Melatonin for Sleep: What You Should Know

It’s not fun to struggle with sleep. Not being able to get a good night’s sleep can have a serious impact on your quality of life. Melatonin is a popular sleep aid that many turn to as a solution to their sleep woes. Melatonin is a hormone that is produced in your pineal gland (part of your brain). The production of melatonin is controlled by the level of light and darkness in the environment. Typically, melatonin release starts shortly after the sun sets. It tends to peak in the very early hours of the morning (e.g. 2-4 am) and then starts to decline. Light (especially blue light) blocks the production of melatonin. In addition to regulating sleep, melatonin plays a role in many other functions in the body. It’s a potent antioxidant and it regulates functions like immunity, energy, metabolism, mood and the activity of hormones. Below are some important facts about melatonin.

Effectiveness

Most of the evidence around melatonin shows that it can be helpful for those who have a biological clock that is thrown off. This includes people dealing with jet lag and night shift workers. There is also some evidence that it can help people who have insomnia for no particular reason (primary insomnia) by slightly decreasing the time it takes to fall asleep, improving sleep quality and increasing morning wakefulness. The effectiveness of melatonin can increase over time and then may eventually hit a plateau after several weeks.

Melatonin and Age

As we age, we start producing melatonin later and later after sunset. The peak levels of melatonin in the body also decreases with age. For this reason, scientists believe that melatonin may work better in people over 50 years of age compared to younger people.

Prolonged Release Forms

Melatonin can often be found in two different forms: regular and prolonged release. When you take regular melatonin orally, it tends to peak pretty soon after you take it (e.g. an hour). The levels spike higher than what your body would naturally have produced and then they quickly start to decrease. Experts have found melatonin levels can drop back to baseline anywhere between 2-8 hours of taking it. With prolonged released forms, the melatonin levels in your body rise more slowly, don’t go as high and drop back down more slowly. Some patients experience better results with prolonged release forms although more studies are needed to verify this difference in effectiveness.

Dosing

Typically, 1-5 mg doses are used (more is not better when it comes to melatonin supplements for sleep). People often take melatonin at the wrong time. In most research studies, melatonin is taken 30-60 minutes before bed.  

Side Effects and Safety

Many people tolerate melatonin well without any side effects, but side effects are still possible for some people. Melatonin can cause vivid dreams and nightmares in some individuals. It can also cause grogginess the next day as well as headaches. I tend to avoid melatonin in patients with depression as it has been associated with transient depression and worsening current depression. Melatonin also interacts with a number of different medications, supplements and health conditions so it’s important to speak to your naturopathic doctor and medical doctor prior to taking melatonin. The safety of taking melatonin continuously long term has not been well studied. This is why I always discuss with my patients about how long and how often we will incorporate melatonin into their plan.

Managing Your Sleep Beyond Supplements

Treating sleep difficulties involves more than just a sleep supplement. A well-rounded approach is required. Underlying conditions like anxiety, depression, thyroid disorders and sleep apnea need to be ruled out or treated. We also need to focus on other factors that can enhance sleep like specific behaviour changes and certain nutrition and lifestyle recommendations. I often find it helpful to incorporate other treatments like acupuncture for my patients with insomnia.

Good sleep affects every aspect of your health. Getting your sleep corrected can be a gateway to vastly improving the quality of your life.

Does Your Bedtime Really Matter?

There are a lot of theories in the wellness industry about the optimal bedtime for adults. Some say that going to bed at 10 pm is optimal for cell repair and renewal. Some say that any sleep after midnight is only worth half the value of sleep before midnight.

I used to insist on going to bed at 10 pm every night but as life got busier, 11-11:30 pm became the new norm. But does that 1-1.5 hour delay really make a difference if I sleep in to make up for it? What does science have to say about this? Does bedtime matter, or should we only be concerned about the number of hours of sleep that we’re getting?

Our sleep happens in cycles. On paper, we should have around 4-5 cycles of sleep throughout the night that last 90 minutes each. Within a cycle, we shift between deeper and lighter sleep (non-REM and REM sleep) and then repeat the process in the next cycle, and the next, and so on until it’s time to wake up.

Many scientists agree that the earlier you go to bed, the more time is spent in the deeper phases of sleep during each sleep cycle. As your bed time gets later, you’re more likely to spend a larger chunk of your sleep cycles in a lighter sleep.

Sleeping late can affect memory, thinking, energy levels and other important health factors. Some doctors argue that going to bed no later than midnight is important to get that deeper quality of sleep we need in order to thrive during the day.

Another reason to avoid a late bedtime is the “second wind”. Do you ever notice that at a certain time in the night you go from feeling sleepy and ready for bed to feeling awake again? This is the second wind phenomenon and many people notice it around 10:30-11 pm, although the timing can be different for everyone. Our body’s internal clock seems to have a built-in wakefulness period in the night that causes this second wind. Going to bed around the second wind time can make it harder to fall asleep. Even ancient systems of medicine from different cultures recognize this phenomenon and recommend going to bed before it happens.

So we’ve established that going to bed earlier likely makes for a better quality of sleep. But can an earlier sleep actually help with cell renewal? The sleep hormone, melatonin, rises when the sun sets and it becomes dark outside. Melatonin is an antioxidant and has been shown to play an important role in DNA repair and other very important repair processes. The later into the night that you stay awake (especially if lights and screens are on), the more your melatonin levels are suppressed. This can potentially impact all of the repair processes melatonin is involved in.

Overall, it seems like science doesn’t point to an exact perfect bedtime. But most sources seem to agree that a late bedtime that’s closer to midnight or later is not ideal, even if you sleep in. If you’re feeling groggy in the morning, you might want to consider experimenting with an earlier bedtime to find what works for you. As for me, I’ve recently reinstated my 10 pm rule and I’m absolutely loving it.

Sleeping the right way for your body is a critical step in transforming your physical and mental health. Diet, stress management, digestion, exercise and lifestyle are other key pillars of health. I work on these areas with all of my patients. If you don’t feel your best right now, it’s worth getting expert help to get these core health factors in order so you can give your all to everyone and everything that’s important to you.