Proper Dosage and Administration of Melatonin for Adults
For adults, melatonin should be taken at a dose of 1-5 mg approximately 1-2 hours before bedtime for optimal effectiveness. This recommendation is based on clinical guidelines and research evidence on melatonin's use for sleep disorders.
Dosage Recommendations
General Adult Population:
- Starting dose: 1-3 mg
- Effective dose range: 1-5 mg
- Maximum recommended dose: Generally not exceeding 10 mg
- Timing: 1-2 hours before intended bedtime
Specific Conditions:
- For Delayed Sleep-Wake Phase Disorder (DSWPD): 5 mg taken between 7:00-9:00 PM 1
- For REM Sleep Behavior Disorder: Start with 3 mg at bedtime, may be titrated up to 15 mg if needed 1
- For older adults (>55 years): 1-6 mg may be more effective, with 5 mg showing significant improvement in sleep efficiency 2, 3
Administration Guidelines
Formulation selection:
- Immediate-release: Better for sleep onset issues
- Sustained/prolonged-release: Better for sleep maintenance issues
Timing considerations:
- Take consistently at the same time each night
- For circadian rhythm disorders, timing is critical (typically 1.5-2 hours before habitual bedtime) 1
Duration of use:
- For occasional sleep difficulties: Short-term use (days to weeks)
- For chronic conditions like REM sleep behavior disorder: Long-term use may be necessary 1
- Regular evaluation of continued need is recommended
Safety Considerations
- Melatonin is generally considered safe with mild side effects including headache, dizziness, and drowsiness 4
- No evidence of dependence or withdrawal effects even with long-term use 5, 6
- Quality control is a concern as melatonin is regulated as a dietary supplement in the US, not a medication 7
- Look for products with USP (United States Pharmacopeia) verification to ensure stated dose accuracy 1
Important Caveats
- The American Academy of Sleep Medicine does not recommend melatonin as a primary treatment for chronic insomnia 1, 8
- Melatonin should not replace proper sleep hygiene practices
- Bioavailability and content may vary across formulations; consider USP-verified products 1
- Higher doses (>5 mg) may increase risk of side effects without proportionally increasing benefits 4
- Melatonin may interact with certain medications including anticoagulants, immunosuppressants, and diabetes medications
Special Populations
- Elderly: Start with lower doses (1-2 mg) and titrate as needed
- Patients with hepatic impairment: Use lower doses due to decreased metabolism
- Patients on multiple medications: Consider potential drug interactions
While melatonin is available over-the-counter in the US, its quality and dosage accuracy can vary significantly. For best results, choose products from reputable manufacturers with third-party testing certification.