Indicates 2mg and 5mg were given along with the placebo. While these are common dosages available in the US, these are higher dosages than recommended by at least some sleep experts. The thesis doesn't seem to differentiate between the dosages when evaluating cognitive processes.
Now I want to evaluate my sleep stack against morning cognition.
I read a while back that our brains produce roughly 0.3 mg of melatonin when signaling us to go to sleep. When I occasionally do use melatonin I split a 1mg pill into half or thirds. I find that it works well enough to help me fall asleep. Wondering how the study would look if hwy used 1/2 mg doses.
Go to the Netherlands, to the Kruidvat (or Etos or something similar) and just buy a lifetime worth of supply of Melatonin. It's 0.1 mg.
I'm Dutch and live here. But my wife is American. If I ever happen to live in the US (chances are there in my lifetime). I'm going to employ this strategy.
I don't trust the US with this and the Netherlands has proven itself to me in this sense. There are probably many more European countries that do this well. I'm simply not changing a winning team.
But I'd love to hear from other people that believe they found a good melatonin supply in a country. I'm curious.
Drugs are regulated with the same care in the US, the problem is you are comparing a drug in Europe with a dietary supplement in the US. You can’t expect to grab a high quality of any dietary supplement from say Walmart. It’s the same in Europe. In the US there are labs making high quality dietary supplements, but you usually don’t find them at retail stores or even Amazon, so it needs a bit of research.
Walmart typically carries a large selection of supplements from the 'Nature Made' brand (yellow label), which tests/certifies most of their products through the independent 'U.S. Pharmacopeia (USP)'.
While that may not help with the arguments over the correct dosage, it at least means you can trust the ingredients and dosage on the label isn't a lie. A random mail order supplement or bulk powder seller on Amazon...not so much.
Fortunately, it's the former. It's a 200+ year old nonprofit founded by a group of physicians in 1820 that developed the modern drug standards that most of the world actually relies on.
Towards the bottom of the page at Delta's careers page you'll note that Delta's headquarters in Atlanta has a Walmart Pharmacy in it. Delta is essentially signalling to its constantly moving employees that you're more likely to find a Walmart near an airport than a CVS or a Walgreens (especially in super-rural America) and that pharmacy is a constant stream of pilots and flight attendants grabbing refills on their way through.
You seem to be beating around some kind of bush by intentionally neglecting to define your definition of "high quality" in this context. Are you saying that 1mg of melatonin from Walmart or Amazon do not actually contain 1mg of melatonin?
If they aren't sold in retail stores or Amazon how are they sold? Private websites?
Amazon requires random sampling confirmation for supplements from independent labs though, so anything officially listed in a supplement category should be reliable.
So much for a good faith discussion here. I don't appreciate that you tell me to "get a grip". You're not steelmanning. Instead, your reaction comes off as a knee jerk reaction. There are enough communities where I have to come up with defenses to deal with that nonsense. Don't do it here please.
US melatonin measured dosage can be 4x as much as what is reported [1, 2].
Also 0.3 mg is the recommended dose [4]. A lot of doses in the US are way higher than 0.3 mg. In the Netherlands it's stupidly easy to find 0.1 mg doses (e.g. at the Kruidvat or at the Etos). It's in part why I never looked further.
And since you're new here (55 days ago, 13 karma as of writing). I strongly recommend you to read the HN guidelines [3]. All people who are on HN should follow them, not knowing them degrades the community experience that we're having here.
> Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes.
> Comments should get more thoughtful and substantive
There are a few others that apply as well.
[1] Cohen PA, Avula B, Wang YH, Katragunta K, Khan I. Quantity of Melatonin and CBD in Melatonin Gummies Sold in the US. JAMA. 2023;329(16):1401–1402. doi:10.1001/jama.2023.2296
(referring to melatonin) yeah this is valid. I used to take melatonin every night, found out about the problems with us supply, couldn't find anything nearing 1/2 mg, and gave up. I took kids gummies for a few weeks, but I still think they were 1mg.
I can Google very well. The smallest dosages I found were 0.5 and 0.25 for kids (against AAP advice!)
The discussion was about 0.1 for finer grained control and implied ability to experiment with dosages rather than stick with third party selected dosage regardless of needs.
You can buy Melatonin in the US at 0.3mg doses. It's a Google away. Instead, you turn it into this silly anti-US statement. You didn't "not look further". You literally said you can't trust the US for this. Okay.
>And since you're new here (55 days ago, 13 karma as of writing). I strongly recommend you to read the HN guidelines
> You literally said you can't trust the US for this. Okay.
Refute my sources, I gave you sources. You're ignoring it. If you're ignoring the studies I provide, why have a discussion at all?
I've been getting melatonin at 0.1 mg for the past 15 years in the Netherlands. I first got wind that it was different in the US on a Huberman podcast. He got it from studies. I cited some.
Pharma and Healthcare was the implication I believe. The US approach to these things has a bad reputation internationally though I am informed that it’s an amazing system if you’re rich.
Let’s not conflate US pharma with their healthcare more generally.
The US is dominant in pharmaceutical and biotech, and FDA is generally excellent as a regulator, despite (IMO) sometimes being too conservative and resistant to any ideas not gestated within the agency. There are weird quirks (like the wide and wacky dosages of melatonin available over the counter, in this example) but most countries have such quirks.
US melatonin measured dosage can be 4x as much as what is reported [1, 2].
Have you never looked into stuff like this? It's all over social media and the claims are relatively easy to verify. I'm asking because I need to know if I'm in a bubble or not.
[1] Cohen PA, Avula B, Wang YH, Katragunta K, Khan I. Quantity of Melatonin and CBD in Melatonin Gummies Sold in the US. JAMA. 2023;329(16):1401–1402. doi:10.1001/jama.2023.2296
I used to do this too, but I learned that will give you inconsistent dosage as the pills aren't guaranteed to have the active ingredient spread uniformly.
