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What does melatonin do to sleep?

Melatonin has two main effects on sleep:

1.  Hypnotic Effect:  Melatonin has an effect that can make people feel more sleepy, get to sleep more quickly and stay asleep for longer.  Not everyone is susceptible to this effect and studies of using melatonin as a sleeping pill have generally been in people that are older.  This is why in Australia it is marketed for use in people over the age of 55 for up to three months only, as this is where there is the best evidence to support its use as a sleeping tablet.

A meta-analysis summarizing the research for melatonin as a sleeping tablet was published in PLOS One in 2013. It showed that melatonin got people to sleep 7 minutes quicker, and kept them asleep 8 minutes longer as well as improving sleep quality. The authors concluded that melatonin was effective, but less effective than other prescription medications such as benzodiazepines. However, because of the low rate of side-effects with melatonin it was worth considering.

In other countries where melatonin is more widely available it is often used as a sleeping tablet but people report that it is variably effective.  Some people report they get a good response to melatonin whereas others find it does not do much in terms of helping their sleep.  This most likely relates to differences in genetic makeup and susceptibility to the sedating effects of melatonin.

2.  Clock-shifting Effect:  This is where there is the best evidence for use of melatonin, to shift the internal body clock in conditions where it is out of synch such as jet lag.  There is also increasing research on use of melatonin for the circadian rhythm disorder, delayed sleep-wake phase disorder, where people have trouble getting to sleep and find they are waking progressively later each day.

How is melatonin taken?

Decisions about use of melatonin should be made in consultation with your healthcare professional, as in Australia it is a prescription medication.

In general if it is being used as a sleeping tablet for its sleep-promoting effects it should be taken around one hour before people intend to go to sleep.  However, if the use is more for its clock-shifting effects it is preferable to take it some hours before people wish to go to sleep.

day-and-night-vector-banners.jpgBear in mind that by taking melatonin you are trying to give the brain a signal that it is dark outside so we generally aim to take melatonin around the same time that the sun is going down to help the body better synchronise with the normal light-dark schedule of the environment. It’s also why being careful about exposure to light after taking melatonin is important, as light, particularly of the blue-green wavelength, can suppress melatonin production.

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