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Melatonin (gwern.net)
385 points by gwern on Oct 4, 2013 | hide | past | web | favorite | 219 comments



I use melatonin regularly to regulate my sleep cycle. It's a very effective part of a regimen (sleep hygiene, f.lux, etc) that allows me to manage a nearly-decade long problem of insomnia.

However, from a psychological standpoint, it's a very good thing melatonin is so safe. Every single person I've ever recommended melatonin to, I've directed to this article and discussed it with them. Every single such person then went ahead to promptly forget the discussion, NOT read the article, and take mildly retarded doses. For example, "one (5mg) pill didn't work, so I took 8 more at 4am." Another uses it almost recreationally - large doses to intensify his dreams; pretty much zero attempt to use it to improve his sleep. I don't talk to people about melatonin anymore.

For a quicker idea of where melatonin sits vis-à-vis other sleep drugs (WARNING: Hilarious Ambien Walrus referenced): http://slatestarcodex.com/2013/09/28/sleep-now-by-prescripti...


This whole discussion is starting to make me feel reckless in a hilariously inconsequential way. I literally said to myself "I think people take melatonin when they have trouble sleeping...", went to the drug store, bought a bottle, and started taking the dose it recommended, at the time it recommended. Apparently I skipped out on a whole bunch of research I was supposed to have done.


Hey, at least you aren't taking ridiculous doses. I'm pretty cautious about such things so I prefer the research.


I have terrible sleep habits and often find it difficult to fall asleep before 5am. I have been considering trying melatonin but my major concern is that I will become dependent on it. I don't want my body to stop producing whatever small amount it already does through its use as a supplement.

How dependent on it would you say you are? How well would you function if you were unable to get hold of it?


Since you are here, I'm going to assume you are looking at a screen at least some of the time when you are awake that late.

You might consider installing blue-light reduction software like f.lux - it's drastically improved my ability to fall asleep late at night.


Thanks. I use f.lux already and it's great (it makes my eyes feel a lot better) but hasn't really helped me fall asleep. I think I am going to try a no back-lit screens after 23:00 rule.


I don't feel any physiological dependence, as I go on and off it with no consequences that I can detect (other than becoming more prone to slip off my sleep schedule). Generally I only take melatonin daily when I'm adjusting to a new timezone/schedule or have lapsed by purposely staying up. Otherwise I use it maybe twice a week, and have gone months without any.

When I don't take it my sleeping time seems to be a function of sleep hygiene.. Your melatonin production cycles are probably most strongly controlled by zeitgeber factors, like the mentioned blue light wavelengths. My insomnia used to be as bad as yours and now it's fairly normal for me to fall asleep at 1am, even using the computer. Once you get in a pattern, it has some persistence to it.


It's not addictive. In fact I found myself not wanting to take it after a while because I had so much energy from getting good sleep, I wanted to stay up late doing stuff. (Even though I should, so I get to sleep at a decent hour.)

I recommended 1mg per 50lbs of body weight, and get the fast acting one, not the slow-dissolving one; those made me drowsy the next morning.

It is a little harder to snap to attention right after waking up, but I shake that off quickly; probably a sign I slept well.

It does affect everyone differently though. I haven't had any negative effects myself, other than with the slow-dissolving "long-lasting" pills (but some might need that to stay asleep).


Interesting. I'm not sure I've seen extended-release melatonin. IIRC melatonin does not help you stay asleep, so that would be fairly useless.

I recommend starting at the smallest dose you can find designed for sublingual (under-the-tongue dissolving) administration. 0.3mg to 1mg is a good range.


This is the extended release one that made me sleepy the next day:

http://www.jamiesonvitamins.com/node/1418

This is the one I use that works great:

http://www.jamiesonvitamins.com/chocolate_mint_melatonin


Hmm. The article specifically says that disappearance of melatonin enables waking.


Use 500mcg pills. It only takes around 300mcg to get the full effects of melatonin. Once you reach around 1mg, your body will quickly adapt and it will lose effectiveness.

I used 300mcg for months and months, slept better, had vivid dreams, and the effect didn't change. I switched to 500mcg pills from Trader Joe's only because the 300mcg pills stopped being carried locally.

Source: an in-depth article I read years ago that I can never seem to find.


It's very unlikely that you will become dependent on Melatonin, it's simply not addictive. It isn't a sleeping pill either, it mainly supports an existing sleep disposition. If you don't want to sleep, you won't sleep.


what about feedback effect and pineal gland attrofiation?

every hormone that you have in excess of what the body expects, have compensation of the opposing message hormone, feedback effect. anyone has any idea which one is for this case?

another consequence is that the original producer of such hormone will get de prioritized by the body and atrophies after too much time. does this happen here?


My youngest daughter is borderline ADHD, and rather than trying Ritalin we've been using Melatonin in the evenings to help ease the bedtime process. (In the hopes that more sleep will help her cope with problems focusing.)

The change has been dramatic. Previously it was a 3-4 hour battle each night for her to get ready for bed and stay in bed. Now with 3mg of Melatonin she spontaneously decides to get ready for bed herself and goes to sleep in minutes.

The most interesting thing about Melatonin isn't that it makes you drowsy or helps you sleep, it's that it increases the _desire_ for sleep. While I don't usually have trouble sleeping, it's often hard to break myself free from a computer or a device at night, and Melatonin changes this. As the author says, "It works."


3mg might be too much. I am not a doctor, but my sleep doctor is, and she recommended half that amount -- right around sunset.


I remember reading in at least one study that there's no added benefit of doses above 1mg. I checked the "Brzezinski et al" article and it says:

  The dose response relationships in 11 of the studies 
  (see Refs. 17,18) support the existence of a plateau
  effect, with maximum effect generally being achieved
  at low doses (e.g. 0.3 mg) and maintained or 
  diminished at higher doses.


That was a concern I had too, so we tried breaking them in half, but didn't notice much difference in her nighttime routine after a week. We actually gave up on the melatonin for a while after that, but I decided to try again with an increased dose after talking with a coworker. Their child is more severely ADHD, and he was taking 5mg per night (and Ritalin).

The pills I have are a dual-release version, so that might have had an affect as well (http://www.swansonvitamins.com/swanson-ultra-dual-release-me...).


I too have ADHD. I was diagnosed with it nearly 10 years ago now. I'm not hyperactive or anything like that. I do tend to bounce from one thing to the next sometimes, and this can be problematic around bedtime.

Not only that but I take medication to treat my ADHD. This medication is a pretty low dose, but sometimes it's still going strong at 8 or 9pm, which is not good for sleep.

Melatonin has helped A LOT. I take between 1 - 3mg. It's not a drowsy feeling. I just want to sleep after taking it. Glad to see there seems to be no side effects.


You may also consider trying different medications. Ritalin/Concerta types have always had weird effects on my sleep, but the Adderall/Adderall XR ones have always been neutral/helpful when it comes to sleep.


Have you been able to reduce your ADHD meds after taking melatonin (or getting better sleep from melatonin)?


This is similar to something I read a couple years ago, where overactive/hyper children could actually be a result of lack of sleep, since tired children do not act "tired" like adults do.

http://news.bbc.co.uk/2/hi/health/8016531.stm


Endogenous melatonin is in the realm of 5-25mcg, I've had great success supplementing 150mcg. Better results than with 3mg even. Consider trying a microdose.

Especially given that you are dealing with a developing brain and melatonin is a hormone.


>The most interesting thing about Melatonin isn't that it makes you drowsy or helps you sleep, it's that it increases the _desire_ for sleep.

Exactly! After having tried almost all Hypnotics/Sedatives for a sleep disorder that has lasted better part of a decade, it was so refreshing to find something that:

Doesn't have any hangover,

Doesn't make you feel more crappy if you are unable to go to sleep after taking it. The headache/light-headedness that follows if you don't sleep after taking other sedatives/hypnotics is generally very annoying and sometimes even unbearable.

The quality of sleep is much better too. No nightmares as such. More dreaming, yes, but that may be just because of better sleep quality.


3mg is a very large dose, particularly for a child.

I take 0.5 mg myself.


Yeah, the Trader Joes ones are 0.5 mg, taste like peppermint candies, and knock me out within 15 minutes.


I buy the 5 mg ones, crush them up to powder and then mix them thoroughly with a carefully measured 5 teaspoons of sugar.

1/2 a teaspoon of sugar is now a 0.5 melatonin dose.


Just curious, what would have happened if you hadn't battled her to go to sleep?


