What is the recommended timing for taking melatonin (melatonin) before bedtime?

From the Guidelines

Melatonin should be taken at bedtime, with a typical starting dose of 3 mg, as recommended by the American Academy of Sleep Medicine in their 2023 clinical practice guideline for the management of REM sleep behavior disorder 1. The timing of melatonin intake is crucial for its effectiveness, and taking it at bedtime allows for the suppression of REM sleep motor tone and renormalization of other circadian features of REM sleep. Some key points to consider when taking melatonin include:

• The dose may be titrated up to address dream enactment in 3-mg increments to 15 mg, as needed 1.
• Melatonin is considered a dietary supplement and is available over the counter in the United States and Canada, but its bioavailability and content may be less consistent across formulations 1.
• Combination therapy using clonazepam and melatonin is common in clinical practice if response to monotherapy is inadequate, although there is a paucity of data examining combination therapies 1. It is essential to note that melatonin works by signaling to your body that it's time to sleep, helping to regulate your circadian rhythm, and taking it at bedtime allows for the best results. Additionally, engaging in relaxing activities and avoiding bright screens after taking melatonin can help enhance its effects. If you find yourself feeling groggy the next morning, try adjusting the dose or timing of melatonin intake to minimize its impact on daytime functioning.

From the Research

Recommended Timing for Taking Melatonin

The recommended timing for taking melatonin before bedtime varies across studies. Key findings include:

• Administration of melatonin 1-2 hours before bedtime is recommended to mimic the natural secretion pattern of melatonin and improve circadian regulation of the sleep-wake cycle 2.
• Taking 0.5 mg of melatonin 1 hour before the desired bedtime, combined with behavioral sleep-wake scheduling, can improve sleep initiation in patients with delayed sleep-wake phase disorder 3.
• The optimal dose of melatonin for older adults is still unclear, but doses between 1 mg and 6 mg may be effective for improving sleep 4.
• A systematic review and meta-analysis suggest that advancing the timing of melatonin administration to 3 hours before the desired bedtime and increasing the dose to 4 mg/day may optimize its efficacy in promoting sleep 5.
• A review of the American Prescribers' Digital Reference recommends taking medications that impact sleep and wakefulness, including melatonin, at specific times of the day to optimize their effects 6.

Key Considerations

When considering the timing of melatonin intake, the following factors should be taken into account:

• The individual's natural sleep-wake cycle and desired bedtime
• The specific sleep disorder or condition being treated
• The dose and formulation of melatonin being used
• Potential interactions with other medications or health conditions

Study Findings

The studies reviewed provide the following insights into the timing of melatonin intake:

• Melatonin PR 2 mg taken 1-2 hours before bedtime can improve sleep quality and latency in older adults with primary insomnia 2.
• 0.5 mg of melatonin taken 1 hour before the desired bedtime can improve sleep onset time and sleep efficiency in patients with delayed sleep-wake phase disorder 3.
• Doses of melatonin between 1 mg and 6 mg may be effective for improving sleep in older adults, but further studies are needed to determine the optimal dose 4.
• Advancing the timing of melatonin administration to 3 hours before the desired bedtime and increasing the dose to 4 mg/day may optimize its efficacy in promoting sleep 5.