I was prescribed melatonin for a sleep complaint some years ago and noticed no detectable improvement: I didn’t get to sleep more easily, wake up less during the night, or feel more refreshed in the morning. What might explain this?
I’ve been prescribed melatonin recently myself, and it’s not helping me much. Here are my theories on the subject.
Melatonin is good for (at least) one thing: if you don’t fall asleep naturally, either at all or at a convenient time, taking melatonin can help fix that. (“Naturally” here means you feel tired and sleepy and genuinely want to go to sleep, so you don’t need to invest will to do so.)
A high level of melatonin tells your body to fall asleep. If you take melatonin at a time during the day when your body produces melatonin already, then the extra-high level may not make any difference. In other words, if the reason you had trouble falling asleep isn’t low levels of melatonin but some unrelated physiological problem, then there’s no point in raising levels.
The second possible scenario is what I appear to have. I have a natural sleep schedule that’s at odds with the day cycle. Left alone (e.g. during summer break), I wil go to sleep at 2am and wake up at noon. If I take melatonin at 10pm, I can fall asleep at 11. But my body still produces its own melatonin until noon, so I don’t wake up earlier—the net effect is that I sleep 14 hours and wake up tired.
The doctor said if I keep taking melatonin at a fixed time every day for half a year, my body may adjust its own melatonin-producing cycle to match. More likely it won’t, but there’s no alternative treatment that I know of. So far I’ve bee taking it for one month with only modest (possibly statistically-insignificant) improvement.
BTW, my prescribed dose is 5mg daily, higher than usual. The doctor said there are still no side effects ever reported, even with higher dosages. He’s a sleep expert, not a GP, so that has some credibility.
The plus side I’ve found is there are radically less distractions around at 1am, so I can often get more work done between 11pm and 2am than I can in the whole afternoon. Last night I managed to complete an entire application form for an internship with BP, whereas in the day all I’d managed was half a page of geometry notes.
Possibly even more importantly, mindlessly hitting refresh on facebook is not an acceptable activity at 2am, whereas earlier in the day it is, so if I am awake then, it’s because I’m actually working.
Indeed. If I moved to the US, after a few weeks I would adjust.
One solution is to create an artificial light & dark cycle that’s earlier than the actual daily cycle where I live. That would work—as long as I never left my room.
Surely you wouldn’t have to stay in your room 24 hours a day? You could go outside when the light and dark of your artificial cycle and the natural cycle coincided, couldn’t you? I don’t know how sensitive human clocks are—maybe going out at nine a.m. right after you woke up when you’re trying to fool yourself into “thinking” it’s noon would create problems having to do with the exact location of the sun—but it seems like there would be a window there.
You’re right, of course. I’ll do the calculations.
Assume I want to shift my sleep cycle 4 hours ahead (i.e. wake up 4 hours earlier, 8am instead of noon).
We currently have sunrise and sunset roughly at 6:30 and 17:00 local time. I assume for simplicity that this remains constant and also ignore DST.
I’ll want to simulate sunrise at 2:30 am and sunset at 13:00. So assuming the sun is “properly up” (high enough) starting at 7am, I can go outside from 7am-1200 and again after sunset at 1700. I have to stay at home during the night (for artificial lighting starting at 2:30) and during the artificial darkness period, 1300-1700.
This might actually be workable if there aren’t too many interruptions. Hmm...
One thing I don’t yet know is how exactly artificial lighting affects the body’s sleep cycle; how the body reacts to it differently than darkness and also differently than sunlight.
I have exactly the same problem. I also tried Lunesta and Ambien, which didn’t really work, and Rozarem, which is supposed to be quite similar to melatonin, and had similar but stronger effects. Nothing that worked. I also tried bright light therapy, which didn’t seem to work at all, and was very inconvenient. At the moment I’m on a free sleep schedule, which seems to cycle completely every 2-3 weeks. (I’m not sure because I’ve never kept a sleep diary.) That’s only currently possible because I’m unemployed.
The second possible scenario is what I appear to have. I have a natural sleep schedule that’s at odds with the day cycle. Left alone (e.g. during summer break), I wil go to sleep at 2am and wake up at noon. If I take melatonin at 10pm, I can fall asleep at 11. But my body still produces its own melatonin until noon, so I don’t wake up earlier—the net effect is that I sleep 14 hours and wake up tired.
If the melatonin works for the “falling asleep” part of the problem, why not simply use an alarm clock to wake yourself up after your desired number of hours of sleep?