I don't have personal experience with it; but my sleep schedule is horrible (I tend to stay up to 5am on alternate nights), so I may give it a try to enforce a normal bedtime, and kick the procrastination monster down a bit (if I don't have the option of doing the unpleasant work at 2am, it's far easier to force myself to do it during normal hours).

But: see here, this is very relevant: http://hpmor.com/notes/98/

Search MetaMed (a few screens down) for Eliezer Yudkowsky's experience with a sleep disorder (his normal day is 24.5 hours): after spending years trying a whole laundry list of solutions including melatonin, he finally paid MetaMed somewhere north of $5K for their analysis, and got a solution using melatonin that worked (but was not the normal approach to melatonin supplementation).

"their best suggestion, although it had little or no clinical backing, was that I should take my low-dose melatonin 5-7 hours before bedtime, instead of 1-2 hours, a recommendation which I’d never heard anywhere before.

And it worked.

I can’t #&$ing believe that #$%ing worked.

(EDIT in response to reader questions: ”Low-dose” melatonin is 200microgram (mcg) = 0.2 mg. Currently I’m taking 0.2mg 5.5hr in advance, and taking 1mg timed-release just before closing my eyes to sleep. However, I worked up to that over time – I started out just taking 0.3mg total, and I would recommend to anyone else that they start at 0.2mg.)"


This is how I do it as well. I use 300 microgram time released at sunset. Then a 1000 microgram instant release before bed. The 1000 microgram is not needed for me to get good sleep, but it puts my dosage at where body temp drops can be seen.


yup. 150mcg makes me feel naturally sleepy around 3 hours later. I highly recommend experimenting with microdoses.


Gwern comes close to suggesting filtering blue light, but I will repeat a previous post. I've tried melatonin, but it is no substitute for for filtering blue light in my experience, and it tends to induce horrific, apocalyptic nightmares (granted, a night dreaming of EAS Emergency Action Notifications is better than no sleep at all).

I used to be an owl for years--decades. A regular 9-5 schedule seemed out of reach. All previous attempts quickly led to backsliding and accusations of moral failure. However, I found that an involuntary physiological response to artificial light in the range 460-484nm was involved.

This May I changed my environment by filtering out blue light after 8PM, turning off white lamps and turing on amber compact fluorescents. I'm asleep ~ 10PM and up usually ~ 5AM. This is now my regular schedule. It would have been inconceivable for me six months ago.

I use the following:

1. Inexpensive Uvex amber goggles from Amazon: http://www.amazon.com/Uvex-S0360X-Ultra-spec-SCT-Orange-Anti... Wear them at least an hour or two before bedtime. I also have the considerably more expensive glasses from lowbluelights.com. In my experience, the inexpensive goggles work just as well, although the more expensive glasses filter more blue light.

2. I replaced most of the white compact fluorescent lights in my apartment with amber compact fluorescent lights https://www.lowbluelights.com/index.asp

3. And I use a sunrise simulator alarm clock. http://www.amazon.com/Philips-HF3520-Wake-Up-Colored-Simulat... Sometimes I forget to set the clock--now I don't seem to need it.

Not to mention f.lux (pardon the paralipsis), though again, in my experience, filtering is necessary.

Concerning the scientific basis for the claim that blue light in the range 460-484nm suppresses melatonin production, here is one reference: http://en.wikipedia.org/wiki/Photosensitive_ganglion_cell

Moral: Nagging and moralizing was both uninformative and ineffective. Science and engineering was both informative and effective.


I'll echo this, I had similar results restricting blue light.

What clued me in was when I went camping for a weekend after not camping for almost a decade. I found myself falling asleep and waking early, feeling better, even after a single night, and it got even better the second. Real darkness after sunset, and tons of bright sunlight in the morning.

Wearing the goggles IS a pain though. Worth it but a pain. F.lux didn't do nearly enough in my experience though it does seem to have an effect.

I also find that sunrise simulator clock is okay for waking up but not strong enough to replace bright light exposure in the morning. I would recommend eating breakfast outside in the sun for awhile, and if you find that helps, get some lights with some heavy duty lux for the winter mornings inside.


Nightmares in response to melatonin suggests low serotonin. Try 5-HTP sometime, which is a partial prodrug for melatonin and in practice works quite similarly to melatonin, except it induces vivid happy dreams and is the proscribed treatment for night terrors in children.


> Nightmares in response to melatonin suggests low serotonin.

Could you please provide a source for that statement? :)


I'm testing an LED light currently, it's color-changing via remote, but not the expensive Philips Hue kind. I'm using it on Orange for early mornings and Red for when I have to stay up late with work.

I think it's probably similar to what you're doing with your amber compact fluorescent lights. I'm happy with the results.

Btw, there was a new study recently, http://www.sci-news.com/othersciences/neuroscience/science-n... or the paper directly http://www.jneurosci.org/content/33/32/13081.abstract

Supposedly red light during the night is the least 'traumatic' to endure.


I'm glad someone else mentioned this. I have delayed sleep phase syndrome, which melatonin helps with, but the horrible, traumatizing nightmares make it unbearable and unusable.


I've reached the same conclusion myself. I always find the lists of "sleep hygiene" suggestions to be incredibly misguided. Proper sleep hygiene is important, but I've come to believe that blue light is the most important "zeitgeber" (an environmental cue that influences the circadian rhythm) and it seems to be very rarely mentioned.


I tried melatonin, among other things, years back, but it wasn't until I became very mindful of light pollution past 9pm that I saw a huge correction in my terrible sleep patterns. Never even heard of that goggle trick, fascinating.

I minimize all of the blue light in my place though I am left wondering if just minimal light is the most important part.

Turn all the lights off, a few nightlights, a computer monitor (flux or better), and a dim tablet seem to do the trick.


  ...it wasn't until I became very mindful of light 
  pollution past 9pm that I saw a huge correction in my 
  terrible sleep patterns. 
Yes, my experience exactly.

  Never even heard of that goggle trick, fascinating.
If you have a chance, read the Amazon reviews of the Uvex goggles. I've suggested the goggles to friends and acquaintances, and they say that the goggles work. Some gave up because they don't like wearing them. One person wants to do precise color matching in PhotoShop at 2AM.

On another note: although I don't have a Facebook account, I find it more than a little amusing that the goggles black out the blue color scheme of Facebook. Mark Zuckerberg's green-red color blindness led him to adopt a color scheme that may have exacerbated insomnia around the planet.

  I minimize all of the blue light in my place though I am 
  left wondering if just minimal light is the most important part.
Perhaps. Since I'm changing the environment not only for myself, but for my significant other, I have had to make some compromises--though she is supportive and likes the warm glow of the amber compact fluorescent lamps. Wearing the amber goggles works for me. Also, I only use amber compact fluorescent lamps at my desk at home.


I have had very vivid dreams on melatonin, but never any nightmares. I'm wondering if you would have had the nightmare anyway, and melatonin just made it stand out more.


Too late to edit: replace "was both" with "were both" in the last paragraph.


> it tends to induce horrific, apocalyptic nightmares

I've used melatonin for years, as have many of my friends and family, and I've never had anyone mention this. I've always had more vivid dreams with melatonin, but I've never had nightmares.


I've attended a few week long meditation retreats where you generally have to adhere to the schedule laid out for you; that includes waking up early (~5:00AM) and going to bed early and also refraining from using anything that could be considered a distraction, namely computers, phones, etc. More often than not, a few days into a retreat I would start experiencing extremely vivid and violent dreams. One of my meditation teachers said that this tends to be a regular occurrence as the mind goes through a form of detox when it's deprived of stimuli. It was interesting to read about the parent's experience with melatonin and then be reminded of these episodes, with possible increased presence of melatonin and deep sleep states being the common factors.


I've also had spectacularly vivid dreams on retreats, but mine weren't violent, at least.


Perhaps it's something to do with particular makes of the drug, but I've also had my worst nightmares while on it, and the words GP used are spot on for me. My mom, aunt and other members of my family had similar experiences and we've mostly stopped taking it. I did partly because it no longer has the surefire effect it once had on me, and partly because I'd often wake up in a crappy/despairing mood because of the apocalyptic nightmares.

On the other hand, I really miss it back when it worked mostly wonderfully. I coupled my intake with an experiment on segmented sleep, where I'd take it some time before 4pm and sleep till around 9pm, often waking up in a so called "writer's mood," and then sleep again (without Melatonin) from roughly 1am till 4am. I tend to be a very unfocused person, but on these intervals between first sleep and second sleep I'd feel in an elevated state of consciousness where my focus was like a laser I could point anywhere. Sublime is a good word, everything feels light and effortless, and the right thoughts just flow when you need them. I'm sure people have felt similarly while on other kinds of drugs, which is interesting to say the least. But I was sober and really productive, and have written my best fiction in this way.


