The author even sort of notes that with the differences between teenagers, 25 year olds and the elderly.
There's also a wide variety of sleep disorders which are touched on in the article.
I've suffered with 2.5mg before for long enough to understand that it doesn't work for me, no matter how many studies you have with 95% CL that the dose is much lower. The 5mg tablets work much better for me.
If you get results at a lower dose, that's fine, I won't tell you to try using more.
I'm a 49 year old though with moderately severe DSPD and at least used to have non-24 hour disorder and would be happiest letting my schedule shift 1-2 hours every night during college for a few years. If you're a 25 year old and you've never quite had sleep that fucked up which wasn't entirely self-inflicted due to partying then you're not me (most young people who think they have bad sleep disorders are just actively doing things to fuck up their sleep and when they stop doing those things they're magically cured -- and then they turn into the most insufferable assholes because they think they understand sleep disorders when they don't).
And one thing to understand about melatonin is that its not really an anxiolytic and if stress/anxiety is keeping you up it may not work (it will not make the pandemic go away). I also find that I need to take it about an hour before bedtime, and rather than making me tired, it more allows me to get tired. I still need a nighttime ritual to unwind.
Melatonin is not like a sleeping pill where more will necessarily make you more drowsy. It is a hormone that signals to your body that it is time to sleep. I can't find it right now, but there was a study of different doses in a large number of people that determined that just 0.2mg was more effective than larger doses for most people. And I've found that's true for me too. When I use melatonin, I use 0.2mg, and I fall asleep within half an hour, sleep a full night, and wake up feeling refreshed. If I use a larger dose, I sleep even less well than I would without a supplement.
I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.
I always wonder if some of the self reported dosage variability for pills comes from differences in absorbtion of pills. Maybe some ppl's stomach acids or bacterial flora destroy particular molecules more or prevents absorption more than in other ppl?
How do you dose it though? Lowest dose I can find is 1mg pills and even those are pretty rare in my country. Do you get 1mg pills, crush them and measure out on precision scales?
> . If I use a larger dose, I sleep even less well than I would without a supplement.
I stopped taking Melatonin because I noticed, on multiple occasions, that after a week of use my sleeping period became extremely easy to disrupt and resulted in a bad sleep.
I was taking a brand sold in costco, each pill being 5mg.
If I ever decide to try Melatonin agin I will try splitting it into 1/20 parts (0.25mg) and try again
> not like a sleeping pill where more will necessarily make you more drowsy
> I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.
So the problem I have with this reasoning is that I have tried this and the higher doses make me way more sleepy. I take a lower "correct" dose anyway (most of the time), but it has nothing to do with what works better.
Yeah I am flabbergasted a psychiatrist of all people would entertain the idea of a “correct” dose. They should look at their own practice and see the range of lithium, SSRI, antipsychotics, antiepileptics doses their patients are on — and these are for medications with far more studies about dose response than melatonin.
They should also know better that serum levels of a supplement/medication that acts centrally can be misleading.
>A single correct dose is a myth. The author even sort of notes that with the differences between teenagers, 25 year olds and the elderly.
The author spends several paragraphs citing studies, different cases and populations, and says explicitly why they concluded to the specific mg dose:
"Based on a bunch of studies that either favor the lower dose or show no difference between doses, plus clear evidence that 0.3 mg produces an effect closest to natural melatonin spikes in healthy people, plus UpToDate usually having the best recommendations, I’m in favor of the 0.3 mg number. I think you could make an argument for anything up to 1 mg. Anything beyond that and you’re definitely too high."
On the anxiolytic side - a warning for those susceptible to such things, when I was taking melatonin it caused me horrible anxiety, something I’d never experienced before. It stopped not long after I discontinued it.
I’m 30, with sleep disorder that fits exactly what you are describing. I’ll share my own anecdote.
I've taken melatonin in 0.3mg sublingual doses, it worked perfectly. It’s incredible the control it gives me over my sleep after having none for decades.
