What is more effective for sleep, magnesium glycinate (Mg) or melatonin?

Magnesium Glycinate vs Melatonin for Sleep

Melatonin is more effective than magnesium glycinate alone for sleep, with clinical guidelines supporting its use and demonstrating modest but measurable benefits for sleep onset and quality. 1

Efficacy Comparison

Melatonin

• The American Academy of Sleep Medicine acknowledges melatonin's efficacy with modest benefits including:
  • Mean reduction in sleep latency of 9 minutes compared to placebo
  • Small improvements in sleep quality
  • Limited adverse effects 1
• Recommended dosing:
  • Adults: 1-5 mg approximately 1-2 hours before bedtime
  • Elderly: Start with lower doses (1-2 mg) and titrate as needed 1

Magnesium

• Recent research shows promising results but with less robust evidence compared to melatonin:
  • A 2024 study found magnesium L-threonate (1g/day) improved deep sleep, REM sleep, and daytime functioning 2
  • Another 2024 study demonstrated magnesium supplementation decreased insomnia severity in diabetic patients 3

Combination Approach

• A 2024 study found that a combination of melatonin (1.9 mg) and magnesium (200 mg) improved sleep quality parameters compared to placebo, though PSQI scores still indicated poor sleep quality overall 4
• A 2011 study in elderly care facility residents showed that a combination of melatonin (5 mg), magnesium (225 mg), and zinc (11.25 mg) significantly improved sleep quality 5

Clinical Decision Algorithm

1. First-line approach: Try melatonin 1-2 mg taken 1-2 hours before bedtime

   • Take on an empty stomach for maximum effectiveness
   • Typical target bedtime: 10 pm to midnight 1
   • Monitor for efficacy over 1-2 weeks

2. If inadequate response:

   • Increase melatonin dose up to 5 mg OR
   • Consider adding magnesium glycinate (200-400 mg) to the regimen

3. For specific populations:

   • Children with delayed sleep phase: Weight-based dosing (0.15 mg/kg)
   • Adults with REM Sleep Behavior Disorder: Start with 3 mg, may titrate up to 15 mg 1
   • Elderly: Start with lower melatonin doses (1-2 mg)

Important Considerations

• Non-pharmacological approaches should be implemented alongside either supplement:

  • Maintain consistent sleep-wake schedules
  • Create a dark, quiet, and cool bedroom environment
  • Reduce evening exposure to blue light from electronic devices
  • Consider cognitive behavioral therapy for insomnia (CBT-I) 1

• Safety profile:

  • Melatonin has fewer risks compared to benzodiazepines (no cognitive impairment, dependence, or significant morning sedation) 1
  • Magnesium is generally well-tolerated but may cause gastrointestinal effects at higher doses

• Special precautions with melatonin:

  • Use with caution in patients with epilepsy, hepatic impairment, or those taking warfarin
  • Monitor for potential drug interactions in patients on multiple medications 1
  • In children, monitor for effects on growth hormone regulation and reproductive function

Monitoring

• Evaluate effectiveness after 2-4 weeks
• Periodically attempt to discontinue treatment to assess continued need 1
• Monitor for side effects:
  • Melatonin: Daytime drowsiness, headache, dizziness
  • Magnesium: Gastrointestinal effects, especially at higher doses