Melatonin isn't a drug, it's the neurohormone that provokes sleep. Your body produces it naturally already.


Damn straight it's a drug. It's one your body just happens to produce. It's having a biochemical interaction at concentrations far less than would be required for a chemical reaction (such as neutralizing acid in the stomach with calcium carbonate). Similar to using the pill to modify the reproductive cycle.


What kind of dosage are we talking about though? Like 1 or max. 2mg once every few weeks to get you over the hump of sleeping or 5mg every few days and occasionally a double dose?


Melatonin intensified my dreams but did not prompt nightmares; but then, I never have nightmares any way!

A friend who was prone to nightmares tried melatonin and it made her nightmares worse.

So perhaps it just induces worse nightmares in those prone to having them in the first place.


It is a common side effect http://umm.edu/health/medical/altmed/supplement/melatonin possibly dosage related. I have found that 1 mg is more effective than 5 mg, but perhaps I could try .5 mg.


I've had intense freaky sex dreams from melatonin, but... You know, they were very tolerable. An acceptable side-effect.


Melatonin does not directly induce nightmares, per say, just the vivid or lucid dreams you are familiar with. However, if just one of those incredibly vivid melatonin induced dreams goes awry and descends into nightmare territory, you will remember it for a long, long time.


I've had nightmares while taking melatonin with the same frequency as I've had them the rest of my life. They're more vivid, but I've forgotten them just fine.


I have had problems with chronic insomnia and tried melatonin — horrible nightmares. So bad I would lay awake in the morning a bit, just stunned at how horrible they were. No thanks.


Melatonin is a clear-cut Good Thing. The gains I have laid out are large enough I consider it irrational for someone not to use it.

I consider it irrational for someone to believe that a limited number of hand-selected studies can give you absolute confidence.


First, it's not a "limited number of hand-selected studies." The Brzezinski meta-study ( http://www.gwern.net/docs/melatonin/2005-brzezinski.pdf ) alone covered 17 studies and 284 participants. There's even a clear, well-documented causal mechanism, which can't be said for most of the supplement industry.

Even if it were a limited number of studies, gwern's not going for "absolute confidence". (Indeed, requiring "absolute confidence" before attempting a thing is irrational by the following sentence.) Irrational here means doing something with expected value less than zero. If you're a person living in an industrialized society with ready access to electrical lighting -- the possible gains are too large to be balanced out by the time wasted trying it. That's what gwern's saying.


Using a meta-study that showed tiny changes (statistical significance is irrelevant here, virtually any intervention could have had that kind of impact) to bolster a handful of anecdotes is pretty silly.

I don't argue that this doesn't help a fraction of people, but the case is pretty weak and the long-term results of tampering with a critical hormone are unknown.

No offense to the author but I've read at least 3 of his articles posted here and they all follow a similar pattern.


And how do you claim to calculate expected value here? You are making the same error he is by ignoring the possible "black swan", which, with every drug, can have dramatic consequences.

A positive but cautious conclusion like http://www.vanderbilt.edu/AnS/psychology/health_psychology/m... would have been much more appropriate.


> You are making the same error he is by ignoring the possible "black swan", which, with every drug, can have dramatic consequences.

The black swan is a pretty useless concept at this point, because people like you will drag it out against anything they dislike. You cannot give any rigorous formulation or evidence for it, and the best you can do is drag out some old example like thalidomide.


No rigorous formulation? The black swan has a very simple mathematical model: an unlikely event with an effect so great that it will affect the expected value. For example, a greater risk of dying after 20 or 30 years of use - which has not yet been studied. In your calculation of ROI you completely ignore unknown long term effects.

Yes it's hard and often impossible to quantify black swans. But keeping them in mind is a way to avoid overconfident articles like the one you wrote.


> The black swan has a very simple mathematical model: an unlikely event with an effect so great that it will affect the expected value. For example, a greater risk of dying after 20 or 30 years of use - which has not yet been studied. In your calculation of ROI you completely ignore unknown long term effects.

Alright, let me clarify it then: by the remotely meaningful version presented by Taleb, your argument doesn't work and Taleb's writings support taking melatonin, rather than not taking melatonin. Why? Because even in the event of a negative 'black swan' your losses are strictly limited: the worse that can happen is you die. In fact, if I may borrow Taleb's 2x2 table from _The Black Swan_ where he brings up positive 'black swans' as well, it's easier to make a case that taking melatonin is a positive 'black swan': the negative possibilities are strictly in Mediocristan, with limited losses, easy to measure over large populations, predictable, not varying over time; while the positive possibilities look like some of Taleb's examples of attempting to exploit positive 'black swans' in Absurdistan - improved productivity, healthy, and seizing opportunities, things with potentially unlimited payoffs - such as moving to cities and networking with people.

> For example, a greater risk of dying after 20 or 30 years of use - which has not yet been studied.

FUD.


> That's true of every black swan - the worst that can happen is everybody dies.

Not at all. Taleb like to use the example of selling insurance and shorts, where your downside is unlimited. Millions, billions, trillions... Think AIG or LTCM. Not everything has consequences solely for health.

> You do not mention any studies of long term effects and you consider FUD raising the possibility that there could be adverse effects.

In the absence of any evidence whatsoever for that, and plenty of positive correlations, short-term studies without any problem... Yes. It is FUD. Fear, uncertainty, and doubt.

> When more and more studies show negative long term effect of substances that were considered innocuous (like vitamins), it's not FUD, it's being reasonably cautious.

Only some vitamins show any mortality effects, the mortality effects while real are pretty small, the vitamins did not deliver the long-term health benefits promised (but never really demonstrated in experiments) which might offset the harm, and the vitamins were being consumed in huge doses. The first reduces the possibility of any such outcome, the second points out that you are exaggerating the harm, the third means that vitamins were a purely speculative play unlike melatonin, and the fourth reduces the concern that any such thing would happen with melatonin when one sticks to the suggested doses like 0.5mg rather than 5mg.


If everybody died, money would have no value. So yes, it's always worse than losing an unlimited amount of money.


Yes you are right, the effect is limited: you die. That's true of every black swan - the worst that can happen is everybody dies. But I don't think that anybody would consider that a "mediocre" outcome. And at the end, you could/should quantify it in your model, or at least mention it as an unknown in your ROI.

You do not mention any studies of long term effects and you consider FUD raising the possibility that there could be adverse effects. When more and more studies show negative long term effect of substances that were considered innocuous (like vitamins), it's not FUD, it's being reasonably cautious.


I recommend you read the article first. Check out the ROI section: http://www.gwern.net/Melatonin#roi


17 studies, 284 participants?? And that's supposed to be reassuring?

That kind of numbers is a red flag to me. It indicates that these studies may have issues, which I suspect they do.


In general, the pattern of regulation of "dietary supplements"[1] in United States law allows a lot of claims that go beyond the available evidence to be made without legal consequences. In an environment like this, I would do more than just listen to anecdotes from satisfied users.

[1] "Dietary supplement industry says 'no' to more information for consumers (again)" 3 October 2013

http://www.sciencebasedmedicine.org/big-supp-resists-giving-...


To the extent that it may permanently inhibit natural melatonin production it is not a good thing. There are tradeoffs.


Do you have any references for that? I'm not pro or con either way (yet), I'm just gathering research. I'd love to know if there are any recorded cases of this and the doses involved.


The problem with a lack of FDA regulation is that there is no guarantee on what you are taking. The freshness of the product and the veracity of what's in the pills will always be suspect to me.

If I could trust where I get my melatonin from, I would gladly take it. But I've learned too much about how terrible this industry is.


The issue here is that it is a natural chemical and with that nobody can patent it. The cost for drug approval (in many countries) is high and this is the crux. No company is going to finance the approval process as they have no way to control there financial return upon that investment as they can not patent the drug they are getting approval upon. So everybody else can just ride there investment and that is the case now in that nobody has any incentive to put it thru the costly FDA approval. Same can be seen for Omega-3 and other naturaly occuring benificial products.

This also means that people with depression or sleep disorders can not be prescribed these products as they are not FDA approved and insurance will not pay for it either. This forces people into patented phara drugs that may or may not be better for them and in all cases have more side effects (upto including death being common disclaimer on the long list).