However it leaves me unmotivated the next day, like I don’t want to get out of bed and if I do, I don’t want to get out of the house or do anything. I thought it was coincidental but it’s systematic. Very annoying.
So I stopped taking it. I now only take it on days where I know I’ll be doing nothing the next one anyway. Curious if anyone has had a similar experience.
Concur. My sleep issues are not severe enough to risk the "do nothing" next day. Only on exceptional bad trends do I use melatonin now. but I may try some of the variants in this.
The "correct" dose happens to be 0.3 to 0.4mg for me. How did I determine that? I started with 3mg, got knocked out way too fast. Then went to 1.5mg, got knocked out way too fast. Rinse and repeat with 0.8mg. On 0.4mg I felt it was just about enough, and then I noticed 0.3mg sometimes helped and sometimes didn't.
> I started with 3mg, got knocked out way too fast.
Yeah, you see that doesn't happen with me with 5 mg.
I take it at least an hour before my planned time to go to sleep and it takes at least that long to kick in for me.
People responding to me still don't understand that there's significant interpersonal variation.
I literally don't understand this concept of melatonin "knocking me out". It doesn't do that to me at all. If I really wanted to just plug myself into a computer game or something I could easily power through the 5mg of melatonin and stay up until >3am.
Ok, in the context of commercial supplements being 10-30x the "correct dose" the significant point is that the commercial doses are stupidly high for anyone. People needing +/- 50% of the dose isn't the important part here.
No, some people need more than the commercial supplements provide. That's the point. The effective range varies by an order of magnitude. The author denies the actual variety of human needs.
Only thing that helped for me was finding a job that didn't care what time I showed up.
I still sleep weird times but at least I'm no longer laying there frustrated and extremely stressed at 5am that after laying there for 5 hours I'm not asleep and worried about oversleeping or just having to go to work without sleep to not risk being scolded about showing up late again.
As someone who was stuck on a 26 hour schedule for years, I just... grew out of it.
One day around age 26 it just went away after having been a problem since early high school. No clue why. If you're still young, your "problem" may simply be youth.
I've had this experience lately of waking up around 3 or 4 AM and having a hard time falling back asleep for 30 mins or so. Nothing catastrophic, but a bit annoying.
To address this, I've tried a couple of different things to help sleep: melatonin; and valerian root extract.
The valerian root worked great, until one night it gave me the worst sleep paralysis night terror of all time. Sleep paralysis is nothing new to me. Getting it once every other month or so, it's a bit unpleasant, but far from terrifying. Sometimes I can even leverage it to induce a lucid dream. But this was on a whole other level, with a full blown out-of-body hallucination and a demonic face across room that locked me in a state of raw horror and doom. Also, it made me feel mildly hung-over in the morning.
Never taking that stuff again!
Melatonin on the other hand, perfectly fine. I take a 3mg supplement with L-Theanine 1 hr before I want to sleep. Makes me nice and drowsy, and I sleep like a baby through the night. Can't speak to how it affects dreams because I have dreams every night anyway even without it. But overall really good experience.
Ah yes, the valerian nightmares lol. I used to take 200-500mg and had those occasionally. It is a good anxilyotic otherwise, sadly tolerance builds up real fast.
To be fair, it was way too much. Something like 4x the recommended amount. My reasoning was "more valerian means more sleepy" couldn't have been more wrong. 25mg teabag is probably like 10% what I was at.
I still enjoy valerian if it's in tea. Just not in a pill supplement form anymore.
Meditation is great and I enjoy it :) Relaxing and falling asleep isn't a problem for me. Just waking up in the middle of the night feeling wide awake is a bummer sometimes. Yes I can relax and fall back asleep again but it's a bummer that it happens at all.
I used to work 7pm - 7am night shift. 3 days on, 4 days off one week and 4 days on, 3 days off the next. With lots of melatonin, exercise and careful adherence to my bizarre schedule I was able to train my body into a diurnal inversion cyclical sleep schedule. As soon as my 3/4 day work week was over I would -- over the course of one day -- inverter myself back to being awake during the day. When my weekend was over I would invert back to sleeping during the day. I did this for years.
