Melatonin: Make it, Don't Fake It
The truth about this popular sleep supplement —and whether it's right for you.
There’s a big myth millions have bought into it — that popping a melatonin pill is a harmless and effective way to get better sleep. The issue with this is that melatonin is a hormone, not a vitamin or a magical sleep aid. Like any other hormone therapy (estrogen, testosterone), when you take a melatonin supplement, you’re introducing an active biochemical into your body to create physiological shifts.
In fact, the United States and Canada are the only two places in the world where you can buy melatonin as an over- the-counter supplement. Everywhere else it’s prescription only. So here, it’s not regulated the same way a pharmaceutical medication would be in terms of consistent quality and dosing.
One big issue with taking synthetic melatonin is that melatonin doesn’t just push a button in your body to make you sleepy. Rather, it’s a chemical signal for your body to start switching off for the day, setting off a cascade of physiological events and metabolic functions. When you introduce additional melatonin into the body, more than just your sleep mechanisms are affected by it. Those effects can extend to things like your digestion and your mood.
In fact, the United States and Canada are the only two places in the world where you can buy melatonin as an over- the-counter supplement. Everywhere else it’s prescription only.
But perhaps the biggest problem with taking this hormone in synthetic form is that it can mess with your body’s natural melatonin processes. Research has shown that taking melatonin at the wrong time or taking too-large doses can desensitize your melatonin receptors, which can start shutting down your body’s ability to use melatonin at all. If you’ve taken a melatonin supplement, you may have seen this in action, as you need larger and larger doses over time in order for it to feel effective.
Supplementing melatonin is also most likely not solving your underlying sleep issues. If your not-sleeping type is anxiety-stress-or gut-related, melatonin won’t help that. And it can’t make up for any of the other sleep-disrupting habits you may have picked up.
When It Might Be Okay to Take Melatonin
While we prefer the artisanal, locally grown melatonin our bodies have been programmed to make versus a chemical isolate from a science lab, we do recognize that there are some ways that targeted, short-term use of a melatonin supplement can be helpful.
A melatonin supplement could be right for you if:
You have a chronic sleep-rhythm issue. Think of a melatonin supplement as training wheels — a way to temporarily introduce melatonin at the correct time of evening until you can get into a consistent sleep rhythm. You can safely take melatonin for at least one year, but I recommend taking it for one month as you prioritize getting into a consistent rhythm, then weaning off over two weeks.
You’re older and experience insomnia. With age, we sometimes experience a decline in our endogenous (in-house) melatonin production. A supplement, along with new sleep-and hormone-encouraging habits, can give your system a jump-start.
You need a re-syncing because of a time zone change or daylight-savings time. A melatonin supplement can be helpful in reestablishing a normal sleep pattern if it’s been temporarily disrupted.
Dosage: The standard 3 to 5 mg dose often used is much more than we need for sleep. More is not better and could theoretically inhibit your endogenous melatonin production. We recommend 0.5 to 1 mg of melatonin and taking it on its own, not as part of a blend. Look for a formula that’s slow-release (see timing below).
Timing: When taking a melatonin supplement, timing is crucial, and most people get it wrong. Melatonin has a short half-life (about 30 to 45 minutes), so taking a standard-release tablet around bedtime results in a peak too early in the night. Instead, in order to regulate your circadian rhythm, you want to replicate when your body would naturally release melatonin. Normally, natural melatonin levels are low early in the evening, rise steadily through the night, and peak in the last third of sleep. That’s why we recommend taking a time- release pill around bedtime or a sublingual regular-release pill in the middle of the night.
Contraindications: Because you’re introducing an active hormone into your body, you want to be mindful of how that may affect your health, especially if you’re managing a chronic disease. For example, the Arthritis Foundation advises against melatonin for patients with autoimmune disease because it can stimulate the release of proinflammatory cytokines. We recommend consulting your doctor before taking a melatonin supplement.
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Take a (Natural) Chill Pill
While we’re not fans (to say the least) of prescription and over-the-counter sleep aids, we do believe that there are some effective, natural alternatives that can make your transition back into rhythm a little easier. Just like a pill is never going to be the one solution to any of your health woes, these supplements aren’t meant to be your one cure-all. But they will support your other sleep-better efforts.
Because many of these supplements have a calming effect on the nervous system, they also have the trickle-down benefit of helping with your underlying sleep issues, such as anxiety or stress. The key to figuring out which of these is right for you is personal experimentation — try them one at a time and see which works. Even better, use them in conjunction with your sleep tracking to see if you can isolate whether a certain supplement is helping you get better sleep.
Many people happen to be deficient in this calming mineral, namely because stress depletes our magnesium stores. Frank is a big fan of rec- ommending magnesium to his patients because it’s not only key for many functions in the body, it also helps calm the nervous system. There are a few different types of magnesium supplements. Ideally, you’d find a supplement with magnesium L-threonate, which is one of the most absorbable forms of the mineral and can cross the blood-brain barrier. Buffered magnesium and magnesium glycinate are also accept- able forms; magnesium citrate or oxide is ideal if you’re also consti- pated because it’s a double-whammy of a relaxant and a laxative. Magnesium usually comes in a pill or powder form, but it’s also available as topical lotions. We’re also fans of adding some Epsom salts to your baths (“Take a Warm Bath,” page 87) because it is a form of magnesium that can be absorbed through the skin.