Same issue in the UK and more so in that melatonin is not allowed to be sold. Sure you can get it on the internet, but from some contries but as there are no standards it is hard to tell. Is it syntheticly made or the type extracetd from animal and with that the whole area of concern starts to rise.

If only some benificial billionair would fund FDA tests for approval for this and other unpatentable naturaly occuring medicines. Certainly be positive for everybody.


Companies can obtain market exclusivity without a patent. In the US, the FDA assigns 5 years of market exclusivity based on a NDA approval. If it's an orphan disease, it's 7 years. You can also bump up the exclusivity by 6 months if you get approved in a pediatric indication.

That said, there isn't much incentive for a company to do this. Let's say a company spend $200M getting FDA approval for melatonin. Considering the huge population that it would be used in, the FDA would require a very large trial to determine safety. Once launched, the drug company would need to recover that cost plus a profit, so suddenly melatonin goes from a few pennies per dose to several dollars. The push back from the public would probably kill any chance of making it a profitable venture.

What drug companies did do was create melatonin analogues. Rozerem by Takeda is a great example. It hasn't done that well.

As for omega-3s, GSK did get Lovaza approved by the FDA although they did have a patent on it (a specific form of omega-3s).


That is encouraging, sadly not aware of anything comparable in the UK, though was unaware of this avenue you mention and with that thank you.

Sad about the investment needed for the limited return window which would be enough time to promote the benifits intime for the market to mature just outside the window of opertunity.

Does make you wonder how many good useful medications are kept back due too fiscal investment to get the various approvals. Not aware of a universal World accepted standard of drug approval, certainly would make sense cost wise for the global return. But guess there is money in running trials as well.


There is an approved form of pharmaceutical melatonin in the UK (Circadin, 2mg modified release), but it's only licensed for use in adults aged over 55.

Any doctor can prescribe it off-label if they wish, although they might be hesitant in the non-insomniac population due to the relatively high cost (>50p per 2mg dose)


I agree that oversight is important. Incidentally, that's why bottled water is generally more dangerous than tap water. Public water supplies are held to stricter standards in terms of quality control and regular testing.


Thats a very good point, also it's important to look for off label side effects (Adverse Events) to the non prescription drugs. I own the site linked to in the 'Uses' section (http://www.drugcite.com/?q=melatonin), it's also to sort the data by date and gender to get more accurate information. This data is put together from numerous data sets including FDA FAERS.


Nice website! It's a great interface for the FDA collected data.


I don't trust many, but I do trust Nature's Way, Now Foods, and Jarrows. They do proper batching and testing.


I'd also strongly recommend the Trader Joe's brand. I've been using melatonin for a couple of years and haven't found anything that has been as consistently effective.


I've heard many of TJs supplements are white labelled Nature's way products


I have to add LiftMode, their products are pretty good, and come with test results to show exactly what you are getting.


I'll check them out, thanks!


How do you define 'freshness' with regard to Melatonin? How relevant is the date printed on Melatonin bottles?


consumerlab.org does independent testing of all sorts of supplements. Highly recommended.


True. A doctor recommended Jamieson.


Melatonin does work wonders, but you never know how your own body might react to it.

I have many issues with my sleep cycle and quality of sleep. Melatonin is one of the few things that alleviates my problems. However, for me, it's only good for one night. I can take melatonin for one night out of a month, and get a blissful, restful night of sleep. If I take it two nights in a row, evil side-effects start creeping up.

It begins with a headache. If I take melatonin two nights in a row, the next day I will wake up with a headache that's hard to shake. My dreams, while very vivid and pleasant the first night, become more gloomy and depressing the second night. By the third day, my dreams are full-on, vivid, terrifying nightmares. I feel depressed and angry all day, and the headache borders a migraine. After four days of melatonin, I'm a wreck. It no longer puts me to sleep, nor gives me restful sleep. It becomes nothing more than a pill full of nightmares, depression, anger, and a bad migraine.

The first time I started taking melatonin, I had no idea it was causing these side effects. It took a while to pin down, and I just assumed it was related to my ongoing battle with sleep. I do recommend it, just know that you may have adverse reactions to continued use.


I'm curious as to what dosage you're taking. Several sources I've seen suggest the dosage they recommend on the package is too high for many of the typical brands out there. Do you experience these symptoms when taking low-dose melatonin (<= 0.5 mg)?


I've tried both high and low dose, and many different brands. Effects are the same either way. I usually go with the high dose since I'll only be taking it for one night anyway.


What dosage do you take? (It sounds too high.)


Ditto on vivid nightmares, I actually posted similar before I even saw your comment.

I had to stop taking it.


Ditto for me as well.


Have you tried different brands?


My wife is a terrible sleeper -- around bed-time she'll suddenly want to do various household chores, vacuum, chat endlessly etc., that combined with irregular and often stressful work, my usually very regular sleep pattern has been totally annihilated over the last 5-10 years.

It also reached the point in the last year that I needed to be at one work site a few days a week, but at 6am, then another site different days at 9am, then work from home the rest of the time which meant trying to "catch up" with a 10-11am wakeup.

I finally broke down and started taking 3 mg of Melatonin, but only if I've had 2 recurring nights if bad sleep. The effect is kind of strange. About 20-30 minutes after taking it, my strongest desire in the world is to want to go to bed, but it doesn't exactly make me "sleepy". After my head hitting my pillow, I'm asleep in about 10 minutes. If I need to, I'll take it multiple days in a row until I feel like my sleep cycle is sorted out, then I stop. I'll also take it if I need to suddenly change my cycle and get up very early the next day or something. Wakefulness comes smoothly and refreshingly, not jarring.

I finally got my wife to start taking it and now all the fuss over getting her to go to sleep has ended completely. As soon as she starts wanting to do things and it's late at night, she pops a Melatonin pill and is asleep inside of 40 minutes.

It's absolutely transformed our sleep/work/live/wake cycles. It feels like I can finally wrestle a bit of control back from an overburdened modern life.

The only problem is that the next day I usually feel very cloudy headed the entire day and have a mild urge to go back to bed until mid-afternoon.


The cloudy headed thing is almost certainly due to a too-large dose. gwern recommends somewhere around 1/10th of the dose you are taking. I've been splitting 1mg pills in half.


Haven't read the article yet, but Melatonin does wonders for my sleep habits. Without it, it seems like my body really wants to function on a day that's 26 or so hours long. That tends to put me in a constant cycle of being not tired enough to go to sleep yet, falling asleep too late, not having enough sleep and being tired all day, then going to sleep the next night too early and starting over again the next day. Melatonin has made it much easier to get about the same amount of sleep every night.


I cut caffeine out of my diet, (apart from chocolate) which has more or less cured my issues with sleeping. I think I could start drinking it again, but only pre mid day.

It is very hard to do (headaches, sleepy in the day etc), but worth a shot.

I also use earplugs, which I find it very hard to sleep without now (unless drunk). They not only block out noise, but you get conditioned that when you put them in it's time to sleep, it kind of gets you into a sleep mind set.

The other thing I find helps is if I find my mind racing I try and slow my breathing down as much as I can. I think it works on two levels, I focus on breathing and free my mind of jumping all over the place and it also slows your heart rate and therefore oxygen to the brain, which I think has the same effect :P


It is generally not recommended to sleep in earplugs, as you're risking inducing a tinnitus. Basically everyone has some background noise in his ears/head, but it is ordinarily discarded (not brought to consciousness) by central nerve system as it's much quieter than external sounds - but if you cut them out, you're risking that your brain becomes aware of that sound and bam - suddenly you have tinnitus. And it may very well stay with you for the rest of your life.


Out of curiosity, do you have a source for this? I developed tinnitus last year and currently do wear earplugs while sleeping, however I certainly don't want to make it worse.


BTW for people whose tinnitus is bothering them enough to shell out a couple grand, check this out: http://www.anm-medical.com/index.php/en/tinnitus/acoustice-c...

It seems to be the first therapy for tinnitus which was confirmed in clinical trials. Unlike TRT, it can actually make the sound go away and not just make you less unhappy about it.


An audiologist told me that.


Great, insomnia here I come!


Why didn't you mention about the effects of a calcified pineal gland resulting from a Vitamin D and magnesium deficiency? Those are very common among the older folk, resulting in poor sleep quality, poor immune system, even increased chance of heart attacks.