Work day 1: wake up 12pm, sleep 7am
Work day 2: same
Work day 3: same
Day off 1: wake up 12 pm, sleep at 10pm
Day off 2: wake up 8am, sleep 10pm
Day off 3: wake up 8 am, sleep 1am
Day off 4: wake up 12pm, sleep 3am
Repeat.
Melatonin was literally the only way I managed that.
I started to gradually notice some tossing and turning throughout the night in my mid 30s. I began taking one 100mg capsule of magnesium citrate right before I attempt to go to sleep. Has worked exceptionally well for about seven years now. Knocks me out, with no negative reaction to the magnesium (some people apparently have a negative stomach and or bowel reaction to magnesium supplements; I haven't attempted high doses). If I don't take it, I go right back to not sleeping soundly. The sleep feels high quality as well, I'm never groggy in the morning. And it's inexpensive, sub $2 per month. For something in the realm of more mild or typical restful sleep problems, definitely try it.
My wife suffered from sleeping issues for a very long time. She tried everything under the sun including nytol, sublingual melatonin , slow release melatonin, passiflora and other teas. Nothing really helped her until eventually someone suggested ZMA (a zinc magnesium complex used by bodybuilders ) . That was a saving pill for her and fixed her sleep.
My experience also. Melatonin did absolutely nothing.
ZMA makes me drowsy within minutes. I can fight that off but will eventually succumb. The only side-effect I've noticed other than the incredibly vidid and sometimes nightmarish dreams is that the effect will linger long into the next day.
Mind you, the sleep is incredibly deep and restorative. It's not like some other sleeping pills that just knock you out, but you never reach REM sleep, waking up feeling tired.
Amazed at the dosages of melatonin that people will take without thinking about it. It seems that the side effect profile is a lot greater than most people let on.
Totally feasible depending on the dosage you're looking for. You just may end up drinking a decent amount of tea (which some people don't love doing before bed).
Melatonin is not like a sleeping pill where more will necessarily make you more drowsy. It is a hormone that signals to your body that it is time to sleep. I can't find it right now, but there was a study of different doses in a large number of people that determined that just 0.2mg was more effective than larger doses for most people. And I've found that's true for me too. When I use melatonin, I use 0.2mg, and I fall asleep within half an hour, sleep a full night, and wake up feeling refreshed. If I use a larger dose, I sleep even less well than I would without a supplement.
I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.
The best melatonin pills would be both chewable and small dosage, but unfortunately they are hard to find. I suspect manufacturers have a hard time selling smaller doses because people think they’re getting a superior product with larger doses.
Personally I settled for a 500mcg chewable dose that I split in half with a pill splitter.
I use 0.25mg and agree completely. The most annoying part is I can't find any pills less than 1mg so have to do a shitty job of separating them into 4 quarters.
Melatonin helped me with my sleep a bit, but never a lot. What did help is much brighter light during the day (on a timer, so the lighting would become dark in the evening) and adding to the basically-useless blue-light filters on my devices some automatic timed screen brightness changes.
I used to have circadian rhythm disorders. The most common pattern for me was the pattern of delayed sleep-wake disorder i.e. night owl disorder. I also experienced non-24 hour sleep-wake disorder, where you go to bed at a different time every "night", offset by an hour or two. At my worst, I experienced irregular sleep-wake disorder, which consists of many short naps throughout the day, with no pattern from day to day. Comorbid with depression, of course. Even the most mild (delayed sleep-wake disorder) is like 50% comorbid with depression.
Fortunately I'm now mentally healthy and free from sleep issues, and I attribute that mostly to the lighting changes I've made to my apartment. I've also heard these kinds of changes can help with SAD if the lights are bright enough. Look up how bright the sun is, and try to get your apartment to at least 10% of that. (100% is still too expensive, and 10% seems to work fine.) Note that most indoor lighting is usually closer to 1%.