Long ago when I paid attention to this, the wisdom was to watch out because most melatonin pills are targeted to geriatric patients. Old folks need a significant boost to their melatonin to deal with eroding sleep quality, not a little hit of it. So as a 30 year old or younger you want a fraction of what grandad is taking.
For sleep aids this is often not the case. I'm in my early 50s and tried Doxylamine Succinate 2 years ago for the first time - an innocent Costco "Sleep Aid".
I was beyond groggy - quite nonfunctional - until the following afternoon and would not have trusted myself with operating a car even then.
Doxylamine succinate is a fairly powerful antihistamine. I only take it when I'm sick, and I take a half -dose. It has closer to a 12-hour half life, which is why you felt so groggy. I have to basically take it at 7pm if I want to be operational by 10am the following day.
You wouldn’t, if you remembered that medically speaking, younger people “needing” melatonin pills has been pretty fringe until very recently, and the number of young people who need it is still comparatively small.
You can find smaller pills. But you might have to try several chains or order online to get them.
It's been the standard recommendation for dealing with jetlag in the last 15-20 years. And usually people who regularly experience jetlag due to repeated international professional trips are not elderly.
Last time I was in the US the lowest dose melatonin gummies I could find in a CVS were 1mg — kids gummies.
That's more than 3x the actual recommended dose for an average adult based on the research others have shared in this thread. So no, they're not starting from a sensible starting point.
Were they packaged as kid gummies or are you presuming that gummies = kids? Because that hasn’t been the case for a long time. Those vitamin D gummies I buy because I will take them instead of might take them consistently, are not child doses either. They’re marketing gummies to adults here.
There is a rumour that the high doses are because the correct dose was under patent.
I can only find that in a comment here: https://slatestarcodex.com/2018/07/10/melatonin-much-more-th... but I could have sworn it was in the main article when I first read it. (If so that makes it less likely, because the author revises his articles for correctness)
That (albeit long) article is worth reading. For example, it explains that melatonin is a phase signal, so being saturated with too much melatonin actually makes the signal less clear (as well as potentially causing other issues).
That's not a "rumour", it's conspiracy theory. Because everything is a conspiracy theory now.
No, the dosage is not patented. It doesn't even make sense. How would it work? "Oh, 0.5mg is patented, so let's put 1mg in the tablets and never sell 0.5mg".
I can get all kinds of dosages from the pharmacy. However, most of what they stock is "too high", probably because there's very little research/wisdom/knowledge around the supplement.
"Americans have a special horror of giving up control, of letting things happen in their own way without interference. They would like to jump down into their stomachs and digest the food and shovel the shit out."
I get what you're saying, but let's not pretend the modern world isn't meaningfully different. Artificial light is a big factor, yes. So are odd and constantly changing work hours from a world that now operates 24/7. So is the common expectation of monophasic sleep in general. So is travel and jet lag that we now have to endure, and dietary changes, and stimulants especially for folks who just don't even have 8 uninterrupted hours available for sleep. So are dramatic global temperature changes. The list goes on, and there is more data in this paper https://pmc.ncbi.nlm.nih.gov/articles/PMC11152632/
I can hardly blame anyone for wanting to "hack" or "optimize" their sleep. It seems more necessary now than it has ever been.
I suspect their point was that optimising sleep is relatively simple. Go to bed in a timely manner, keep your bedroom cool, use blackout blinds and sunrise lamps. Don't drink caffeine in the afternoon or evening. It's not rocket science.
I apologize for not reading the full study before submitting it on Hacker News and for the misleading headline on the frontpage given the context of the dosages used, I really should have noticed that the link only contained an abstract.
Would it not be easier to not drink so much caffeine late in the day? Unless you're jetlagged, there's not much evidence AFAIK that melatonin will induce sleep better than a placebo.
Not OP, but I’ve had horrible sleep over the past year. I had taken melatonin a while back before stopping, so on a whim, I decided to bite off a bit of one of my old 5mg pills before sleep. Didn’t give it any second thought — didn’t even think it would do anything. But I slept like a baby for the first time in months. And it’s completely reproducible.
I end up biting a lot of pills to get around that dose. I definitely always felt groggy until I dialed down the dose to just right, and it works perfectly: I fall asleep far quicker and more assuredly, and I don't feel to groggy. I can't believe they sell pills as large as they do, what other medication varies in dosage as much?
Vitamin B12 supplements can be found in a range covering about 4 orders of magnitude. The RDA is 2.4 ug/day and the Costco daily multivitamin provides 6mcg, but here is someone selling 10,000 ug supplements: https://www.hartzells.com/b-12-10000mcg-90960
It's easy to find any other order of magnitude between those if you like. A half-pound of beef liver would give you about 186 ug.
I suspect the dosage and absorption isn't fully understood yet or very individual. For me some 2mg pills work fine and other 3mg pills don't; currently I use 4mg time-release and it's mostly fine. 1 mg is definitely not enough for me.
I would be groggy a few hours after taking the pill but not in the morning.
Since they're not regulated as medication, melatonin pills have no guarantees about actual melatonin content. In studies, the vast majority of supplement labels are inaccurate.
And having a 0.3mg (300mcg) group - the dose many meticulous online self-experimenters have found sufficient, a mere 15% of their lowest-tested 2mg.
Would a headline "morning coffee found to cause stomach problems and anxiety" be reasonable, if the smallest dose tested was 7 cups – and that dosage fact was omitted from the attached abstract/story?
As someone who (foolishly) only drank decaf until my early 40s, I can tell you that the mental difference when you start drinking caffeine is just amazing.
It is wonderful stuff. And not only can you finally think in the mornings, but provided you don't get heart issues from it, it appears to reduce your risk of Alzheimer's substantially.
Everyone is different. I'm in my 40s and throughout my while life have found that caffeine only has two effects on me: 1) If I have any later than afternoon, I can't fall asleep when I want to, 2) If I have too much at once (like a single diet pop), I get the jitters.
