How Much Melatonin Do You Actually Need? A Sleep Doctor Explains

But if they're used every night, it's generally known that when you stop the medication, you'll get this kind of anxious insomnia for a few nights. So, we're talking about rebound insomnia. Is melatonin a sleeping pill? What does it actually do in the body? Melatonin is actually a hormone our own body secretes, which can also be taken from a bottle.

And melatonin starts being secreted in the evening during twilight, and then the concentration is at its highest from midnight until three a.m. And melatonin is the kind of hormone that can indeed be used as a supplement. It speeds up falling asleep and improves staying asleep. However, the main indication for melatonin is considered to be jet lag, so if the circadian rhythm has shifted a bit, it can be used for that, but melatonin can also be used to support sleep. Many people take melatonin every night for years.

What are the consequences? Well, in principle, using melatonin from a bottle doesn't actually affect the body's own secretion of melatonin. So, that's what we see. And if we're here in northern Finland, where it's dark for half the year and light for the other half, then melatonin is quite justified for us. So, it gives our brains that impulse that the night is starting now.

And then in the morning we know, when we physically exert ourselves or use a bright light in winter, we know that it's daytime now. So, our body needs that melatonin to pace the circadian rhythm. We need night and day for the sake of our physiology. We need it because our blood sugar levels, we're fasting a bit during the night, the body rests, the heart recovers, internal organs heal. So, in a way, melatonin paces that rhythm.

And for some, melatonin secretion is a bit low, so melatonin in the evening can provide support. However, the current recommendation is that we take breaks from melatonin every now and then. And then especially the dosage, quite a few people take a lot of melatonin. Even a very small amount is enough to pace the body, but the body secretes melatonin itself too. Regarding recommendations, I can't recommend continuous use of melatonin, but I probably see more harmful substances than melatonin to take continuously.

When is melatonin the right tool and when is it the wrong tool for the right problem? Melatonin is the wrong tool, for example, if you come from shift work and take melatonin in the morning. That way, you can really mess up your circadian rhythm. Melatonin should always be paced. It should always be taken according to natural secretion.

So, let's say between seven p.m. and eleven p.m. So, if you take it later, it shifts the rhythm for the next day. Or if you take it too early, then the rhythm starts to advance. So, melatonin can indeed be taken at the wrong time, and then it ruins the rhythm.

But then if it's taken in the evening in a small dose, it maintains our circadian rhythm. If you take regular-release melatonin right before bed, which is absorbed quickly, then when the melatonin is absorbed most strongly and the blood concentration rises fastest, that's when we fall asleep most easily. Then we have long-acting melatonin, which can support the sleep structure for a bit longer. So it might slightly extend the time before waking up in the early morning hours. Is that long-acting one a prescription drug?

It is actually available without a prescription too. But I would say that the maximum dose for melatonin is six milligrams. With amounts larger than that, the side effects increase. And I personally recommend melatonin in significantly smaller amounts. And for example, if we think about the dark winter season coming up, half a milligram of melatonin is enough for us to maintain the rhythm.

So the amounts that are actually needed are very small. That one point nine milligrams, I certainly wouldn't go over that. And let's say, I recommend more caution in the use of melatonin. Well, how do you safely get off sleeping pills? Give me the order of what needs to be done and how it proceeds from there.

If we think about sleeping pills, quite few people use actual sleeping pills anymore. Meaning we're talking about sedatives or sleeping pills, benzodiazepines or similar preparations. Quite few people use those anymore. Sometimes I'd say there's a reason to use them, but that's maybe not the problem. Then we have these sleep-supporting medications, like doxepin and mirtazapine.

Quetiapine is used a lot, but there's very thin evidence for it in treating sleep disorders. These aren't addictive, so you can stop these pretty much immediately or gradually taper the dose, and that's how you successfully quit. But then with sleeping pills, if they're used on individual nights, there's no problem stopping immediately. But if you use them every night, it's generally known that when you stop the medication, you get this anxiety-induced insomnia lasting a few nights. So we're talking about rebound insomnia, and that's a completely normal phenomenon.

That's why sleeping pills aren't recommended for nightly use, because their effectiveness usually starts to weaken over time and then you have to withdraw from them. If someone decides to stop using melatonin as a result of this video, what's the first step and what should they absolutely not do to themselves? Well, first of all, you shouldn't do this to yourself, if sleep doesn't come that night. Usually, melatonin also acts as a sleep prop, like all these sleep-supporting systems we have, whether it's reading a book in the evening or whatever, so if a routine changes, we think we won't be able to sleep. But you shouldn't do this, if you're stopping melatonin, thinking, okay, I couldn't fall asleep because I ...

didn't take that melatonin, so I'll take it now at two in the morning. No, you must not do that. You can support sleep when stopping melatonin, for example, by calming down well in the evening. If sleep doesn't come then, it's not dependent on the melatonin. It's perhaps more dependent on other things.

The next morning when you get up, even if you're tired, even if sleep was poor, I would sit in bright light for a while and that morning I'd run for the bus or bike to work. So, I'd use other ways to reinforce the body's rhythm. So, we need bright light in the morning, or physical exertion, for example, or a meal, which basically gives the body a signal in the morning that it's now morning, and that helps synchronize the melatonin secretion for the following evening. If the viewer could remember just one sentence, what would it be? You can use melatonin, but you can also support the rhythm in other ways.

So, let's keep up the activity in the morning, with bright light and exercise. This kind of rhythm is good for sleep.