Melatonin is best for sleep quality improvement with people who are above 40 as endogenous melatonin production usually starts to decrease from 30. You’re much younger than that, so sleep disturbances are less likely to be caused by low night melatonin levels (so supplementary melatonin is less likely to be a significant remedy).
For at least some of us, the decrease in sleep is a boon. I’m only 36, and over the past 4-5 years I’ve had a very noticeable decrease in sleep, without any apparent side effects. It’s not uncommon for me to sleep six hours and wake up refreshed before the alarm clock goes off, which is wonderful for someone who used to have to budget at least 8 hours a day for sleep.
It could be that you weren’t taking enough. Another major factor is your bedtime routine. Exercise, bright lighting, and other stimulating activities (video games, emotionally-engaging movies) can discourage sleep.
Is it? It seemed like a normal enough U-curve as far as I knew.
It varies drastically from person to person. The effective dose has varied by a factor of 60 even among people I’ve designed cognitive/nutritional stacks for and varies even more so in the general case.
The inverted U is also different to the way it is usually used. Usually things have benefits to a certain level but then disadvantages start weighing them down if the dose gets too high. The cognitive enhancement from stimulants like caffeine for example reaches a peak then declines along that specific metric. But you certainly don’t go back towards normal in the obvious effects. You’re totally wired. With melatonin some will get a drastic alteration in their sleep behavior at 0.5 mg while a mega dose of 100 mg is not incredibly disruptive. For a hormone and especially a hormone with mind altering effects you can’t usually get away with that.
I meant more in the way of clinical evidence, than anecdotes; I’ve never tried 100mg or heard of trying it before (my 1 9mg experience being sufficiently unpleasant to deter me from higher doses), so I guess I have to take your word for it on the claim of it not being incredibly disruptive.
Nope. A tentative hypothesis is sleep apnea, since my dad had that, but how well I sleep is extremely inconsistent (some nights I get excellent sleep, some nights I wake up a dozen times and am a zombie all the next day) and seems to correlate better with whether I’ve set an alarm than with any of the factors that are supposed to affect sleep apnea.
I was prescribed melatonin for a sleep complaint some years ago and noticed no detectable improvement: I didn’t get to sleep more easily, wake up less during the night, or feel more refreshed in the morning. What might explain this?
I’ve been prescribed melatonin recently myself, and it’s not helping me much. Here are my theories on the subject.
Melatonin is good for (at least) one thing: if you don’t fall asleep naturally, either at all or at a convenient time, taking melatonin can help fix that. (“Naturally” here means you feel tired and sleepy and genuinely want to go to sleep, so you don’t need to invest will to do so.)
A high level of melatonin tells your body to fall asleep. If you take melatonin at a time during the day when your body produces melatonin already, then the extra-high level may not make any difference. In other words, if the reason you had trouble falling asleep isn’t low levels of melatonin but some unrelated physiological problem, then there’s no point in raising levels.
The second possible scenario is what I appear to have. I have a natural sleep schedule that’s at odds with the day cycle. Left alone (e.g. during summer break), I wil go to sleep at 2am and wake up at noon. If I take melatonin at 10pm, I can fall asleep at 11. But my body still produces its own melatonin until noon, so I don’t wake up earlier—the net effect is that I sleep 14 hours and wake up tired.
The doctor said if I keep taking melatonin at a fixed time every day for half a year, my body may adjust its own melatonin-producing cycle to match. More likely it won’t, but there’s no alternative treatment that I know of. So far I’ve bee taking it for one month with only modest (possibly statistically-insignificant) improvement.
BTW, my prescribed dose is 5mg daily, higher than usual. The doctor said there are still no side effects ever reported, even with higher dosages. He’s a sleep expert, not a GP, so that has some credibility.
I’m interested in hearing more ideas, stories, …
I have a friend with this disorder, which sounds like what you describe. Pretty much what you have to do with that is be nocturnal.
I’ve been nocturnal since I’ve started attending university, but it makes for a lonely life. I’d rather fix it if possible.
The plus side I’ve found is there are radically less distractions around at 1am, so I can often get more work done between 11pm and 2am than I can in the whole afternoon. Last night I managed to complete an entire application form for an internship with BP, whereas in the day all I’d managed was half a page of geometry notes.
Possibly even more importantly, mindlessly hitting refresh on facebook is not an acceptable activity at 2am, whereas earlier in the day it is, so if I am awake then, it’s because I’m actually working.
Move to another time zone.
