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When you've worked in the sleep industry long enough, you're going to hear one question resurface time and time again: “How much melatonin should I take?” The answer will vary from person to person, and the best person to deliver it is your doctor.
To be clear, I'm not a doctor (although my family really wishes I were), but I am a certified sleep science coach and professional mattress tester of five years and some change. Over the years, I've conversed with and attended lectures by many medical professionals on sleep aids and supplements. I also asked David Kuhlmann of the American Academy of Sleep Medicine to give insight into best practices when it comes to melatonin (and sleep supplements, for that matter).
Chill Pill
First of all, let's back up. What is melatonin? It's the hormone your brain produces naturally as part of its circadian rhythm, or the internal clock your body has to keep you on a natural, daily sleep schedule. Your pineal gland is in charge of making it, and sunlight signals it to slow down production so you can wake up and go about your day. Though your brain is already producing melatonin, the idea of taking a supplement is that it jump-starts your sleep cycle.
If you've taken melatonin before and felt it didn't work for you, or are considering starting it, this is where you should consult your doctor. And do it before starting any supplement, melatonin included. You may be on medications that won't make it work as well, giving you the impression that you need more. Or, you could experience the side effects of mixing melatonin and medications. Let's avoid the late-night WebMD doomscrolls and check off that box first.
Snake Oil or Sleep Supplement?
Another reason to talk to a licensed health care provider ahead of jumping on the melatonin train is that they can give you a tailored recommendation on how to go about getting melatonin, either in supplement or even nutritional form. Or, as Kuhlmann recommends to me, bypassing it altogether, for many reasons—one of which is possible unforeseen side effects, like GI upset. More on that in a minute.
The reality is, supplements are not regulated by the FDA. The University of Pennsylvania's Regulatory Review has reported that the FDA evaluates supplements on a dietary basis, pretty much like what is done for food or medication. According to Pieter Cohen in an interview for the American Medical Association, the FDA actually evaluates supplements as a “subcategory of food” and not medication. Kuhlmann corroborated this for me, emphasizing that “increased access” and the fact that brands are not as “tightly regulated” in the market have led to dangerous outcomes. He described the uptick in melatonin poisoning cases that medical professionals have seen over the past decade, primarily in kids under the age of 5.
There's a whole lot of gray area for what's OK and what's not before a product hits the market, and even after it's sold to customers. So if an extra (and questionable) ingredient weasels its way into the formula, and the supplement hits the market, there's not much the FDA can do besides send companies a warning letter to recall the supplement. It's the equivalent of shrugging, saying “Whoopsie, your fault,” and putting responsibility on a brand to make it right—which, as The Regulatory Review also points out, they don't always do.
“There's this misperception that because we can buy it over the counter, it means it's safe,” says Kuhlmann. He describes it as a toss-up on how much melatonin you are actually ingesting versus what the product is actually advertising, not to mention any other additives being used and how that will react with your body chemistry. And the crowd is now … worried.
Kuhlmann also expressed to me that he personally “wishes that melatonin would be available as a prescription, not to limit access, but it could help with the quality of melatonin people are able to get.” This is yet another reason why it's much better to get a doctor involved than to throw caution to the wind and get a product that might not be effective or could even be counterfeit. Brands may try to sell you their “secret sauce” with all sorts of claims, and that's not just for melatonin, but for all supplements. Be oh so careful about this.
Two things I always watch for with supplements, even with guidance from my doctor: Does it have a CGMP certification, and is there any data to back up the marketing claims? CGMP stands for “Current Good Manufacturing Process,” which are FDA guidelines put in place for a product's safety. This includes where and how it was made, as well as what it was made of. But even with this kind of baseline, it's hard to tell what additives are used in a supplement, and how that can counteract its effects or react with your body chemistry.
So, Can I Take Melatonin or Not?
I tell you these things out of an abundance of caution. If your doctor gives you the go-ahead to use melatonin, follow their advice. Kuhlmann says he advises his patients to start at 3 milligrams, but to never take more than 10 milligrams. For kids, he also urges speaking to a pediatrician and/or a sleep medical professional.
Melatonin also can't do all the heavy lifting, and timing is crucial. As part of maintaining good bedtime habits, he also emphasizes the importance of taking it on time, at the same time, nightly. This will help establish the wind-down routine your brain follows via its circadian rhythm; as we established earlier, melatonin is supposed to lead this process.
For those of you who are just researching options, consider these alternatives. Diet and exercise, as tired as you may be of hearing that, really are essential to getting good, quality sleep. Case in point: You took a CrossFit class for the first time and are ready to conk out right after you manage to get dinner and a shower. Something else to consider: Perhaps relying on melatonin or a sleep supplement is treating a symptom you're dealing with, as opposed to the actual issue impacting your sleep.
Bedtime Habits
It's hard to overstate the importance of sleep hygiene and bedtime routine habits—a sleep supplement won't be the end-all and be-all. Also, no caffeine after a certain time of day—you know your body best, but I'd say early afternoon at the very latest. Also, I'm sorry to my fellow readers and late-night scrollers, but devices need to be put away an hour or more before bedtime, too. Blue light that radiates from devices’ screens mimics that of sunlight, and your brain can't discern the difference. All it knows is there's still “daylight” that you need to be awake for, and that prolongs the falling-asleep process.
Other alternatives to supplements in the pursuit of better sleep can include sound machines (my favorite is above), where various frequencies of noise lull you to sleep. We've also tested sleep gadgets pretty extensively to not only get us to sleep, but also maintain deep sleep.
And maybe melatonin is a different sort of band-aid over the reality of your sleep situation, meaning that your mattress may need to be replaced. We have plenty of beds we've tested for every kind of sleeper, along with the best sheets and pillows too. Supplements may not be the answer after all, but more of a sleep space upgrade—all things to consider!