It's an article on melatonin. Vitamin D and magnesium are discussed elsewhere ( http://www.gwern.net/Nootropics#vitamin-d , http://www.gwern.net/Nootropics#magnesium ), but gwern's focus isn't on old people because he's not an old person, so it's harder to self-experiment on them.


Thanks for pointing that out. It answered my question. Thanks also for the links.


Pineal gland calcification happens to almost everyone[1], whether you're vitamin D deficient or not. Not only is it completely normal, the health effects you mention have certainly not been shown to correlate with calcification.

Honestly, the only people that bring this up are people still steadfast against fluoridation of water and people looking for an overly simplistic cause for alzheimer's.

[1] http://radiology.rsna.org/content/142/3/659.full.pdf


Your study focused on newborns to 20 yrs. It didn't consider the 30 to 70 crowd. Children and young adults usually don't have this problem since their bodies are rapidly growing and absorb large amounts of iron/calcium/etc to grow.

Not only that, but your study observed extreme cases: "The majority of patients included in the study had a history of seizures or minor head injury."

I never heard of calcification linked with fluoridation and Alzheimer's. So I wasn't suggesting that.

Apparantly you've never given magnesium citrate to older family members and watched them get the best sleep in a long time. Moreover, an American diet filled with calcium + little magnesium + Americans taking calcium supplements for osteo-porosis + plus deficiency of various nutrients is bound to lead to various problems. Then again, I'm not a doctor. In fact, I don't even have a college degree. So feel free to ignore anything I say.

If people want to be more concerned about vitamins/supplements rather than a diet rich in iron/HFCS + deadly FDA-approved drugs, so be it. I will take my chance with the vitamin fanatics like Linus Pauling (took mega doses of Vitamin C, died of cancer... at the age of 93).

I will grant your wish. I will stop talking about vitamins and supplements on HN. However, for any crackpot vitamin fanatics out there, head over to http://knowledgeofhealth.com That's one of the best sites I know and are very good at spotting mistakes in mediocre research proving that vitamins are deadly, cancer inducing toxins.


...and how can this be fixed?


5,000 - 10,000 i.u.: Vitamin D3 in the morning.

300 - 600 mg: magnesium citrate.

My favorite brand is "30 Minutes of Sunshine" http://www.lifespannutrition.com/lsn/products.asp?itemnumber... Bio-Tech Vitamin D3 is also very good: http://www.biotechpharmacal.com/


Ignore the Vitamin D supplements that the other guys are suggesting and just go into the sun for 10 to 15 minutes a day.


Take VitD + Fish Oil, then ZMA before bed.


Interesting data about melatonin, but I am very wary of appeals to "nature" and "natural" in articles like this. Such references are often proxies for the concept of "good" or "healthy", but that's not necessarily true. Epidermal sun damage is natural too.

For example biphasic sleep is a pattern that arises when the darkness period is significantly longer than the human need for sleep. If the darkness period is reduced to about the same length as the sleep need, then the sleep period is less interrupted. But humans are not any more or less healthy under either sleep regime.


>Epidermal sun damage is natural too

If we're talking from an evolutionary stand-point, humans have protections to keep the sun from killing us. If you're in the sun a lot, you would have darker skin (or skin that grows darker as the sun's rays increase in intensity per the season). You wouldn't be spending all day inside in the Midwest and then be in Brazil the next day. The sun is natural, the way you're exposing (or not exposing) yourself to it is what is unnatural.

It's the same argument that cyanide is natural. Yeah, but humans tend not to find cyanide very tasty at all (as an evolutionary protection). People don't go around eating peach pits just for fun. Pure cyanide being added to foods in concentrated doses as a poison is a human invention and is not natural. Melatonin being used by the body to regulate sleep cycles is natural in the sense that it happens whether we supplement it or not. The unnatural human invention is to boost the natural effect by taking more, or by taking it at a specific time rather than trusting our body to fully regulate its production.


> I am very wary of appeals to "nature" and "natural"

I think it's an important distinction to be made here that melatonin is something you already produce at certain times of day (maybe not the desired time), and not something your body does not normally encounter, which you put into your body to interrupt a normal process.

This is not to say that any concerns about melatonin are invalid; only that one shouldn't be as wary of melatonin as of, say, Ambien.


I've had on and off problems with insomnia, but have finally come up with a pretty reliable method for overcoming it. Some of my methods were used by others as well.

I think it's important to identify what's causing the insomnia. It's not always going to be the same thing for everyone, or even for you, every single time.

Some days, for me, it's just simply because I have too much on my mind. Other times, it's because I've had too much stimulation and some times, it's just because I haven't had enough physical exertion during the day (most of my work is on a laptop).

Here's the routine that I now employ and I've been really good for a number of months straight (I helped a friend create a similar "routine" and he even blogged about it).

So my routine is as follows

1. No HN, book reading ,or any kind of blogs, reddit etc (basically anything intellectually stimulating) after 8pm.

2. Some strenuous physical exertion (e.g. Gym) every 2nd or 3rd day

3. Anything that puts me into a more relaxed state, e.g Some fresh air at least half an hr before bed time, writing in a journal if my mind is going crazy with ideas, or reading some poetry/fiction (but nothing intellectually stimulating. i.e. something entertaining or relaxing).

4. No computer screens at least 45mins before bedtime

5. 1 teaspoon of blackseed oil 5 minutes before bedtime

6. A decent mattress (Mine is a silentnight miracoil) - Some people don't realise how important your mattress is and how badly it can affect sleep.

7. No stimulating conversation at least 45mins before bedtime, that includes emails, text messages, in-person conversations and phone calls.

I also make sure that i'm out of bed before 8am each day if i want to make sure I get good sleep for that night.

Basically, i've whittled it down to identifying which state is not in a relaxed mode and getting it to a desirable state .

i.e. emotional state (writing in a journal or meditative exercise), mental state (avoiding anything intellectually stimulating), physical state (physical exertion/blackseed oil/mattress)


What is the Blackseed oil for?


Magnesium (amongst other important minerals and fatty acids). To relax the nervous system.


I've been using melatonin on and off when I hit a patch of insomnia. It's pretty good; it just makes me super sleepy. Even with a low dose I end up groggy in the morning, however. But being able to actually fall asleep when I would otherwise lay awake for hours is worth the price of admission.

I don't use it regularly but sometimes I just know when I'm going to have trouble falling asleep, and will take one about a half hour before I'd like to be asleep. Works like a charm.


Have you tried taking it earlier in the evening? Half an hour before bed seems very late.

My professor in psychology grad school presented it's functioning and said it's best taken not later than ninety minutes before bed.


You should try a lower dose. Most melatonin packaging suggests 3-5 mg (like shampoo instructions that tell you to "rinse and repeat"), but other sources recommend just 0.3 mg for regular use.


I've been using melatonin for years every night. As a person that has extreme obstructive sleep apnea, I credit melatonin with providing me a modicum of restful sleep for the years I didn't use a CPAP. Now that I have one, melatonin helps improve my "normal" sleep patterns.

Anecdotaly, I find melatonin usage helps my brain rewire itself every night. My belief is that increases the number of connections and associations that various concepts have, and it also elevates my mood. Not bad for something that costs mere pennies!

During the time I had almost no sleep, I would take quite a bit of melatonin in a desperate attempt to get some kind of rest. At times I would pop 25mg or more. I found there were no side effects, except perhaps being sleepy for the next couple of days.

I've also quit a number of times for various reasons. Just a few months ago I quit for three months due to surgery. I found quitting to be completely symptom-free, which kind of amazed me. I figured with years of usage, quitting would make it impossible to sleep. I based this opinion on numerous studies that show when you replace a naturally-occurring hormone with a supplement, your body stops producing it. Instead, I slept fine. Once I was out of the no-supplements period after surgery, I started back up with the melatonin. No side effects, and I almost immediately noticed an increase in creativity and mood.

I'm a supplement junkie. It's that irrational thing that I do, my black swan interest. Yes, I know, most of the market is just BS and marketing hype. But not all of it. Melatonin is one of the 2 or 3 supplements I use that I believe really make a huge and immediately perceivable difference. Can't recommend it highly enough.


> But not all of it. Melatonin is one of the 2 or 3 supplements I use that I believe really make a huge and immediately perceivable difference.

What would the other 2 or 3 be? I've found Vitamin D (taken as a liquid) to be one.


Vitamin D-3 is one.

Resveratrol is on my "maybe" list. I'm seeing some really interesting research, but the good stuff may end up being patented and sold as a drug, which sucks.

