child’s sleep hygiene. Start with regular sleep and wake times, and make sure your child is sleeping in a cool, dark environment (in their own bed). Avoid electronics usage an hour before bedtime, and avoid eating large meals less than two hours before bed. According to the FDA, there is no standard dosage recommendation for melatonin in children, so consult with your child’s pediatrician first.    
• Older adults: In adults older than 55, research indicates that melatonin levels remain elevated in the body for a longer period of time than in younger individuals. For this reason, older people should take the lowest dose of melatonin available in an  immediate-release form. 
• Pregnant and breastfeeding women: During pregnancy, melatonin can reach a developing fetus through the placenta. Because sufficient research studies have not been conducted, it has not been established as safe. Supplementation with melatonin should be avoided during pregnancy. Similarly, no data exists on the safety of melatonin while breastfeeding, so it is not recommended. 
• People with epilepsy or other seizure disorders should take either low doses of melatonin under medical advice or none at all. Although previously conducted research does not indicate consistent improvement or worsening to epileptic seizures from melatonin, further research is needed before it can be deemed safe. 
• People taking certain medications: Melatonin may interfere with some medications, including immunosuppressants, oral contraceptives, and anticoagulants, to name a few.

Melatonin interactions

Taking too much may increase the typical melatonin side effects and may cause drug interactions with other medicines you’re taking. Especially in higher doses, melatonin can interact with the following prescription medications, according to the Mayo Clinic:

• Anticoagulants and anti-platelet drugs or supplements, such as warfarin
• Anticonvulsants 
• Blood pressure medication, such as Procardia XL (nifedipine)
• Central nervous system depressants
• Diabetes medications
• Contraceptives
• Cytochrome P450 1A2 (CYP1A2) and cytochrome P450 2C19 (CPY2C19) substrates 
• Luvox (fluvoxamine)
• Immunosuppressants
• Seizure threshold lowering drugs

Caffeine consumption may impair melatonin production. Coupled with the stimulant effects of caffeine, it’s best to avoid it close to bedtime to avoid sleep disturbances. Taking melatonin with alcohol is not recommended as it may cause drowsiness, breathing difficulty, fainting, dizziness and increased risk of falling.

Side effects of melatonin

Like any other dietary supplement, melatonin may cause side effects in some people—possible side effects include:

• Nausea
• Headaches
• Dizziness
• Drowsiness

Dr. Bollu says “drowsiness” can mean either excessive sleepiness at night or grogginess the next day. He also adds that interfering with your body’s natural sleep cues may carry another side effect as well.

“Taking a hypnotic medication regularly, on a nightly basis, would dampen your innate drive to sleep,” explains Dr. Bollu, who adds that although we don’t know for certain, this could also be true for melatonin. However, some research suggests melatonin may not dampen this drive in the same way that Ambien, for example, does. When your body recognizes more melatonin in the body, it begins to slow down its own production of melatonin over time. Therefore, short-term use of a melatonin supplement is preferred. 

If you experience hypothermia, shortness of breath, chest pain, high blood pressure, or an accelerated heart rate, seek emergency care.