Otherwise, literally no effect. I sometimes drink tea in the morning for breakfast (a London fog) and it doesn't affect my cognition or mood at all.
I take a 3mg every night, but I've read that independent labs have studied the common OTC brands and found wildly different Melatonin content than advertised.
Tangentially: as a 'young adult' I was a typical 'night owl'. Cognitivly I peaked between 10pm and 3am, typically slept from 4am to 11am. When I got kids and a more 'regular' job, I was forced to change to a more normal schedule. The transition from 'owl' to 'lark' was not easy. It took about 7 years. These days, I peak 7am to 1pm.
But when I moved on my own I found that it shifted quite naturally. I'd wake up earlier and go to bed earlier, and then productive peak shifted to be during working hours.
I think for me the key factor was primarily that the house was quiet after 9 pm.
If I wake up with sunlight I'm useless until noon. If I allow myself to sleep in the dark until when I feel it naturally, I will wake up at ~9AM and be super fresh mentally with a lot of positive energy.
Interesting. I’m also a night owl who struggled waking up like an early bird. Was the transition and efforts worth it? Recently I tried to find a better schedule other than spending another X years fighting my biological clock
As a night owl who tried to fight it for too long my advice is don't change your natural circadian rythm. For some reason hustle influencer culture made us believe we should wake up at 6AM for a productive day. We all have 24 hours, just do what works for you.
Most of Europe doesn't wake up that early. Only the US is obsessed with 4AM hustle culture. Stop that!
I tried to change my sleep for 10 years and for the last 2 I have been embracing the night owl rhythm. And yes I have kids and an amazing partner.
agree with this poster. my "normal" is falling asleep between 00h-02h (12am-2am) and waking between 09-10h (9am - 10am). waking up earlier than this usually results in me being irritable for the first few hours of being awake. i spent thousands on CBT-i in part to try and become a morning person and fix this. it did quell my insomnia, but the "morning person" part of my routine eroded away.
Not op, but I have been forced to switch to morning workouts for the past year and they as bad as they always were for me.
Above low intensity and I am impaired for the rest of the day - struggling with low energy, cognitively dulled and desperate for a nap. This applies even though it's not from sacrificing sleep at 05:00 like some folk do but a leisurely 08:30 or later.
My evening workout schedule (for decades) lets me push to total exhaustion and pass out immediately after eating. One of it's prime benefits was totally solving insomnia/sleep-procrastination of a night owl with an involuntarily regular sleep schedule. I am always spent after exercise not energised.
For me the difference is anaerobic vs aerobic exercise.
I can only go for a run first thing in the morning. Although, that's more about the empty stomach (and outdoor temperatures in summer). If I got sugar in my blood, food in my stomach, I kinda "crash" very soon and tend to get heart burn. The empty stomach also makes me feel lighter and the slight hunger feels in tune with the overall experience, if that makes sense. Running in the morning doesn't leave me tired, if I've reached the "maintenance level" (got no specific exercise goal, tho). Aerobic exercise has the benefit of giving me overall higher "energy" by making everything slightly less exhausting. And the peaceful calm of an early morning run in the green (city park) is a blissful, almost spiritual experience radiating into the day. That said, running in the evening can be fun, too, because I feel supernaturally fast. I do that too sometimes, if I feel very, very stressed/anxious and need an outlet.
On the other hand, doing strength training blood sugar is an asset, but pushing limits leaves me exhausted and tired no matter what. I presume, it's natural to feel tired, if the body has tissue damage to repair from exercise. The difference is, running can be done effectively (as far as health maintenance is concerned) without excessive tissue damage and inherently pushing limits as much.
It's silly to say that "Europe" has substantially different working hours for the majority of the population, compared to the US. Grindset hustle sigma influencers are an outlier of course.
For having lived in both continents, American is generally an early morning culture and Europe is generally an evening culture. There are local differences within the continents of course.
I wouldn't generalize Europe like that, our differences in the normal schedule are massive from north to south.
Here in Sweden, it's a morning culture. Blue collar workers often start work at 7, daycare is open from 6 in the morning for parents with early jobs, dinner is at 18 or even 17 for people. At 22, most places are closed including supermarkets and restaurant kitchens. Lunch for the vast majority of working people is at noon.
That is totally different to a country like Spain, where you see families - with kids! - start dinner at 21 or later. In Sweden people would say it's strange not to have your kids in bed by then. Lunch is at 14, cities are full of life until midnight every day.
A large part of that is probably due to daylight hours. A big chunk of Sweden is dark by 16 for the winter half of the year. During November-January there's minimal light and it's gone by 15.
Don't know about the US, but isn't it "9to5" there too? Is there much "culture" before 9?
I can say in Germany "9to..." is also applying to cafes, supermarkets, ... pretty much nothing is open before 8 in the morning (with the exception of stuff in train stations), even some supermarkets only open at 9. So there certainly is no "culture" earlier than that. School often starts at 8, so parents frequently start the day at 6 or earlier. Same if you got an hour commuting time etc.. I don't know anybody who would wake up at 4 by choice, tho.
Eliminate all screens after sundown. It's literally the nr 1 reason why people struggle. I used to as well (I could easily work in front of a monitor until 4am without getting tired with no coffee or anything). After that, avoid any bright white lights in the evening (usually kitchen/bathroom). It's not always possible, depending on your work and place of living and especially while travelling. I ended up getting extreme blue light filtering glasses too (make sure they cover your eyes fully so light doesn't leak in from the side). Looks ridiculous, but that helped a lot. Finally, add a wind down routine that does not involve any kind of mental or physical excitement. For me it was as simple as walking around the block for 10-15min. But it can be anything that doesn't stimulate you in any way. You can try to sit in the darkness and meditate.