I'm still a Vitamin C fan, even though it's fallen out of favor. Seems to help when I've stressed out my system through alcohol or other chemical irritants.

Also on my "to-watch" list is delta tocotrienols, one of the components of vitamin E. Saw some interesting evidence that it might be good at actually helping to remove coronary artery blockage, but it's still WAY preliminary. And no, that's not a recommendation for vitamin E itself, which in larger doses can cause all sorts of problems. Just the delta series.

The B series of vitamins are interesting, as there seems to be a good-sized gap between the amount most people have in their bloodstream and the amount that they can carry easily. A little dose of B-12 seems to help me enormously with concentration. At least for a short period. YMMV.

Note this is all subjective, and based on half-assed research and gossip. That's one of the rules in this arena: there are no rules. :)


1) I don't think it's known how big the "addictive" effects are. Meaning, if you use it a lot, you might get "used to it"(downregulation), and require more to get the same effect. See the link at the bottom; My doctor told me not to use it more then 4-5x a week; I have anecdotal evidence of it being less effective from my use

2) It might not be as effective as you're making it. It surely isn't as simple as "replacing the melatonin you're lacking". Melatonin you naturally produce happens in a series of step; the melatonin you take via a pill surpasses some of these steps, which means there isn't the same effect.

See http://www.supermemo.com/articles/sleep.htm#Melatonin


I found melatonin to be very effective, especially on mountaineering trips, where I'm not guaranteed a decent sleeping environment but really need to get some sleep when given the opportunity.

My girlfriend however reported nightmares when she started supplementing with it, but it appears to have gotten better.


I take it when I travel across time zones to reset my internal clock. Works great! If I take if for more than 3-4 nights in a row it seems to lose its effectiveness.


I was going to mention the same thing. I used it when I was flying a lot internationally and it worked to overcome my jet lag pretty effectively.

Definitely recommend it if you travel internationally.


I works great when you have this "thinking in your sleep and wake up even more tired" syndrome.

Melatonin related supplemements helps you relax quickly and really sleep deep. I personally found that taking 1/3 of recommended dose works perfectly. Taking full doze making me wake up in such a limb state - that it takes me literally one hour for muscles to get back into their ability to move the body.

Another thing is that I found that taking it for a week or two (no more) is optimal. Few cycles of deep, relaxed sleep are enough for body/mind to get into relatively better balance than before.

Adding regular physical exercise to the mix helps to reignite the whole system back.


I can confirm the 1/3 size dose (the strips are 3 mg and I take one third of that, 1 mg), I take it from time to time when I get insomnia and that seems to be the sweet spot.


How much more deeply does it make you sleep? I have small children; I don't want to be difficult to wake.


I use this (sleep support one):

http://vibrantme.isagenix.com/ca/en/brainsleepsystem.html

1 week was enough for me.

It allows to relax and fall asleep quickly. Small doses will do and they will not diminish your ability to wake up and take care of kids.

Again - start with 1/3 of recommended dose and you should be fine.


I'm disappointed to see no comments here whatsoever that are addressing one of the central (and AFAICT unsupported) claims of this article-- that regular melatonin use can reduce the amount of sleep needed by almost an hour.

I have no doubts that melatonin is very useful for getting to sleep quicker, but if the reduced sleep claim is accurate, then it may move from an occasional use when needed, to a default use.

There are many melatonin users here- any regular users care to share their feelings/anecdotes (or better!) on this?


I remarked on this above also. I have early morning waking also (not sure if it's insomnia or just my getting older).

I use melatonin when I know I'm stressed and would normally have trouble falling asleep. I try not to use it more than once a week and I am hesitant to habituate myself to it.

It is an interesting idea that my nights with early waking might nevertheless be more restful when taking melatonin, but I haven't noticed this particularly. Presently I am hoping more exercise will get me sleeping more solidly through the night.



Interesting. I work on call shifts. (Linux sysadmin, one week out of three is 24/7 on call -- which works much better than rotating one day out of three.) I've used Melatonin for years to 'regulate' my sleep cycle so that I can stop my tirelessly creative brain from thinking about that article I read a few hours ago on Hacker News.

My other 'hacks' to keep my sleep cycle regulated are f.lux where possible, using only dim incandescent lights in the evening around the house once I am ready for bed, and NOT using a laptop, iPad, or anything with white/blue LEDs in bed. Wake-up is accomplished with an alarm clock that activates a piece of "wall art" that slowly changes color spectrum to full daylight using LEDs and shines on the bed.

Having good control of my sleep cycle keeps jet lag, time changes, mid-night alerts, and other things that disrupt most people from disrupting me as much for as long.


Melatonin does NOT work as a remedy for jet lag. I don't find open access links to the relevant studies right now but http://www.nojetlag.com/melatonin.html might give you a first idea.


Anecdotally, melatonin works wonders for me when traveling.

I take 1mg of melatonin between 7 and 9pm in the target time zone's frame, usually starting the day I travel or sometimes the day before. This translates to taking a pill at noon or so in SF before flying to Europe. I follow that up with a pill on the first few evenings of a trip.

I've been doing this for a few years now, and the only remnant of jetlag on such trips is that I feel terrible around 3pm in Europe, which translates to 6am. So I'm guessing that my natural not-yet-shifted sleep cycle is rebelling at that point and trying to convince my body that I just stayed up all night.

Of course, I am an n=1 population size, and the routine has worked so well that I haven't dared to do a significant time zone shift without it. So it could just be me, or it could be the placebo effect. And I'm perfectly ok with that, as long as the jet lag stays at bay.


What no one is talking about but should know:

Melatonin is amazing for people that smoke weed. If you're one of those people that casually smoke but wake up the next morning feeling groggy and out of sync, take melatonin at night as directed in this article and other places. Getting into your bed will feel amazing. You will drift off to sleep, even if your iPad or music is on. And you will wake up like a normal person, except a bit more relaxed. As I became more and more successful I smoked less and less because of how it affected my performance the next day. With Melatonin I can smoke like Sophomore in college enjoying Adult Swim on a Sunday for the first time.

What no one else is talking about:

Melatonin can make you super constipated. Eat fiber, take fiber pills, eat a balanced diet high in vegetables and it should else. If you're on a neckbeard died, say goodbye to pooping regularly and when you do, it will be compact.


There are some problems with Melatonin (as supplied) - you don't really know how much (if any) you're getting. Investigators found that quality control was very poor and some brands contained very little melatonin. (I can't find it now, but it was something like Consumer Reports or similar?)

It's a prescription only med in some places (UK) so you might not be able to get it.

But it is "remarkably effective"[1] for jet lag.

You might want to consider sleep hygiene[2] as well as (or instead of) melatonin or other sleep meds. (I really like zopiclone.)

[1] (http://summaries.cochrane.org/CD001520/melatonin-for-the-pre...)

[2] (http://www.nhs.uk/Conditions/Insomnia/Pages/Treatment.aspx)


Zopiclone can be habit forming and has an associated increase risk of road traffic accidents like most hypnotics - wikipedia is a good start for the risks.

I think melatonin is a better drug for correcting problems with sleep cycles which can include jet lag, changes in season and the like but there's plenty you can do help your sleep quality without drugs.

Here's a great article (about Huntington's disease but applies to everyone - it really helped me) based on a published paper in Experimental Neurology:

http://en.hdbuzz.net/120


> (I can't find it now, but it was something like Consumer Reports or similar?)

Are you thinking of the Consumer Labs report? I quoted that in a footnote, but it does not show what you seem to think it showed:

> Can melatonin help you sleep? "Melatonin supplements may help some people get to sleep sooner, particularly those with chronic sleeping problems, but don't just buy any supplement - they vary [substantially] in strength, dosage, and cost," says ConsumerLab.com President, Tod Cooperman, M.D. ConsumerLab.com recently selected and tested nine different melatonin supplements. The testing showed that all contained their labeled amounts of melatonin, but the suggested daily dosage ranged from 1 mg to 50 mg [!]; and cost ranged from just 4 cents to $1.36 for an equivalent dose of melatonin. This means you may not be using the right dose for your needs and you could be paying as much as 33 times more than necessary. ConsumerLab.com also found that one supplement failed to properly disclose all of its ingredients.

That is, each contained all the melatonin it claimed to, but there were irresponsible doses being offered. Unfortunate, yes, but this is not a problem for anyone who did their homework and know what dose they want to try.


A quick google gives me a big bunch of options for buying Melatonin in the UK - http://www.hollandandbarrett.com/HealthNotes-Search?search=%... for example.

