🧠 What Is Melatonin?

Melatonin is a hormone naturally produced by the pineal gland in the brain. It's often called the "sleep hormone" because of its central role in regulating our body’s internal clock, also known as the circadian rhythm.

Hormones like melatonin act as chemical messengers, travelling from one part of the body to another, delivering instructions, just like a carrier pigeon delivering notes. In melatonin’s case, the message is: “It’s time to sleep.”

⏰  Circadian Rhythm: Our Natural Sleep-Wake Cycle

Humans are biologically wired to be awake during the day and asleep at night—this is our circadian rhythm. Light exposure helps regulate this cycle.

• Melatonin begins to rise in the early evening, as the sun goes down
• It peaks between 2–3 a.m., encouraging deep, restorative sleep
• As morning light appears, melatonin production drops, helping us wake up

Disruptions to this rhythm—through shift work, jet lag, screens at night, or hormonal changes—can affect sleep quality.

💊 How Do You Take Melatonin?

For slow-release melatonin (also called prolonged-release or PR melatonin), it’s best to take it as the sun goes down, to mimic or support your natural hormonal rhythm.  This timing can help your body re-establish a healthy pattern and may promote sustainable, long-term improvements in sleep quality.

For immediate-release melatonin, it may be taken closer to desired sleep time if the goal is to initiate sleep quickly.

In resetting circadian rhythms eg like with delayed sleep phase disorder or during perimenopause, this approach can be particularly useful.

⚠️ What Are the Risks or Side Effects?

While generally considered safe, melatonin is not without side effects. These may include:

• Drowsiness (helpful at bedtime, but avoid driving after taking it)
• Headaches
• Diarrhoea
• Joint pain
• Vivid dreams or altered sleep architecture
• Lack of effect in some individuals
• Potential tolerance with regular use (especially at higher doses)

📈 In paediatrics, when tolerance is suspected, some practitioners:

• Titrate doses upwards (sometimes up to 10 mg),
• Then pause use for a few weeks, and
• Restart at a lower dose (e.g., 2 mg) with renewed benefit—clever, isn’t it?

There’s no solid evidence that melatonin suppresses growth in children, though this concern has been raised. It does not apply to adults.

🧪 Duration and Use

• Typical course: 12–13 weeks (around 3 months)
• Goal: to help “reset” the sleep rhythm, especially in cases of disrupted circadian patterns or hormonal sleep disturbances (e.g., perimenopause)It may be used intermittently or long-term, but long-term safety data is still limited, especially beyond several months.

🧠 Melatonin in Special Populations

✴️ ADHD & Autism

People with ADHD and autism often have disrupted melatonin rhythms.  Supplementing melatonin appears to improve sleep onset and quality, though mechanisms may involve neurotransmitter regulation and delayed circadian signaling.

🌙 “ADHD of Menopause”?

It’s been proposed that perimenopausal brain fog, restlessness, and sleep issues resemble ADHD-like symptoms.  The overlap may relate to hormonal shifts affecting dopamine and circadian regulation, suggesting shared underlying neuroendocrine disruptions.