Recommended dosage: 300 to 500 mg at night
This amino acid, found in tea, is like nature’s valium, calming down the nervous system. You can often find this in a blend with other sleep- promoting compounds like GABA, skullcap, passionflower, and magnolia. THE WELL supplement Liquid Calm contains L-thenine, along with Gaba.
Recommended dosage: 100 to 200 mg at night
B1, B2, B3, B6, and B12 all contribute to maintaining a healthy ner- vous system, which in turn helps mitigate the effects of stress on the body. Stress can also deplete the amount of B vitamins we have avail- able, which is why supplementing is not a bad idea. Look for a methyl- ated B vitamin with folate.
Recommended dosage: Follow manufacturer’s instructions.
Another amino acid that we make naturally, glycine plays an essential role in the nervous system. Studies have found that when taken supple- mentally before bedtime, glycine can improve sleep in individuals who had been experiencing chronically poor sleep.61
Recommended dosage: 3 to 5 grams at night
This phospholipid, or a major component of all cell membranes, helps balance the body’s cortisol levels. This is an excellent support if you find yourself perpetually stressed, and it often comes in a formula bundled with other stress response-mitigating herbs such as magnolia and ashwagandha.
Recommended dosage: 200 to 400 mg a day
Just like their name sounds, this class of plant helps your body adapt to the stresses of life. They’re like thermostats — energizing you if you’re tired and relaxing you if you’re wired. Instead of just conking you out like a sedative, they smooth out your cortisol levels to where they should be when it’s time to rest, helping bring your sympathetic and parasympathetic nervous systems back into balance. When taken regularly, they can help you fall asleep, stay asleep, and get better sleep. Two adaptogens in particular are great for sleep: ashwagandha and reishi, which you can buy in powdered form and stir into your evening tea.
Ashwagandha: 500 to 1,000 mg per day of an extract standardized to 2.5–5 percent with anolides may reduce anxiety and help with sleep in people who are stressed or anxious
Reishi: 1 to 2 grams per day can help support sleep and the immune system
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Your body converts this essential amino acid into serotonin, which helps regulate your mood (resolving anxiety, in particular) and sleep (especially improving how quickly you can fall asleep). You’ll often see L-tryptophan in herbal sleep formulas. However, know that in some people, L-tryptophan can have a paradoxical effect, keeping them up instead.
Recommended dosage: 1 to 2 grams at night
A member of the mint family, this botanical has been used in tradi- tional healing practices to address sleep issues and anxiety. We now know that skullcap stimulates gamma-aminobutyric acid (GABA), a neurotransmitter that has a calming effect on the nervous system.
Recommended dosage: 1 to 2 grams at night
Chinese and Ayurvedic Herbs
Traditional Chinese medicine and Ayurveda are traditional healing practices that have used medicinal herbs as part of their protocol for centuries. These herbal formulas are thoughtfully blended and pre- scribed with rhythm in mind—the herbs working in rhythm with one another, and the formula working in rhythm with your physiology. They’re meant to be used over time in order to create a layered, cumulative effect that puts you back in sync, thereby addressing a wide range of health complaints. There are formulas that can be particularly beneficial for sleep, and we recommend working with a qualified prac- titioner to create a protocol that addresses your specific needs.
Gamma-aminobutyric acid (GABA) is a naturally occurring amino acid that works as a sort of bouncer in the brain, blocking or inhibiting brain signals in order to calm down the nervous system. This helps quell stress and feelings of anxiety or fear, while also encouraging relaxation and facilitating restful sleep. Sleep medications and anti-anxiety meds (like Valium, Lunesta, and Xanax) work by targeting the body’s own GABA system to increase sedation and sleep, since low GABA activity is linked to insomnia and disrupted sleep. You can get GABA through your diet, particularly in fermented foods like kimchi, miso, and tem- peh, as well as in black and oolong tea, but you can also supplement.
Recommended dosage: 300 to 660 mg at night.
This plant has been used to promote relaxation and sleep since ancient times and contains a number of compounds that may reduce anxiety and promote sleep, including valerenic acid, which has been found to inhibit the breakdown of GABA in the brain, resulting in feelings of calm and tranquility (the same way anti-anxiety medications and sleep meds work, but much safer). Research suggests that taking valerian root may improve the ability to fall asleep, as well as sleep quality and quantity.
Recommended dosage: 300 to 600 mg at night
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Adapted from BETTER SLEEP, BETTER YOU. Copyright ©2021 by Frank Lipman, MD, and Neil Parikh with Rachael Holtzman. Used with permission of Little, Brown Spark, an imprint of Little, Brown and Company. New York, NY. All rights reserved.