You will not just sleep better, you will have no issues sleeping at night and getting up in the morning. Downside is that you will definitely be awake once the sun rises (sucks in summer if you live far from the equator) and if you shut the blinds and have no automatic opener you are very likely to oversleep. Tuning your body to the solar day has pros and cons.
You are assuming every brain is wired like yours. It has been proven multiple times that we all have different hormonal levels during the day based on the light patterns. Some people only produce melatonin several hours after it's getting dark.
Your assumption of a world where we all behave the same regarding sleep is one of the reason why the US became such a bad 6AM hustle culture.
You are conflating several aspects here. The 6am hustle culture originated during the industrial revolution in Britain.
And the reason why people struggle with melatonin cycles is because it is almost impossible to escape artificial light. A single bright light exposure at night can acutely alter your hormonal levels. I'm not saying that what I have done is easy or even possible for everyone.
Essentially some people will naturally delay sleep multiple hours after the last light. It is believed it might be an evolutionary mechanism to not have every single person asleep at the same time.
And I don't care where hustle culture started. It is more alive than ever in America.
All these studies are highly limited. In addition to general self-reporting issues, you can't say anything about natural day and night cycles unless you carefully control all light exposure (and ofc other stimulants like caffeine, exercise or simply noise) for an extended time. Noone available as participant in these studies would have been living like humans used to before artificial light. You can't expect an undisturbed circadian rythm from them.
What worked for me is mirtazapine at 7.5 mg (higher will make it a stimulant anyway). The irony is my doctor is really sceptical. A friend prescribed it to me, who is also a doctor. And he was a bit pissed at my doctor. Quite literally: "your doctor can fucking call me if she questions my methods and I will overflow her with research on this" type of vibe. He did quite some research into it. And I trust him.
Of course, do your own research, consult your own doctor, not a doctor. And as you say: it's not for everyone. But not enough people mention it.
Let me it at least kick it off by looking for a study myself [1, 2, 3] (I just used Google Scholar).
Four things I've noticed:
1. For the studies saying it only works for 6 weeks, not if you only take it three to four times per week (three is better). You can literally feel the habituation go up and down when you play with the dose. I become really sensitive to it within days.
2. First time I took it, it gave me a sedated feel for like 14 hours. So the first few times, you need to desensitize a bit to it actually (don't drive a car the first few times).
3. For me, when paired with 0.3 mg melatonin 2 hours before bed, it stacks.
4. When I'm super stressed, it doesn't work. I need to be and feel normal.
Again: not a doctor, not medical advice. My advice is to discuss this with your doctor and see if they know anything about it. If they don't, well then, I guess my doctor friend knows something that other doctors don't.
Interesting you're the first person to mention this.
I had chronic insomnia for >25 years (my entire life) making it extremely difficult to hold down a job or generally interact with society. I've since been on Mirtazipine for about 15 years and the difference is unbelievable.
In the UK it's only dispensed in 15, 30 or 45mg. I was started on 15mg but that left me extremely groggy for most of the next day. My doctor convinced me to move up to 30mg and I'm able to mostly sleep and actually function the next day.
It's not all roses and there's a handful of side effects. Personally I had about 6 months of metallic taste in my mouth and it absolutely buggered my sex drive. A few friends jokingly call it "mirfatapine" as it can make them binge-eat and put on weight, but personally I find the good absolutely outweighs the bad and it's literally life changing.
I know if I forget to take it, because I suddenly realise it's 4am and I'm still wide awake and gibbering. If I'm working festivals then I can _choose_ not to take it and go back to my old routine working 52-hour shifts before falling asleep.
Whilst I'm not overly thrilled at taking psychoactive drugs nightly, it's been the only thing I've ever found (and I spent a lot of my childhood trying anything and everything the doctors recommended and self-medicating in various forms) that actually makes it possible to sleep nightly, and therefore function long term when I'm forced to wake up for work. If you're desperate and out of options it's absolutely worth trying, but do be aware it takes months to become effective.
Edit: this comment got out of hand and also became a journal entry.
> Interesting you're the first person to mention this.
I'm also surprised it's not mentioned more. Maybe because it's regulated as a drug? I mean I'm also making a ton of necessary disclaimers.
> I had chronic insomnia for >25 years (my entire life) making it extremely difficult to hold down a job or generally interact with society. I've since been on Mirtazipine for about 15 years and the difference is unbelievable.
Same, entire life, my life was falling apart. Suicide would be realistic within 5 to 10 years. Now it's not. Suicide by insomnia is a dark thing but when I'm on r/insomnia I can relate. The agony is too much and when the insomnia hits hardest there's no willpower to stop anything, it's just pure suffering and torture. I wasn't there yet thankfully but insomnia is fucking dark and it is sad to see that there's not much more of a focus on it. It's damn debilitating. Moreover, like you probably did, I saw it as normal. Because Dutch doctors went with the "ah you're fine" strategy. Dutch doctors are quite stiff in that sense (if you're almost dying... sure then they'll help you. Or if there's something clearly wrong with you like a broken arm). It differs from US healthcare by quite a lot.
> In the UK it's only dispensed in 15, 30 or 45mg. I was started on 15mg but that left me extremely groggy for most of the next day. My doctor convinced me to move up to 30mg and I'm able to mostly sleep and actually function the next day.
I have a 15 mg that you can snap in 2 because it has a ridge in the middle (or however you call that).
> It's not all roses and there's a handful of side effects. Personally I had about 6 months of metallic taste in my mouth and it absolutely buggered my sex drive. A few friends jokingly call it "mirfatapine" as it can make them binge-eat and put on weight, but personally I find the good absolutely outweighs the bad and it's literally life changing.
No bad side effects at 7.5 mg here, thank god.
> I know if I forget to take it, because I suddenly realise it's 4am and I'm still wide awake and gibbering.
Same
> If I'm working festivals then I can _choose_ not to take it and go back to my old routine working 52-hour shifts before falling asleep.