P.S. this is essentially "light therapy" which they prescribe with those pathetic little light boxes, but if you look up the amount of light they give off, it's not nearly enough (and not for a long enough period). Hence why the stupid light boxes had no effect, but my own lighting setup changed my sleep dramatically. Here is a setup similar to my own: https://arbital.com/p/lumenators/
P.P.S Another thing you can try if you have circadian rhythm issues is to exercise hard in the morning right at your desired wake-up time. I never had to try it, but I did see a promising study in mice that showed it could reset their circadian rhythm more dramatically than anything else.
P.P.P.S If your sleep issues are not circadian in nature, don't bother with melatonin. You develop a tolerance to the sedative effects of melatonin pretty quickly, in my experience.
I've been wondering about lighting brightness for a while now. Lighting still leaves rooms kind of dark - not even as bright as they look like with daylight, let alone the sun shining through the window. In nature the sun wouldn't be shining through a window either - it would be all around you. Should we perhaps get brighter lighting overall? Would that help with sleep issues? Eyesight?
Does anyone have any tips/advice to solve the inverse problem which is waking up on a regular schedule?
I mostly follow sleep best practices - no phone before sleep, sleeping at a regular time, meditation, blackout curtains, no caffeine after noon, etc and am able to fall asleep.
But however I have a problem with waking up. I either need 9+ hours of sleep or I’m awake in just 5 hours - almost a bimodal distribution. The lack of consistency makes it very frustrating to plan the day. Considering I got to bed around the same time each day, not being to able to wake up on the same time is quite puzzling to me.
As a night owl, I abandoned the consistent bedtime approach and went with a pure consistent waketime. The approach that worked for me was having the same wake time, irrespective of time of year, light levels, or tiredness. There are some days when I'm a zombie because I messed up and stayed up too late, but I treat that as a negative reinforcement learning.
The second step was to immediately get out of bed. No matter how warm it was, or how tired I am, no matter how much my brain protested. I moved my alarm to the other side of the room to facilitate this.
What made it stick for me was giving myself permission to be sleepy after the alarm, but not be sleepy in my bed. Many days I stop my alarm, and immediately go to the couch and give my brain some time to boot up before even going to the bathroom or having breakfast
It might be worth saying I _only_ sleep in bed (no reading, no phone, only sleep) and I make sure to _never_ sleep on the couch
5 hours is almost certainly not enough, and plenty of people need more than 8 hours, so 9 hours is probably what you need.
Are you able to go back to sleep after 5 hours if you try?
For a lot of people anxiety is the culprit -- for some people it prevents them from falling asleep, for others it wakes them up early. If anxiety is coming and going in your life, whether on a daily or weekly basis, that might be the explanation for the 5-hour nights.
I've read (or might be a YT video) that this could be genetic, some people have evolved to wake up at certain hours (something about provide protection to other tribe members).
This is all from my recollection, so you'll have to google around to get the scientific details.
Readit News
A single correct dose is a myth.
The author even sort of notes that with the differences between teenagers, 25 year olds and the elderly.
There's also a wide variety of sleep disorders which are touched on in the article.
I've suffered with 2.5mg before for long enough to understand that it doesn't work for me, no matter how many studies you have with 95% CL that the dose is much lower. The 5mg tablets work much better for me.
If you get results at a lower dose, that's fine, I won't tell you to try using more.
I'm a 49 year old though with moderately severe DSPD and at least used to have non-24 hour disorder and would be happiest letting my schedule shift 1-2 hours every night during college for a few years. If you're a 25 year old and you've never quite had sleep that fucked up which wasn't entirely self-inflicted due to partying then you're not me (most young people who think they have bad sleep disorders are just actively doing things to fuck up their sleep and when they stop doing those things they're magically cured -- and then they turn into the most insufferable assholes because they think they understand sleep disorders when they don't).
And one thing to understand about melatonin is that its not really an anxiolytic and if stress/anxiety is keeping you up it may not work (it will not make the pandemic go away). I also find that I need to take it about an hour before bedtime, and rather than making me tired, it more allows me to get tired. I still need a nighttime ritual to unwind.
