We’re all familiar with Count Dracula, right? And we’re equally familiar with the lore that vampires only come out at night? Well, melatonin works in much the same way — it only comes out at night too.
Melatonin is actually a hormone that our brains produce naturally, and some hormones, even in small amounts, can have potent actions throughout our bodies. During the daylight hours, the brain’s pineal gland, which produces melatonin, remains inactive. However, a few hours before it’s time for sleep and daylight begins turning to darkness, this gland, sometimes referred to as our “third eye,” kicks into the “on” position and begins flooding the brain with melatonin. As melatonin levels rise, levels of the stress hormone cortisol begin to decrease; respiration slows, and soon after our eyelids begins to droop.
Melatonin doesn’t produce a “lights out” effect because it’s not a sleeping pill — although many people tend to use it for sleep. Typical hypnotics like Ambien or Lunesta generally induce sleep rather quickly, thus the sedative effects of these medications far exceed what melatonin provides for the user. This is because melatonin acts more like a “dimmer” switch, turning day to night by fooling the body into believing it’s time for sleep; but the impact it has on our sleep depends on the time of day it’s taken. Thus taking melatonin in the morning or midday doesn’t work because it’s inactive during these hours.
Effective dosage ranges are as low as 0.3mg up to 5mg. Lower the dose if you feel a bit groggy or even sedated the next morning. It’s probably true that for many people melatonin may not work any better than placebo, but placebos work pretty well for insomnia, in that the mere action of taking the medication helps people relax and drift off to sleep.
Melatonin side effects include the aforementioned morning grogginess or hangover feeling. If this happens frequently, it’s a sure sign the dosage is too high. Melatonin is not associated with dependence or addiction. By far the most common reported side effect of melatonin is the occurrence of rather vivid dreams — a common adverse effect of most other traditional sleep agents as well.
Sleep specialists often use melatonin to help patients with circadian rhythm disorders better regulate their sleep-wake cycle. For example, if you find yourself routinely unable to fall asleep until 2 or 3 in the morning, a trial of melatonin may help you establish an earlier sleep time. And since jet lag is also a circadian rhythm disorder, melatonin can be effective for helping you readjust your body clock, particularly on a long-haul flight.
Like any other OTC alternative medicine, the actual content — as well as the quality and purity — of melatonin products does vary. As such, you really don’t know what you’re actually getting, so it’s wise to go with trustworthy manufacturers. I recommend melatonin products manufactured by Jarrow Formulas or Nature Made, as both companies have outstanding track records when it comes to the actual concentrations contained in the product compared to what’s printed on the label.
And finally, if melatonin doesn’t help you better drift off to sleep; it’s notably beneficial for managing symptoms of GERD (gastroesophageal reflux disease), so all may not be lost.
Attribution Statement:
Joe Wegmann is a licensed pharmacist & clinical social worker has presented psychopharmacology seminars to over 10,000 healthcare professionals in 46 states, and maintains an active psychotherapy practice specializing in the treatment of depression and anxiety. He is the author of Psychopharmacology: Straight Talk on Mental Health Medications, published by PESI, Inc.
To learn more about Joe’s programs, visit the Programs section of this website or contribute a question for Joe to answer in a future article: joe@thepharmatherapist.com.