Yea, the routine changes I can make are a super power. I can only be awake for 12 hours today and I need to sleep? No problem!
Stay awake for 20? Sure I'll just not use the drug.
It's insane. I am now almost the opposite, I have sleeping super powers.
> Whilst I'm not overly thrilled at taking psychoactive drugs nightly
I agree not thrilled either.
> that actually makes it possible to sleep nightly, and therefore function long term when I'm forced to wake up for work. If you're desperate and out of options it's absolutely worth trying, but do be aware it takes months to become effective.
For me it worked the first time taking it. We're all different that way.
What nudges me towards sleep (but is not enough):
1. 0.3 mg melatonin two hours before bedtime (a higher dose doesn't do much more for me)
2. L-theanine (makes me a bit more chill, literally a chill pill haha)
3. Apigenin (still under research if it's placebo or not)
4. Magnesium (sometimes; I think it's because I sometimes have a deficit, usually related to light restless leg syndrome. It always helps when I have restless leg syndrome)
5. Vipassana meditation (25% chance of knocking me out cold unmedicated, so pretty cool but also... not enough)
6. Cuddling with my wife before bed (also like a 10 to 25% effect, I need a higher sample size to do this unmedicated but don't want to risk my sleep rhythm nowadays)
7. Sleep restriction (apply strategically because 6 hours of sleep is not fun, especially not if you've had insomnia for decades - I have little reserves, even if I sleep well for weeks nowadays - insomnia fucked me up hard)
8. General CBT-I stuff and general sleep hygiene
9. I have a Spotify playlist that is my type of winddown music (very chill lofi, very chill chillstep, or slow Hawaiian guitar music)
10. Night walks. And they may actually be the key to fix my insomnia unmedicated but I'd need to experiment a lot. My insomnia is related to feeling "false energy". Aka I sleep 2 to 4 hours and I wake up and I feel like I'm immediately ready, immediately energetic. Wanna go for a 5 mile run? Sure! Sounds fun! And it usually keeps up x2 the ours I sleep (so 4 hours of sleep means 8 hours of feeling awake - and shit - but also awake; afterwards I completely crash). What a night walk can do is that sometimes I've noticed after 30 minutes I feel the "false" part of the "false energy" vibe and I notice I actually feel dead tired. Once that feeling comes over me like a blanket. I can go right back to sleep and fall asleep. The annoying thing is the feeling has to come.
11. Cuddling a pillow, even when I sleep next to my wife. It helps.
12. Temperature control. I don't notice temperature that well but when I self-reflected deeply I noticed higher temperatures keep me awake, and sometimes that was the actual issue.
13. Mosquito control (lights out, phone light on, small vacuum ready, easiest way to get rid of them)
--
Funnily enough I don't notice much of an effect that when I have blue light at night that it is harder for me to sleep. It probably has a mild adverse effect but nothing major.
All of these 13 things are not enough. I still miss 3 days per week on average by doing all of this. And sometimes I also get in a horrible loop if this happens from Sunday to Monday as I am prone of "if you feel super tired it can be even harder to fall asleep". I've lost a job from that effect. Losing that job is what made me determined to wage an internal war on it and let everyone know I was doing it. That's how I know to solve really difficult things: fix the problem or die trying. I was that desperate, which is my my doctor friend intervened after seeing me a year of doing that (knowing I was doing this for 3 years already).
Nowadays though it is:
1. Mirtazapine 7.5 mg (one hour before bed)
2. Melatonin 0.3 mg (two hours before bed)
I carry it in my pockets so I always have it so I can take it. It's a bit odd to have my sleep meds by day, but I've missed timings because I was too focused on something and wouldn't go upstairs or still at a friend's place just about to leave.
3. Mosquito and temperature control
These 3 things don't nudge me to sleep. They make me sleep.
For fellow insomniacs, we're all different but I hope there are one or two things that you haven't tried yet. I doubt it, but one can hope that they can help alleviate some insomnia of other people, haha.
Disclaimer: I'm not a doctor etc. I'm a former lifetime insomniac. And my friend quite literally saved me. For now at least he did. Who knows how long Mirtazapine is going to work, but I'm happy to see BuildTheRobots is on it for 15 years and still going strong. I know that anti-histamine medication are able to be taken for a lifetime. So that's a promising sign.
It was not an option. Kids need a regular schedule with school and things. It was rough though. I did not ever drink coffee before that time, but starting then I needed several cups just to avoid accidents in the morning.
"I grew up in Europe" can literally be any one of over 40 different countries, and even more education systems.
I am in Germany, and school starts at 8 in Berlin, 8:05 in Wiesbaden, 7:45 in some small cities in Baden-Württemberg... And those are only the ones that I, personally, experienced. I'm sure Poland and Spain have different times, not lastly owing to timezones etc.
Please don't treat all of Europe as one single country with one set of customs.
Yes Germany is famous for starting too early, it is an outlier.
The 5 countries around where I grew up have starting times between 8:30AM and 9AM. Overall Europe is simply nor as much as a morning culture as the US. Probably because life is more communal and cities have things to do in the evening (in the US, my theory is that car culture killed all energy in the evenings).
This is how I did it: this is about two things: mornings and evenings and both need attention. Set a new wake up time. Deduct 7 hours from it. Deduct one more for buffer. This tells you when you need to be in bed with lights out and trying to fall asleep to then get the mandatory 7h of sleep to be a functional human being in the morning. If your new wake target is 5:45, you need to be in bed lights out at 22:45 and since 21:45 with no screens. So you need to deduct another hour to cut off screens early, and in optimal case like -3 more to cut food intake and -6 more to cut caffeine intake. I got some reminders on my phone which let me know the time comes, so I spend the last hour before nights out reading or writing or whatever. So that’s evenings. In the morning my phone rings and to turn it off I need to scan a QR code in my bathroom (alarmy app). This forces me out of bed and then I drink about 500ml of water. I also have a smart plug with a LED light on it which go on together with the alarm clock and goes on for 20 mins. Once wake, I spend 15 minutes in front of it getting light in my face which signals the body the day starts. Then I get dressed and go out for a short quick walk/run outside (aka powerwalk) which gets my heart working. Then I come back, make coffee and start work. This way I get enough good quality sleep + each morning physical signals (water, light, movement) that signal my body it is action time. I was very surprised that already after a week my body started waking up minutes before the alarm clock! And that’s after decades of irregular late sleep! But consistency is key: early sleep and early wake up on as many days as possible. It is totally doable and you can streamline in into a simple process which doesn’t take much time or effort.
