Melatonin: Sleep Aid or False Friend?

Melatonin is a hormone naturally produced by the pineal gland in response to darkness. Its main role is to synchronize the internal biological clock with the day-night cycle.

When melatonin is useful

• Jet lag: 0.5 to 3 mg taken in the evening at destination, for 2-3 days. Well-demonstrated efficacy.
• Night work: helps with falling asleep during the day
• Phase delay (chronic late sleeper): taken 4-5 hours before the desired bedtime
• Elderly people: natural production decreases with age

When it is NOT the right choice

• Psychophysiological insomnia: classic insomnia related to stress and rumination responds better to CBT-I (Cognitive Behavioral Therapy for Insomnia)
• Nocturnal awakenings: melatonin acts on falling asleep, not on maintaining sleep
• High dose: beyond 3 mg, efficacy does not improve and side effects increase

Practical points

• Take 30-60 minutes before bedtime
• Start with the lowest dose (0.5 mg)
• Melatonin is not a sleeping pill: it gives a signal to fall asleep, not a sedative effect
• In France, supplements are limited to 1.9 mg; beyond that, it is a prescription drug

Melatonin is a chronoregulator, not a hypnotic. For chronic insomnia, consult a sleep specialist rather than increasing doses.