Why Melatonin Isn't Working for Your Sleep Issues?

Ineffective Melatonin Supplementation?

Hello, Doctor Gao: I have struggled with unstable sleep since childhood, and I wonder if it is related to my severe ADHD.
As an adult, the problem has only worsened.
I often cannot fall asleep at the designated time, regardless of whether I only slept five hours or even two hours the previous day.
Despite having a high level of physical activity, not taking any naps, and avoiding caffeine, I usually only feel sleepy after 22 to 25 hours.
With rotating shifts, this often leaves me in a difficult situation.
Recently, I heard that melatonin is effective for some people, so I bought a bottle of 10 mg white capsules.
I read online that some people find 3 mg to 5 mg effective and I worry about overdosing.
However, the first few times I took one capsule, it had no effect.
Last night, after waking up at 11 PM, I took two capsules totaling 20 mg at 3 AM to see what would happen, but even now, 18 hours later, my eyes are still wide open, and my thoughts are sharp.
It seems that unless I stay up until two or three in the morning, I will have a hard time feeling any sleepiness.
I previously tried Seroquel, but I don't know what condition my brain has; within a minute of taking it, I would fall into a forced sleep and uncontrollably slam into walls, causing my head to swell while feeling euphoric.
At that moment, I was very aware and had clear memories, but my brain felt compelled to act that way, so I stopped taking it.
Doctor, do you think that taking 20 mg of melatonin and still feeling energetic after nearly a day is a noticeable situation, or is it quite rare? What other methods could improve my insomnia? Thank you.

Niming, 30~39 year old female. Ask Date: 2015/12/22

Dr. Gao Chunde reply Neurology

Insomnia can have many different causes.
If you have taken the maximum dosage without any response, it is still advisable to consult a psychiatrist to evaluate whether there are other secondary factors interfering with your sleep.

Reply Date: 2015/12/22

More Info

Melatonin is often touted as a natural remedy for sleep issues, but it doesn’t work for everyone. Your experience with melatonin, particularly the high dosage of 20 mg without any sedative effect, raises several important points about sleep regulation, individual differences in response to supplements, and the complexities of sleep disorders.

Firstly, melatonin is a hormone that regulates the sleep-wake cycle. It is produced by the pineal gland in response to darkness, signaling to the body that it’s time to sleep. While melatonin supplements can help some people fall asleep faster, they are not a one-size-fits-all solution. The effectiveness of melatonin can vary significantly from person to person due to factors such as genetics, the underlying cause of sleep disturbances, and individual biochemistry.

In your case, the fact that you have a history of severe attention deficit hyperactivity disorder (ADHD) may play a significant role in your sleep difficulties. ADHD can be associated with sleep problems, including insomnia, restless legs syndrome, and sleep apnea. These conditions can disrupt the natural sleep cycle and make it challenging to fall asleep or stay asleep, regardless of melatonin intake.

Moreover, the dosage of melatonin is crucial. While some individuals find success with lower doses (around 1-3 mg), higher doses like 10 mg or more can sometimes lead to paradoxical effects, such as increased alertness or vivid dreams. It’s also important to note that taking too much melatonin can disrupt your body’s natural production of the hormone, potentially leading to further sleep issues.

Your experience with Stinose (a brand of sleep medication) suggests that you may have a unique reaction to certain sedatives. The fact that you felt compelled to move and had a heightened awareness while under the influence of the medication indicates that your brain may process these substances differently. This could be due to a variety of factors, including your neurochemistry and the presence of ADHD.

Given your situation, here are some recommendations to consider for improving your sleep:
1. Consult a Sleep Specialist: Since you have persistent sleep issues, it may be beneficial to consult a sleep specialist who can conduct a thorough evaluation. They may recommend a sleep study to rule out conditions like sleep apnea or other sleep disorders.

2. Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a structured program that helps individuals identify and replace thoughts and behaviors that cause or worsen sleep problems. CBT-I has been shown to be effective for many people with chronic insomnia.

3. Sleep Hygiene Practices: Establish a consistent sleep routine by going to bed and waking up at the same time every day. Create a relaxing bedtime environment, limit screen time before bed, and avoid stimulants like caffeine and nicotine in the hours leading up to sleep.

4. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, or progressive muscle relaxation can help calm your mind and prepare your body for sleep.

5. Limit Stimulants and Heavy Meals: Avoid heavy meals, caffeine, and alcohol close to bedtime, as these can interfere with your ability to fall asleep.

6. Consider Alternative Therapies: Some individuals find relief from sleep issues through acupuncture, herbal supplements, or other holistic approaches. However, it’s essential to discuss these options with a healthcare provider to ensure they are safe and appropriate for you.

7. Medication Review: If you are currently taking any medications, discuss with your doctor whether they could be contributing to your sleep issues. Sometimes, adjusting the timing or dosage of medications can help improve sleep quality.

In conclusion, while melatonin can be beneficial for some, it may not be the right solution for everyone, especially in cases of complex sleep disorders or underlying conditions like ADHD. A comprehensive approach that includes professional guidance, behavioral strategies, and lifestyle modifications may yield better results for your sleep challenges.

Similar Q&A

Melatonin for Sleep Disorders: Does It Really Help?

Melatonin is a hormone that regulates sleep-wake cycles and has been studied for its effects on sleep disorders, including insomnia, frequent awakenings, and early morning awakenings. Research suggests that melatonin supplementation can be effective in improving sleep onset, incr...

Dr. Cai Jueren reply Family Medicine
Hello, melatonin has become a popular topic in medicine in recent years. Some claim it can combat aging, but the experimental results are inconclusive. Others suggest it can treat insomnia, yet there is no scientific evidence to support its efficacy, and the safe dosage has not b...

Struggling with Sleep Issues: Seeking Solutions for Better Rest

Hello, doctor. When I was younger, I could fall asleep instantly and sleep through the night until morning. However, over the past decade, I have gradually developed issues with staying up late and difficulty falling asleep. In the past, this was not a significant problem, as I c...

Dr. Wang Zhenbang reply Psychiatry
Hello, a person's sleep patterns may change with age and other factors. Here are 10 recommendations for better sleep, especially note the 10th point: 1. Maintain a regular schedule. (Go to bed and wake up at the same time. Regardless of what time you fall asleep, you shoul...

Melatonin: Drug or Supplement? Exploring Its Effectiveness for Insomnia

Currently, melatonin is classified as a dietary supplement in the United States. Regarding its efficacy for insomnia, research suggests that melatonin can be effective in improving sleep onset and overall sleep quality for some individuals, particularly in cases of circadian rhyt...

Dr. Hou Fangmin reply Pharmacology
Hello: Melatonin, also known as "poly-melatonin," is a hormone secreted by the brain's pineal gland. It causes the aggregation of melanin granules in the pigment cells of frog skin near the cell nucleus (hence the name poly-melatonin), making the skin appear lighte...

Struggling with Insomnia: Why Sleep Aids and Coffee Aren't Working

I can't fall asleep even when lying in bed; my mind keeps racing with thoughts, whether it's songs or past events, and I can't help but feel restless. However, after having breakfast and lunch, I feel an overwhelming urge to sleep, to the point where I lose conscio...

Dr. Qiu Junda reply Psychiatry
Hello: Insomnia is quite common in today's society, and its causes are not necessarily simple; they can include physical, psychological, and environmental factors. It is recommended that you practice good sleep hygiene (there are many educational articles available online). ...