I have done all this and more. Done all the stupid advice you get from everyone who was simply a morning person living an irresponsible life but then grew up, hired professionals, and even tried prescription drugs for a period of time.
It is not totally doable. It just makes fitting into the economic world slightly less shitty.
I yearn for retirement not so I can stop working, but so I can finally get a full “night” worth of sleep and wake up with a clear mind for the first time since my 20s when I worked a night shift. It’s been decades of being rather miserable.
Not everyone is built for the current world, and the gatekeepers all apparently seem to be morning people who despise night folks.
Waking up is the easy part. Having your brain engage to full power is the hard bit. I will get 8-9 hours of sleep and still spend the whole day groggy until the evening, and then my mental energy and motivation really kicks in around 9pm or so. But then it’s time to wind down.
Vacations for me are just taking a week off so I can go back to my natural sleeping patterns and do personal projects at 4am.
In all software jobs I've had (small, medium, and big tech), there's been no question about my start time. This has allowed me to sleep until 9-10am, and start work at 11. Huge help for getting any amount of good work out of me.
Unless your team has "core hours" which basically align with US school hours and standup is at the top of that block...
But, yeah, generally this is true and is something that I miss from my FTE days. (I'm in tech sales now, and our hours are whatever fits into our customers' calendars...sometimes that means I start at 11, other times I'm going to be on an 08:00 zoom and like it!)
Anecdotally, I’m a night owl by default but if I force myself up for exercise at 7am, I am tired that night and I am better (mentally and physically) that day. My workouts aren’t as good as if they were after work, but it doesn’t matter if I’m going 3/4 times a week.
My mood is better, my routine matches the “world” better, and I would say I’m mentally sharper on those days too. YMMV
Being a coffee drinker, I would not agree with the "worth it" part, but I was indeed surprised to learn some time ago that a can of Diet coke contains 46 mg of caffeine, which is basically a half of espresso shot. We don't let kids drink coffee, but we let them drink coke, which just does not make any sense. Out of these two, I would assume espresso brings much less harm!
Recently, I started using an app to track my caffeine consumption during a day (there are a bunch of those in the stores), and even though I haven't stopped drinking coffee and not planning to, I'm trying to stay within a reasonable limit and switch to decaf if I'm close to it.
I’m curious where you are located? I’m in Canada and I don’t think I know anyone who would let a child drink a coke. I have a 14 year old and it still isn’t something we’d offer.
You are rarity/have sheltered kid well. ( Have met some families where kids never had fast food, sweets, like rod and todd Flanders in the Simpsons lol)
I'm on West coast, kids in elementary school, and half the bday parties in the lower grades families serving mini cans of coke for the kids (and juice with just as much sugar, pick your poison).
Goto any fast food joint/mcd and see 5yr olds with a soda.
I have traveled throughout Canada to east coast and kids love soda pop/coke too.
Not all kids like soda, many do.
Not all parents allow their kids to regularly have side, but may give as a special treat.
More and more kids are drinking coffee due to Starbucks type drinks, but that's mostly just sugar.
Why is it worth it? Why are you fighting against your natural circadian rhythm? We still all got 24 hours right?
My background is that as the poster above, I have always been a night owl, with the ability to function and wake up earlier if I need to.
For years I have tried to change it because of beliefs like yours that it was "worth it". Whenever I tried to change it I would feel unergetic, crappy and unmotivated. I would stumble on words and have terrible sleep. Yes, I tried to stop caffeine, use candle light only, ton of supplements. Nothing worked.
Since then I have accepted I'm a night owl, and I should embrace it. I have never felt better since the day I have decided to stop fighting it.
The 6AM hustle seems amazing in theory but at the end of the day we all only got 24 hours.
I have kids. I have an amazing partner, but can also rally the days I need to get them to school myself. But even when I need to wake up abnormally early (kids should never wake up that early but that's a different debate) I still don't feel like going to sleep early.
Next, the same experiment could be done with individuals who would be more likely to use melatonin supplements, or even just a broader group than "healthy young adults". I feel that the starting point of the experiment is a bit flawed since there's a high chance these healthy young adults don't have the problem the supplements are designed for. I'm not surprised about "We found no significant differences between the melatonin and sleep groups on any of our sleep measures" for these people.
Personal experience: I have mild insomnia* and I sometimes take melatonin. It generally does help, but I can be groggy in the morning, if I took it too late in the evening. Happens sometimes. But for me, it's so much better to be sometimes a bit groggy for a short while, compared to being completely exhausted from sleep deprivation all day.
*I was a startup founder for 10 years and practically did not sleep during that time. Even years after that life, it feels like my body is not responding to melatonin that much. Or my body is not secreting enough itself. Who knows.
> I feel that the starting point of the experiment is a bit flawed
This is from the first paragraph in the abstract:
> Exogenous melatonin has been shown to improve sleep in individuals with sleep disorders, such as insomnia and delayed sleep phase disorder. However, research on the effect of exogenous melatonin on sleep in healthy young adults is limited.
Exactly. The relevant comparison for someone with insomnia isn't melatonin vs perfect natural sleep, it's melatonin plus some morning grogginess vs not getting enough sleep at all
Generally yes, and I definitely am an advocate of getting enough sleep and good quality sleep.
