Abstract Summary
Objective
The objective of this research is to determine the most effective and safest dosage of melatonin for improving sleep outcomes, with a focus on sleep latency, duration, and quality in both general and clinical populations.
Context
Melatonin, a hormone secreted by the pineal gland, regulates circadian rhythms and sleep-wake cycles. It is widely used as a supplement for conditions like insomnia, jet lag, and circadian rhythm disorders. While it is available over-the-counter, dosage recommendations vary widely. Clinical data suggests that lower doses may mimic physiological levels more effectively, while higher doses can cause side effects or lose efficacy over time.
Methods Used
Approach
This analysis focused on randomized controlled trials and meta-analyses evaluating melatonin's effect on sleep parameters. Emphasis was placed on studies using pure melatonin and standardized release formulations (immediate vs. extended), allowing consistent comparison of outcomes.
Data Collection
Sources included PubMed, Cochrane Library, and medical journals. Key trials included adult populations using 0.3 mg to 10 mg of melatonin, with a focus on those using 1–3 mg nightly. A 2022 JAMA clinical review and a meta-analysis of 23 trials were among the primary data sources, confirming that melatonin at doses between 1–3 mg improves sleep onset and overall quality, especially when timed correctly before bedtime.
Researchers’ Summary of Findings
Health Implications
Melatonin is most effective at doses between 1 to 3 milligrams, taken 30 to 60 minutes before bedtime. Lower doses, such as 0.5 mg, have also shown efficacy in adjusting circadian timing and improving sleep onset in sensitive individuals. Doses above 5 mg do not consistently improve outcomes and may increase side effects such as grogginess, vivid dreams, or hormonal desensitization. Children and older adults may benefit from even lower doses tailored to their metabolism and sleep architecture. Extended-release formulas can support sleep maintenance, while immediate-release is more suitable for sleep onset. Melatonin's overall safety profile is favorable when used appropriately and in the short term. It is especially effective for people with delayed sleep phase disorder, shift workers, or those experiencing jet lag. Long-term effectiveness may diminish without concurrent sleep hygiene practices.
Sustainability
Melatonin is a synthetically produced compound, minimizing pressure on natural resources. However, sustainable use lies in avoiding over-supplementation and public education on proper timing and dosage. Encouraging informed use helps reduce dependency on pharmacologic sleep aids and supports public health efforts to manage sleep disorders with lower risk interventions.
DOI
10.1001/jama.2022.10744