I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.
I stopped taking Melatonin because I noticed, on multiple occasions, that after a week of use my sleeping period became extremely easy to disrupt and resulted in a bad sleep.
I was taking a brand sold in costco, each pill being 5mg.
If I ever decide to try Melatonin agin I will try splitting it into 1/20 parts (0.25mg) and try again
> I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.
So the problem I have with this reasoning is that I have tried this and the higher doses make me way more sleepy. I take a lower "correct" dose anyway (most of the time), but it has nothing to do with what works better.
They should also know better that serum levels of a supplement/medication that acts centrally can be misleading.
The author spends several paragraphs citing studies, different cases and populations, and says explicitly why they concluded to the specific mg dose:
"Based on a bunch of studies that either favor the lower dose or show no difference between doses, plus clear evidence that 0.3 mg produces an effect closest to natural melatonin spikes in healthy people, plus UpToDate usually having the best recommendations, I’m in favor of the 0.3 mg number. I think you could make an argument for anything up to 1 mg. Anything beyond that and you’re definitely too high."
Melatonin should never be taken by those with existing or predisposition to mental health conditions.
I've taken melatonin in 0.3mg sublingual doses, it worked perfectly. It’s incredible the control it gives me over my sleep after having none for decades.
However it leaves me unmotivated the next day, like I don’t want to get out of bed and if I do, I don’t want to get out of the house or do anything. I thought it was coincidental but it’s systematic. Very annoying.
So I stopped taking it. I now only take it on days where I know I’ll be doing nothing the next one anyway. Curious if anyone has had a similar experience.
YMMV
Yeah, you see that doesn't happen with me with 5 mg.
I take it at least an hour before my planned time to go to sleep and it takes at least that long to kick in for me.
People responding to me still don't understand that there's significant interpersonal variation.
I literally don't understand this concept of melatonin "knocking me out". It doesn't do that to me at all. If I really wanted to just plug myself into a computer game or something I could easily power through the 5mg of melatonin and stay up until >3am.
Helped me get enough sleep that my anxiety and ADD became 10x moreanageable. (ADD meds don't work for me, they blow up my anxiety.)
I still sleep weird times but at least I'm no longer laying there frustrated and extremely stressed at 5am that after laying there for 5 hours I'm not asleep and worried about oversleeping or just having to go to work without sleep to not risk being scolded about showing up late again.
One day around age 26 it just went away after having been a problem since early high school. No clue why. If you're still young, your "problem" may simply be youth.
Dead Comment
To address this, I've tried a couple of different things to help sleep: melatonin; and valerian root extract.
The valerian root worked great, until one night it gave me the worst sleep paralysis night terror of all time. Sleep paralysis is nothing new to me. Getting it once every other month or so, it's a bit unpleasant, but far from terrifying. Sometimes I can even leverage it to induce a lucid dream. But this was on a whole other level, with a full blown out-of-body hallucination and a demonic face across room that locked me in a state of raw horror and doom. Also, it made me feel mildly hung-over in the morning.
Never taking that stuff again!
Melatonin on the other hand, perfectly fine. I take a 3mg supplement with L-Theanine 1 hr before I want to sleep. Makes me nice and drowsy, and I sleep like a baby through the night. Can't speak to how it affects dreams because I have dreams every night anyway even without it. But overall really good experience.
These links might get you started on the topic:
https://www.sciencealert.com/humans-used-to-sleep-in-two-shi...
https://www.medievalists.net/2016/01/how-did-people-sleep-in...
I still enjoy valerian if it's in tea. Just not in a pill supplement form anymore.
Work day 1: wake up 12pm, sleep 7am
Work day 2: same
Work day 3: same
Day off 1: wake up 12 pm, sleep at 10pm
Day off 2: wake up 8am, sleep 10pm
Day off 3: wake up 8 am, sleep 1am
Day off 4: wake up 12pm, sleep 3am
Repeat.