Regarding "sleep more to be more efficient"; Hard to say without visiting a parallel universe. But in this specific case it was really about having enough hours in a day. Most of the work did not require me at my sharpest. If I was in the same situation today, Claude would be doing these menial things for me and I'd sleep more. But we didn't have Claude then.
It was a tech startup that I wanted to build without any outside money. With investments of course I'd just hire more people. I had luck and perseverance, and everything turned out great. I had 100% ownership and sold it for private equity. Now I only work because I like solving tricky problems, and not working gets incredibly boring after a while.
Well there are a lot of social pressures in the startup/tech world to be go-go-go. It's the pure form of grind culture, coming out of silicon valley over the last few decades.
Hard to discuss this with only a short abstract. They don't even give a dose or formulation of the melatonin, and details like "We found no significant differences between the melatonin and sleep groups on any of our sleep measures." raise more questions than they answer.
Hi Gwern, just wanted to say your post on melatonin helped me sort out my sleep in my twenties. I had hangups using it on a regular basis and your arguments helped me get over that taboo. Thank you.
The study is on "healthy young adults". How much improvement would you expect on someone who is already "healthy"? It's not like they are going to ascend and become superhuman.
Anecdote - I've used it dozens of times and I'm always foggy in the AM, so I avoid it if I have to be sharp the next morning. Perhaps it's a coincidence and this study is flawed, but I can believe it pretty easily.
What dose are you using? Most OTC melatonin supplements are sold in a 3 or 5mg dose, while the correct one is ~0.3mg or even lower for some people. High dose may be related to the fogginess.
same here.
I use 5HTP instead, apparently the same chemical pathway just goes in at a different point. no fog in the morning at all. Nice and sharp, feel good.
My understanding is that you ought to take melatonin in small doses (0.3 or so) an hour or two before sleep in order to get tired, whereupon you sleep (normally, ish, unless you take too much and then you get crazy dreams or sleep paralysis). If I take it and go right to bed I always wake up still in the 'window' of its effect.
I was taking small doses of melatonin before go to sleep for a year or two. To help me begin to sleep. I have a tinnitus. Usually I have a deep sleep. I can get sleep, I can sleep all night without problems. it's only the first hour that can be problematic for me.
I stoped like half year, and I don't having problems to sleep.
Like almost every psychoactive drug it really depends on the individual. I have ME/CFS from a strong genetic propensity to dysautonomia. I think that my ME/CFS is an autoimmune reaction to the dysautonomia where, counter intuitively, medications like melatonin and amitriptyline, by helping with dysautonomia, actually substantially increase energy levels and mental cognition during the day. My case is a bit extreme at ~1/20K but I think ~1/50 of the general population have a similar but much milder reaction. At N=120 a study like this would not be able to detect that. These ~1/50 people are more likely to have the sort of sleep issues / burnout that makes them more likely to reach for melatonin in the first place. So the more interesting study would be conditioned by the subset of the general population that have already decided they need melatonin.
Not OP but I seem to get a benefit from GABA. Valerian root is effective at inducing sleep but leaves me groggy and I've had paradoxical anxiety reactions to it and there's some question around its longer term use. L-theanine is often mentioned but I'm not sure I benefit. Magnesium glycinate is another that comes up often.
Doxylamine for OTC, but if you take too much it will really make you groggy the next day (other people in the thread have shared the same experience.) Zolpidem/Ambien works really really well, but it's prescription only and also addictive so doctors advise to not take it more than a few days in a row at max.
Be careful with long-term or frequent doxylamine use, especially if you’re older. It’s an anticholinergic drug, and studies have linked sustained anticholinergic use to increased dementia risk, though it’s not proven the drugs cause it.
Insomniac for 20 years. What was a complete solution for me was: magnesium, b6 p5p (p5p form very important) and the ultimate punch glycine.
Glycine takes some getting used to, as you will have crazy intense dreams at first. But it is a very safe supplement to take even in large doses.
I always had huge insomnia issues after a physically intensive days after workouts. The stack I settled on solved it. A heavy day just needs a bit more magnesium and quite a bit more glycine.
As with so many experiments, the study itself is clear and testing something valid, but when it gets shared somewhere like reddit/HN/Facebook etc. everyone takes the broadest possible, unintended reading.
- study: we tested specifically healthy young adults and found melatonin may have a negative effect on this cohort. We make zero claims about any other cohort.
- every lay person reading the study, of any age: scientists just proved melatonin makes me dumb in the morning! Oh no!
In holistic circles, people swear by magnesium. Magnesium glycinate in particular has worked really well for me. It makes sense, because magnesium is a co-factor for converting tryptophan into serotonin, which is turned into the hormone melatonin. So, you could try supporting your body's natural production of sleep hormones by ensuring you have enough available tryptophan and magnesium in your diet.
A couple of years ago, my wife (around 40 at the time) was struggling to sleep (she had very light sleep and woke up in the middle of the night for no reason). She tried most of the things everybody recommends, melatonin, slow release, Gaba, magnesium, etc. The only thing that helped was ZMA (a compound body builders use with Magnesium and Zinc).
No idea why, but while the Magnesium alone didn't do anything, the ZMA helped her.
Nowadays we always have a bottle by the bedside. I use it sparingly whenever I want to get deep sleep. What I like vs Melatonin is that when I take Melatonin I dream a lot and I dont feel that "rested" next morning. I even wake up groggy. With ZMA, I sleep very deep, like shut my eyes and suddenly I am wake next day. I feel way more rested.
My understanding is that melatonin can overload certain receptors and cause an issue with fogginess since it works directly on the brain. 5HTP is more broad and is “gated“ on the same metabolic pathway, so cannot overload the system the way melatonin does.