Doesn't seem to be prescription-only unless I'm misunderstanding.


Wikipedia suggests prescription only in the UK. I think this is because it was banned as a food supplement in the 1990s, and only one medication got a licence, and that was a POM. Thus, any melatonin product is either an unlicensed medication (illegal) or prescription only.

The page you link to doesn't allow me to buy any product. Entering [melatonin] in their search box doesn't return any products containing melatonin.

(http://www.mhra.gov.uk/Howweregulate/Medicines/Licensingofme...)

"You can't buy melatonin over the counter in the UK" (http://www.webmd.boots.com/sleep-disorders/insomnia-in-adult...)

MHRA does regulate melatonin sales and prescriptions. Here are two examples:

UK website has prescription only melatonin, being advertised for off-label use (jet lag) and is told to stop (http://www.mhra.gov.uk/Howweregulate/Medicines/Advertisingof...) (Even though Cochrane found it's excellent for jetlag)

Also, unlicenced product (http://www.mhra.gov.uk/Howweregulate/Medicines/Advertisingof...)

EDIT: also, a web search for [buy codeine uk] returns many hits for offshore pharmacies selling into the UK.


Thanks for the detailed reply! Having looked into it a bit further - yep, you're right.


You can buy melatonin online in the UK from Biovea http://www.biovea.com/uk/product_detail.aspx?NAME=MELATONIN-...


Interesting! Any idea how they get around the legal issue?


It is legal to import prescription-only medicine into the UK, providing it does not have a higher level of scheduling too.


That link shows some automated content brought in from healthnotes/aisle7 which is a Portland, Oregon based company. If you search Amazon UK for melatonin you'll find lots of supplement that are described as 'melatonin-like' but don't contain any active ingredients.

I buy it when I'm in the US which is fine for me as I take it for jet lag but I know GPs (family doctors) I talk to are often confused to learn they can prescribe melatonin and will often prescribe much more powerful and, in my opinion, dangerous hypnotics. I think that's probably because there's no patent on melatonin so not much marketing push to inform GPs of its uses - though I believe there's a patented slow release version of melatonin that might get a bit of marketing behind it.


That page only describes melatonin, I can't see any products containing it for sale?


There was a study by Kripke showing that many sleeping pills, namely benzodiazepines, tripled your likelihood of death even if taken very infrequently.

Zopiclone is not a benzodiazepine but I don't know if it has been studied in a similar manner.


The upside of being a prescription med is that you can expect it to have better quality control.


The downside is that it's not usually prescribed to people under 55.

(http://www.nhs.uk/Conditions/Insomnia/Pages/MedicineOverview...)


Melatonin may help to battle cancer along with chemo: http://virtualtrials.com/pdf/williams2013.pdf (Page 46)

My life partner started taking 20mg melatonin per day when she started her chemo and radiation treatment after surgery for grade III anaplastic glioma (fully resected) about year and a half ago. She's taking it ever since. No side effects. It doesn't seem to help her sleep. She always fell asleep easily and slept good.

We decided it should be safe for her as there was a research (can't locate it now) where some women were given 20mg/day dose for, I guess two years or so, in hopes it shows some contraceptive properties. It didn't but no side effects showed up.


I've tried pretty much every Over-The-Counter sleep aid there is. Melatonin is indeed the most effective one I've tried, but my experience is that tolerance builds up rather quickly. I can use it every night for maybe 2-4 weeks, but after that, the amount required to achieve the same effects become absurdly high.

Also, one thing I like about Melatonin is the lucidity of the dreams I experience while sleeping with it. Colors, sensations, and my memory of the dream the next morning are very intense.

Currently I'm using Valerian root[0], which is all-natural, and I don't develop a noticeable tolerance.

0: http://en.wikipedia.org/wiki/Valerian_%28herb%29


I didn't see any citations for his claim that melatonin saves you an hour sleep per night. His entire argument is premised on this, but he barely discusses it - he just states it as a fact. Did I just miss something? Is there research supporting this claim?


It's my understanding that taking Melatonin supplements will mess up your bodies natural ability to make it's own Melatonin (as will taking a lot of supplements). You are far better off trying to get your body to produce Melatonin on it's own.


Citation?

The article says:

> A 2010 trial tested a delayed-release melatonin over 6 months and found minimal adverse effects and no tolerance or "addiction"


As for Melatonin Adverse Events, it's my site that's linked to under 'Uses', (http://www.drugcite.com/?q=melatonin) It's important to sort the data by age and gender as the AE's can vary greatly. That data is FDA FAERS data that runs against many other datasets by the way.


As I've pointed out in the past to you, I'm not sure what use we're supposed to be making of your admittedly nice site, given that we don't know how many people are using melatonin, how reliable any of these cases are, or what.


I tried melatonin thanks to this article (thanks gwern!).

It does help me get to sleep. I've used it about 10 times now and only once did I still have trouble falling asleep, and even then I did within an hour or so.

Unfortunately, it does NOT stop me from waking at 4:30 or 5 AM and then having trouble falling back asleep. Still, this is less stressful than not falling asleep in the first place.

Note that the probable effective dose is much lower than what you're likely to get in one pill from the store. I couldn't remember the effective dose, got 5mg pills, ended up quartering them.

I don't have any hangover effects, and I wonder if you all that do are taking too much.

It's worth trying if you have sleep issues.


I have had issues with going to sleep my whole life (nap time in preschool I was last to fall asleep and last to wake up). First I have to say I took 3mg as a test run and it did nothing. My gf then said they give 10-15mg for patients at the hospital.

9mg was too effective at putting me out in 30 min (I weigh 200lbs). It was too difficult to wake up in the morning. 6mg seems best. My minds eye feels like it's wearing a sleeping mask because dreams are few and far between.

When I stopped taking it, dreams became vivid and memorable. I also took ZMA before and that does nothing in terms of getting to sleep, but you get some crazy strong dreams while on it.


I've used melatonin and it definitely works, especially for improving the quality of sleep and sleeping under the sun.

However I've found that just not eating for 6-8 hours before you go to bed helps much more. Even eating an apple can disrupt sleep. This works really well because if you suppress eating before you got to sleep, you also wake up on time and pretty fresh to boot.

The only downsides are that some people get tempted too easily to eat before bed or that if you absolutely have to stay late an hour or two more, you'll still wake up 16 hours after you stopped eating, leaving you with less sleep than intended.


I used to have a wildly erratic sleep schedule. Then I had a baby. Now I sleep from 10 pm to 7 am every single night.

While I know a lot of people have sleep disorders, I think a lot of people have bad sleep schedules simply because they can.


I assume your child is grown up, because 10 hrs of sleep a night for someone with an infant is absurd. And unfair.


He's 12 months, and I am absurdly lucky he has slept from 8:30 pm - 7 am since 7 months. He is really intensely physical at all times while awake, which I think wears him out.


Ok, 1 year is reasonable. My daughter started sleeping though the night pretty early, too, but the first few months were weird and hallucinatory in their sleeplessness.


Post-children I try to go to sleep at 10pm (been an "owl" for most of my life) and am forced roughly awake at 6.30am (if I'm lucky).


I had been taking concentrated cherry juice which is high in natural meltonin.. made no discernible difference to me.. so I will try to see if melatonin tablets are available here (in New Zealand) and give it a go.

One thing I would love to know is (I may have missed it in the article) is whether melatonin supplements help with staying asleep. I fall asleep just fine (10-15 minutes, often earlier) but it's when my brain gets into a routine of waking up at 3 or 4 am that I find particularly hard to deal with. I've simply not worked out strategies around it yet.


This is my problem too, and it normally happens when I am highly strung. I have had success with meditation, but during very stressful periods I still tend to awaken at 4am.


Keep in mind that melatonin is a hormone. Exogenous hormones can downregulate your body's natural production. Like anything hormonal you should not take it continuously for long periods of time.


Yes, this was exactly what I thought when I began using it. (See my other comment on this article) https://news.ycombinator.com/item?id=6495786

In practice, however, that didn't occur, at least for me.

I have no idea why. It would interesting to see if this is true for others. It's certainly true for other hormones besides melatonin.


The pharmacokinetics of pill-form melatonin may be responsible for the uneven-, or late-onset and morning grogginess. Others here have reported that and I experienced it as well.

I have yet to see others mentioning the following answer so ...

My doctor advised using sprayed liquid melatonin (purchased at Whole Foods). 1-2 sprays under the tongue and held there for 30 seconds, then washed throughout the mouth (a highly vascularized area) and swallowed, transports the hormone consistently so that sleep is compelled in 1 to 1.5 hours with no morning grogginess.