Melatonin was literally the only way I managed that.
Dead Comment
ZMA makes me drowsy within minutes. I can fight that off but will eventually succumb. The only side-effect I've noticed other than the incredibly vidid and sometimes nightmarish dreams is that the effect will linger long into the next day.
Mind you, the sleep is incredibly deep and restorative. It's not like some other sleeping pills that just knock you out, but you never reach REM sleep, waking up feeling tired.
https://impossible.co/blogs/health/melatonin-side-effects
I've found a magnesium + l-theanine combo works wonders without any hormone interference or dependency issues to worry about.
I suggest to anyone who is taking 1mg or larger doses to experiment with a "microdose" of 0.2mg and see how it affects you.
Personally I settled for a 500mcg chewable dose that I split in half with a pill splitter.
They also last a reaaaly long time for me, because I take such a low dosage and I don't use them everyday.
For higher dose people, I would investigate a smaller dose that dissolves in your mouth/under your tongue.
In general - I'm surprised people take melatonin so casually without realizing that it's a hormone - not a mineral or amino acid like other sleep aids - https://impossible.co/blogs/health/melatonin-side-effects
Dead Comment
I used to have circadian rhythm disorders. The most common pattern for me was the pattern of delayed sleep-wake disorder i.e. night owl disorder. I also experienced non-24 hour sleep-wake disorder, where you go to bed at a different time every "night", offset by an hour or two. At my worst, I experienced irregular sleep-wake disorder, which consists of many short naps throughout the day, with no pattern from day to day. Comorbid with depression, of course. Even the most mild (delayed sleep-wake disorder) is like 50% comorbid with depression.
Fortunately I'm now mentally healthy and free from sleep issues, and I attribute that mostly to the lighting changes I've made to my apartment. I've also heard these kinds of changes can help with SAD if the lights are bright enough. Look up how bright the sun is, and try to get your apartment to at least 10% of that. (100% is still too expensive, and 10% seems to work fine.) Note that most indoor lighting is usually closer to 1%.
P.S. this is essentially "light therapy" which they prescribe with those pathetic little light boxes, but if you look up the amount of light they give off, it's not nearly enough (and not for a long enough period). Hence why the stupid light boxes had no effect, but my own lighting setup changed my sleep dramatically. Here is a setup similar to my own: https://arbital.com/p/lumenators/
P.P.S Another thing you can try if you have circadian rhythm issues is to exercise hard in the morning right at your desired wake-up time. I never had to try it, but I did see a promising study in mice that showed it could reset their circadian rhythm more dramatically than anything else.
P.P.P.S If your sleep issues are not circadian in nature, don't bother with melatonin. You develop a tolerance to the sedative effects of melatonin pretty quickly, in my experience.
Deleted Comment
I mostly follow sleep best practices - no phone before sleep, sleeping at a regular time, meditation, blackout curtains, no caffeine after noon, etc and am able to fall asleep. But however I have a problem with waking up. I either need 9+ hours of sleep or I’m awake in just 5 hours - almost a bimodal distribution. The lack of consistency makes it very frustrating to plan the day. Considering I got to bed around the same time each day, not being to able to wake up on the same time is quite puzzling to me.
The second step was to immediately get out of bed. No matter how warm it was, or how tired I am, no matter how much my brain protested. I moved my alarm to the other side of the room to facilitate this.
What made it stick for me was giving myself permission to be sleepy after the alarm, but not be sleepy in my bed. Many days I stop my alarm, and immediately go to the couch and give my brain some time to boot up before even going to the bathroom or having breakfast
It might be worth saying I _only_ sleep in bed (no reading, no phone, only sleep) and I make sure to _never_ sleep on the couch
Are you able to go back to sleep after 5 hours if you try?
For a lot of people anxiety is the culprit -- for some people it prevents them from falling asleep, for others it wakes them up early. If anxiety is coming and going in your life, whether on a daily or weekly basis, that might be the explanation for the 5-hour nights.
This is all from my recollection, so you'll have to google around to get the scientific details.