Recently, I started taking a 3mg dose of melatonin for 1-3 days after flying to a timezone requiring a fair amount of effort to get a full night's sleep (3-6+ hours time difference), and find it helps to quickly get me on the new schedule. I maybe feel a little groggy, but nothing unsettling.
Note: I take a trip like this maybe once or twice a year (no more), and typically wake up with zero grogginess otherwise.
Anecdotally, I've taken 3mg a couple of times to adjust my sleep schedule and have found that I do feel a bit drowsy/slow the next morning. Fine for me since it's just ad hoc usage, but I wouldn't take it nightly.
This may just be too much. I settled up on 0.2mg dosage - you can find 0.1mg tablets, easy to try different dosages with them. Also seems to work better if you take it 2-3 hours before sleep.
I live in the US and I take 300mcg - Extended Release - once in a while mainly after/before long flight - (depending on the time). And it works fine. It doesn’t work well for me after a good meal. So pop two or take it before the meal.
My experience with Melatonin was very hit-or-miss. Sometimes it landed like a hammer and I was very groggy the next day. Sometimes it seemed not to work at all. This was with all sorts of doses.
I've found Tart Cherry - as an OTC supplement to work much better. More pleasant drift off to sleep, less waking up at night, and no morning grogginess.
The body gets used to melatonin. It is actually a crap sleep supplement. It works worse every time you take it. What you should be doing is give the body the ingredients it needs to make its own melatonin like it is suppose to work.
As a long term insomniac the head line result is not surprising. My overall experience with "sleep aides" is they all lead to impairments in morning cognition. The worst of which don't last just the morning... (seroquel, I'm pointing at you...) Melatonin is surprisingly powerful for a hormone / supplement. For me, it hits like a truck, and I find it strong enough that I had to stop taking it.
I'd be careful with the methodology here. There's been research that shows that most melatonin supplements are megadosed, with something like the "physiological dosage range" being 1 - 2 micrograms (ug.) So I'd hope the researchers got a trustworthy source for their tablets. It seems to me that with such a low dosage range you don't have much margin to avoid errors.
I think when it comes to sleep problems the worst possible place to start is with pills. Pills quickly lead to dependence and a lot of them either stop working or introduce so many side effects that there's little "therapeutic benefit." I think the right approach for insomnia is to focus on improving overall health. A lot of symptoms people go to the doctor for in that category are due to life-style factors. So if you maintain healthy habits you don't have to end up on 10 different pills just to function...
I would love to find a natural or lifestyle remedy to common RLS or PLMD symptoms that I get from time to time. The problem is that for some people it's impossible to identify what are the triggers and sometimes it's just genetics you have no control over.
But sure, do tell people to avoid doctors and make them suffer even though there are drug remedies that don't cause dependence and augumentation.
Being charitable to OP, I think their advice is to look after your health before hyper focusing on your sleep. I’ve had a similar experience - the better I care for my body the better my sleep is (and the opposite is a self reinforcing cycle). For me, personally, CBT and therapy helped hugely with the feelings of overwhelm I got from feeling like I wasn’t getting enough sleep and gave me the tools to deal with the fact that I’m not going to fall asleep at 11:30 and wake up at 7:30 like I would like to. It’s not perfect, but what is?
I could be convinced, however for me personally sleep defines how I feel throught the day, and if my sleep is bad or not restorative, it's almost impossible to take care of myself and adhere to "being healthy and mindful" because it requires just too much energy I won't have.
Yeah - that’s what I mean by it being a self reinforcing cycle. I have no kids which helps hugely, but I have a checklist of things to do that I made during a period when I was feeling good and had good habits. I don’t think it matters what that list is, but I’ve found that doing those things on that list has 0 impact on my mood that day but “would you rather be tired and not exercised than tired and exercised” is a good motivator for me.
Some element of it is not taking advantage of your body when you are restored - if you empty the tank every time you’re feeling good you’re always going to yo-yo a bit.
> The results suggest that negative performance effects of exogenous melatonin may outweigh any benefits for healthy young adults
Not surprising at all. The vast majority of people taking supplements are avoiding either the doctor, eating a better diet, or regular exercise.
What are the odds that someone comfortable taking overpriced sketchy pills is also probably comfortable taking other substances? I only have to look at any random suburban strip mall in the USA to get my answer. I always chuckle at the IV drip place next door to the bar.
melatonin should be consumed in doses an order of magnitude smaller than the smallest available dosage. melatonin should also be consumed in a particular time period to correctly trigger the circadian rhythm. long term consistent melatonin use is not advised outside of special cases (eg elderly where morning cognition is unimpactful). irregardless I don't believe that consuming modified release melatonin is healthy long term, because it breaks the circadian rhythm ... but if it works it works.
if you can afford expensive supplements, perhaps consider trying magnesium threonate for sleep. anecdotally this caused intense dreaming, leading to 1 less sleep cycle being required for restfulness. you could also try eating tons of tabouli and see if a massive apigenin hit calms the body for sleep. skullcap as a tea has some interesting properties regarding GABA modulation. on tea, passionflower is a decent MAO inhibitor and knocks some people out, but that's way less sustainable than melatonin. lastly dont lie down on your right side after eating!!!
>melatonin should be consumed in doses an order of magnitude smaller than the smallest available dosage.
It's available on Amazon in doses as low as 100mcg: https://www.amazon.com/dp/B08MJL2GTC Are you saying this because you believe the correct dose is on the order of double-digit mcg, or because you're under the impression that the lowest available dose is single-digit mg?
the lowest otc dose I previously witnessed was 1mg, perhaps my phrasing should have been "smallest commonly available dosage", because the correct dose is indeed in the vicinity of 100mcg
https://d.lib.msu.edu/etd/51312
Indicates 2mg and 5mg were given along with the placebo. While these are common dosages available in the US, these are higher dosages than recommended by at least some sleep experts. The thesis doesn't seem to differentiate between the dosages when evaluating cognitive processes.
Now I want to evaluate my sleep stack against morning cognition.
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