Melatonin is this person’s religion. I wonder how much time they spend thinking and talking about it.

Stranger still is the herd of commenters who condone the stuff. Do you really think this will make you need an hour less sleep than everyone else?

Sleep is important. Don’t intentionally destroy your body’s ability to regulate it. If you aren’t already addicted to melatonin, it’s not too late:

Go to bed and wake up at the same time every day. Don’t drink caffeine after breakfast. Expose yourself to natural sunlight every day. Don’t play Grand Theft Auto after midnight.


I used to deal with periodic weeks of insomnia. As a stifle I really could not afford to spend a whole week without sleeping more than 5 hours as I would be basically non functional after a couple days. I began supplementing a single 5mg dose of melatonin and it has almost completely erased my insomnia. I have found that it has improved the quality of my sleep as well. The only side affect I've noticed is increased dreaming while taking it, however I quite enjoy that.


Melatonin is not easily obtainable here in the UK (as far as I know) so when I saw some in a regular store in the US, I grabbed some to try it.

And boy.. I usually have no trouble falling asleep except when travelling or otherwise "out of sync" so I tried it and I felt like I wanted to sleep almost constantly for two days. So it works, but perhaps a bit too well for me, even with a single tablet. Maybe I have an abundance of melatonin already coursing my veins? :-)


Got mine from biovea.com (with a eurovital.com logo shrugs ) ; they seem to have no problem whatsoever about shipping to the UK. IIRC, it's widely available in many countries in the EU (specifically eg. Finland), who have no problem whatsoever about shipping it to countries where it's prescription-only.


I suspect you already know this so this is for the benefit of third parties reading this.. but it's legal to buy prescription only drugs from overseas in the UK as long as they're only POM (e.g. modafinil) and not scheduled/classed (e.g. ritalin).


Melatonin supplements have helped me numerous times to get to sleep after tossing and turning in my bed. It is something that I've taken as needed and as a nightly supplement. The biggest drawback to melatonin supplements is that you can sometimes wake up slightly groggy the next morning. The stuff is dirt cheap and commonly available. If you haven't tried it, this could be the sleeper supplement your missing.


I don't think my body handles Melatonin very well... it definitely helps me sleep great! But the next day I am groggy for nearly half the entire day


There is currently a study being conducted at the Woolcock Institute in Sydney in its effectiveness to treat delayed sleep phase disorder among other circadian rhythm disorders. http://www.abc.net.au/news/2013-08-24/new-hope-to-treat-misd...


I experienced a strange side effect when experimenting with melatonin: My vision degraded as if I was having a migraine. I experienced tunnel vision and colorful artifacts without the headache. I can't say with 100% certainty that melatonin was the cause, but there was a correlation... and I have not experienced the problem since I stopped taking it.


The key to using melatonin is to stop every few days and see if you sleep through the night. If you don't keep going otherwise wait until you have two nights without proper sleep. I had major sleep problems but this system has worked great and I have not had to use melatonin in quite a while. Like everything, moderation is key.


A couple years back I was taking 3mg of melatonin nightly. It worked brilliantly for about 3 months. After that, while I'd feel sleepy and fall asleep as expected, I'd be wide awake 1 sleep cycle later (~90min).

I'd still recommend melatonin as a short term way to re-establish a regular bedtime/routine. Long term usage - less so.


I take 1.5 mg every night before going to bed. It has solved pretty much all my sleep problems, and allows me to control my sleeping schedule much more easily (ie. on weekdays I go to bed at 12:15 AM, but on weekends I usually go to bed at 3 AM. I have no problem re-transitioning back to weekday schedule now, but I used to).


Just throwing this out there... a bit of lost research on the subject. Pitty not all of the images were cached.

http://web.archive.org/web/20011211164100/http://www.mechabi...


I have been taking Melatonin for a while now. However, I do not take it daily. I usually take it to adjust sleep schedules after a poor pattern. Sunday night for example I would take it to fix my poor weekend sleeping schedule. I think it's great to FIX sleeping schedules, not necessarily to take daily.


I've taken it and really does help me sleep better. It helps me fall asleep easier if I wake up in the middle of the night. I was taking about 1/3 of a 3mg tablet.

I did stop taking it though because I felt depressed after about 2 weeks of taking it every day.

I will probably take it again periodically if I am traveling.


I've taken meltonin for 19 years now. I've moved up my dosage in the last few months. I stayed on a very low dosage for a really long time, but am up to 10mgs now, and sleeping wonderfully.

The main side effect is being much more tired when you wake up, and that is cured by coffee. I love the stuff.


The main side effect is being much more tired when you wake up, and that is cured by coffee. I love the stuff.

I noticed this the very first time I tried it - I slept in on a weekend, about 13h total and then felt very fuzzy and hung over.

That only happened once, and now I take it nightly.

Other recommended sleep hack: Tempur-Pedic sleep mask.

Seriously, it costs a lot more than the cheap plastic ones (although still only $30) but it is worth its weight in gold. For shift workers, it's great - you can sleep like a baby in full sunlight.


A new report in yesterday's Science (http://www.sciencemag.org/content/342/6154/85.full) indicates that vasopressin receptor antagonists might be the jetlag drug of the future.


I'm sure Melatonin is great, but it won't ever solve the "kids are waking up" problem.


Give melatonin to the kids.


Melatonin has made a huge difference in my life. I don't use it regularly, but when there's a day when I absolutely need to get a good night's sleep or other things will go badly, I no longer have to worry about it. I take 3mg of melatonin and wake up refreshed.


I take 3mg and it works to help me sleep after an hour. I try to get to bed by 10:30.

My biggest problem still is that my alarm at 6AM wakes me during my active dream cycle and most restful sleep. I'm not sure how to time shift that to meet my needs.

Any advice?


I was going to recommend sleepytime[1] to try and find a good time to go to bed at if you want to get up at 6AM. It looks like 10:30 is a good time though. Maybe try to find your sleep cycles and set your alarm for a time when you are not in deep sleep? There are some smartphone apps that are meant to help do this.

[1] http://sleepyti.me/


You can check [1] Sleep Cycle.

I'm using it mainly to track my sleep quality and to see my sleep patterns, but the app can wake you up when you're in the lightest sleep phase.

Unfortunately, I didn't use it extensively, so I can't give you adequate opinion on the wake-up function, but it's worth the try.

[1] http://www.sleepcycle.com


There's alarm apps that will let you set your alarm based on sleep cycles. If that doesn't work, you can try various sleep measurement devices to wake you up at the right time.


I miss my WakeMate!


Nightmares and sleep paralysis! Wheee! Advil works better as a sleep aid for me.


Given that this is a naturally-occurring hormone, is there any chance that taking Melatonin regularly could cause your body to "get lazy" and eventually produce less of its own?


Melatonin is prescription only in Germany. Bad luck, I guess.


Also in the UK according to some comments here[1]. Some comments suggested buying from websites like biovea. Do you happen to know if it's legal to buy there and import to Germany? (they even have a .de website in German).

I'm living in Germany, but not a native speaker, that's why I'm asking.

[1]https://news.ycombinator.com/item?id=6495576


I've tried it a few times. I find that I sleep like a rock, but have a dull, throbbing headache in the morning. My wife swears by the stuff...


It doesn't really make me fall asleep. It improves the quality of my sleep, making me wake up in the morning much easier.


If I take Melatonin I feel like I've got St. Elmo's Fire and I can't sleep at all for hours.


What is St. Elmo's Fire? I can only find a weather phenomenon.


I have a tactile perception of glowing all over my body. It's really creepy.



This happens to some people with Benadryl as well (though doubt its related, just anecdotal). Curious - have you tried multiple (reduced) doses?


Benadryl is a first generation antihistamine which crosses Blood-brain barrier and makes you sleepy. Its mechanism of action is very different from melatonin and it has much more severe side effects (bad feeling after wake up) than melatonin.


Anyone used Melatonin w/ 5-HTP?

Is it safe (is it worth it) taking Melatonin if you're under 30 years old?


This is very interesting. Wish hacker news had more hacking the human body articles.


Check OP's website for other hacks. Very comprehensive research(meta-analysis) on pretty much all nootropics and memory improving techniques.


Cool thanks. I'll check it out.


I tried it for a short while but it gave me vivid nightmares.


Why are all these Gwern.net posts showing up now?



See lef.org for more info


why is it so pro melatonin?




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