That wouldn’t help for the long term; circadian clocks, even wonky circadian clocks, are set by cycles of daylight and darkness.
Indeed. If I moved to the US, after a few weeks I would adjust.
One solution is to create an artificial light & dark cycle that’s earlier than the actual daily cycle where I live. That would work—as long as I never left my room.
Surely you wouldn’t have to stay in your room 24 hours a day? You could go outside when the light and dark of your artificial cycle and the natural cycle coincided, couldn’t you? I don’t know how sensitive human clocks are—maybe going out at nine a.m. right after you woke up when you’re trying to fool yourself into “thinking” it’s noon would create problems having to do with the exact location of the sun—but it seems like there would be a window there.
You’re right, of course. I’ll do the calculations.
Assume I want to shift my sleep cycle 4 hours ahead (i.e. wake up 4 hours earlier, 8am instead of noon).
We currently have sunrise and sunset roughly at 6:30 and 17:00 local time. I assume for simplicity that this remains constant and also ignore DST.
I’ll want to simulate sunrise at 2:30 am and sunset at 13:00. So assuming the sun is “properly up” (high enough) starting at 7am, I can go outside from 7am-1200 and again after sunset at 1700. I have to stay at home during the night (for artificial lighting starting at 2:30) and during the artificial darkness period, 1300-1700.
This might actually be workable if there aren’t too many interruptions. Hmm...
One thing I don’t yet know is how exactly artificial lighting affects the body’s sleep cycle; how the body reacts to it differently than darkness and also differently than sunlight.
I’ll have to think about this some more.
I have exactly the same problem. I also tried Lunesta and Ambien, which didn’t really work, and Rozarem, which is supposed to be quite similar to melatonin, and had similar but stronger effects. Nothing that worked. I also tried bright light therapy, which didn’t seem to work at all, and was very inconvenient. At the moment I’m on a free sleep schedule, which seems to cycle completely every 2-3 weeks. (I’m not sure because I’ve never kept a sleep diary.) That’s only currently possible because I’m unemployed.
If the melatonin works for the “falling asleep” part of the problem, why not simply use an alarm clock to wake yourself up after your desired number of hours of sleep?
Melatonin is best for sleep quality improvement with people who are above 40 as endogenous melatonin production usually starts to decrease from 30. You’re much younger than that, so sleep disturbances are less likely to be caused by low night melatonin levels (so supplementary melatonin is less likely to be a significant remedy).
For at least some of us, the decrease in sleep is a boon. I’m only 36, and over the past 4-5 years I’ve had a very noticeable decrease in sleep, without any apparent side effects. It’s not uncommon for me to sleep six hours and wake up refreshed before the alarm clock goes off, which is wonderful for someone who used to have to budget at least 8 hours a day for sleep.
It could be that you weren’t taking enough. Another major factor is your bedtime routine. Exercise, bright lighting, and other stimulating activities (video games, emotionally-engaging movies) can discourage sleep.
Too low of a dosage for your body’s tolerance level could explain it.
Too much is just as likely. Melatonin’s response curve is weird.
Is it? It seemed like a normal enough U-curve as far as I knew.
It varies drastically from person to person. The effective dose has varied by a factor of 60 even among people I’ve designed cognitive/nutritional stacks for and varies even more so in the general case.
The inverted U is also different to the way it is usually used. Usually things have benefits to a certain level but then disadvantages start weighing them down if the dose gets too high. The cognitive enhancement from stimulants like caffeine for example reaches a peak then declines along that specific metric. But you certainly don’t go back towards normal in the obvious effects. You’re totally wired. With melatonin some will get a drastic alteration in their sleep behavior at 0.5 mg while a mega dose of 100 mg is not incredibly disruptive. For a hormone and especially a hormone with mind altering effects you can’t usually get away with that.
I meant more in the way of clinical evidence, than anecdotes; I’ve never tried 100mg or heard of trying it before (my 1 9mg experience being sufficiently unpleasant to deter me from higher doses), so I guess I have to take your word for it on the claim of it not being incredibly disruptive.
You could take my word for it that large doses are not found to be incredibly disruptive (even in the long term) in clinical studies either.
Did you get a proper explanation for your sleep complaint?
Nope. A tentative hypothesis is sleep apnea, since my dad had that, but how well I sleep is extremely inconsistent (some nights I get excellent sleep, some nights I wake up a dozen times and am a zombie all the next day) and seems to correlate better with whether I’ve set an alarm than with any of the factors that are supposed to affect sleep apnea.