From the Guidelines
The maximum recommended dose of melatonin is up to 15 mg for adults, as indicated in the most recent study 1. When considering the use of melatonin, it's essential to prioritize the lowest effective dose to minimize potential side effects. For adults, the starting dose is usually 3 mg taken at bedtime, and it can be titrated up to address sleep issues in 3-mg increments, with a maximum dose of 15 mg, as supported by the 2023 study 1. However, for children, lower doses are advised, typically 0.15 mg/kg, as suggested by the 2015 study 1. Melatonin is a hormone that regulates sleep-wake cycles, and supplementation can help with insomnia, jet lag, or shift work sleep disorders. Higher doses don't necessarily work better and may cause side effects like headaches, dizziness, nausea, or daytime drowsiness. Long-term safety of high-dose melatonin hasn't been well established, and it's best to use the lowest effective dose for the shortest duration needed, as cautioned by the 2015 study 1. Some key points to consider when using melatonin include:
- Starting with a low dose and titrating up as needed
- Being aware of potential interactions with other medications, such as blood thinners, immunosuppressants, and some diabetes medications
- Monitoring for side effects, such as headaches, dizziness, and nausea
- Using the lowest effective dose for the shortest duration needed to minimize potential risks. It's also important to note that melatonin may not be suitable for everyone, particularly children and adolescents, due to concerns about its effects on reproductive health and the lack of long-term safety data, as highlighted by the 2015 study 1. If sleep problems persist after trying melatonin for a few weeks, it's recommended to consult a healthcare provider to rule out underlying conditions that may require different treatment, as suggested by the 2023 study 1.
From the Research
Maximum Dose of Melatonin
- The maximum dose of melatonin is not strictly defined, but studies suggest that doses between 0.1 mg and 10 mg are commonly used 2, 3.
- A review of clinical studies found that melatonin doses ranging from 0.5 mg to 10 mg were effective in improving sleep in older adults, but the optimal dose was not identified 2.
- Another study recommended using the lowest possible dose of immediate-release formulation melatonin to mimic the normal physiological circadian rhythm of melatonin and avoid prolonged, supra-physiological blood levels 3.
- The effective dose of melatonin supplementation in older adults remains unclear, but doses between 1 mg and 6 mg appear to be effective for improving sleep 2.
- Higher doses of melatonin may be maintained longer above a certain threshold than lower doses, but the maximum concentrations measured in serum and urine were all elevated compared with placebo 3.
Dosage Considerations
- The dosage of melatonin varies widely, and the optimal dose may depend on individual factors such as age, sleep disorder, and other health conditions 3, 4.
- Melatonin has been shown to be well-tolerated and effective in improving sleep quality, duration, and onset, but the dosage should be individualized to minimize side effects 4.
- Cognitive behavioral therapy for insomnia (CBT-i) is a recommended treatment for chronic insomnia, and melatonin may be used as an adjunct therapy to improve sleep outcomes 5, 6.