Melatonin: what is the appropriate dose for insomnia? - Literature Review & Commentary - Brief Article

Townsend Letter for Doctors and Patients, Jan, 2003 by Alan R. Gaby

In a double-blind crossover study of persons over age 50 years, 15 individuals with normal sleep patterns (controls) and 15 who had decreases in sleep efficiency received, in random order, a placebo and 3 melatonin doses (0.1, 0.3, and 3.0 mg) orally, 30 minutes before bedtime for one week each. Sleep data were obtained by polysomnography on the last three nights of each treatment period. The physiological melatonin dose (0.3 mg) restored sleep efficiency (p < 0.0001) and also elevated plasma melatonin levels to normal. The pharmacological dose (3.0 mg) also improved sleep efficiency; however, it induced hypothermia and caused plasma melatonin to remain elevated into the daylight hours. Although control subjects, like insomniacs, had low melatonin levels, their sleep patterns were not affected by any melatonin dose.

Comment: These results suggest that 0.3 mg of melatonin is an effective dose for treatment of insomnia in elderly individuals. Many melatonin preparations contain 3 mg per dose, an amount that was chosen somewhat arbitrarily in early studies. The larger dose is apparently unnecessary for the average person who needs melatonin to enhance sleep; the larger dose is also more expensive and may increase the risk of side effects.

Zhdanova IV, et al. Melatonin treatment for age-related insomnia. J Clin Endocrinol Metab 2001;86:4727-4730.