Melatonin Use for Sleep Disorders

Indications and Dosage

The American Academy of Sleep Medicine suggests the use of melatonin for adults with Delayed Sleep-Wake Phase Disorder (DSWPD), with or without depression (weak recommendation) 2
For children and adolescents with DSWPD without comorbidities, melatonin is suggested as treatment (weak recommendation) 2
The American Academy of Sleep Medicine recommends initiating with 3 mg of immediate-release melatonin for sleep disorders, with titration in increments of 3 mg if necessary 1

In adults without depression, melatonin treatment increased total sleep time by 56 minutes and decreased sleep latency by 37.7 minutes 2, 1
The most frequently reported adverse effects are daytime sleepiness (1.66%), headache (0.74%), and other sleep-related effects (0.74%) 4
Melatonin has been associated with an increase in depressive symptoms, and caution is recommended when prescribing for patients using warfarin and for patients with epilepsy 4

The American Academy of Sleep Medicine suggests that melatonin should be used as part of a comprehensive approach to sleep hygiene, not as a single intervention 5
For children with DSWPD without comorbidities, a dose based on weight of 0.15 mg/kg is recommended, administered 1.5-2.0 hours before the usual sleep time 2, 1
For children with DSWPD and psychiatric comorbidities, 3 mg if <40 kg or 5 mg if >40 kg is recommended, administered at 18:00-19:00 for 4 weeks 1