Jerry, from Denver, notes, "I took 3 mg of melatonin for 2 months because I was going through a rough divorce. I stopped taking it last week and did not notice any withdrawal. My sleep is not as deep, but not any different than what it was before I started taking melatonin."

Even though withdrawal is uncommon, and mild, it is still best to taper off slowly. For example, if you have been using 3 mg of melatonin regularly for a while and you feel you don't need it anymore, lower the dose to 2 mg for a few nights, then 1 mg for another few nights, and stop.

Sleeping problems in children have also been treated successfully with melatonin supplements. James Jan, M.D., from British Columbia's Children's Hospital in Vancouver, Canada, has effectively treated over 90 children with insomnia due to conditions such as autism, Down's syndrome, mental retardation, hyperactivity, neurological disabilities, benign sleep myoclonus (muscle spasm), certain types of epilepsy, and more. He reports in the March 1995 issue of Developmental Medicine and Child Neurology that no side-effects or tolerance has been found. The doses used were 2.5 mg to 10 mg, with little benefit from higher doses. Melatonin was required for two to three months, after which many of the children maintained the improved sleeping patterns without it.

Jet Lag
Symptoms of jet lag include irritability, difficulty concentrating, headache, low mood, and fatigue. The change in sleeping patterns may also contribute to temporarily lowering our immunity, making us more prone to colds and infections.

Jet lag symptoms are usually worse when traveling west to east since most people have a circadian cycle longer than 24 hours (Harma, 1993). Melatonin taken in the evening of the new time zone can provide a quick readjustment.

Should melatonin be taken a few days before a trip or on the night of arrival? In a double-blind placebo-controlled trial (Petrie, 1993), 52 members of an international cabin crew were randomly assigned to 3 groups:

The early melatonin group took 5 mg starting 3 nights prior to the flight and continued 5 nights after arrival.

The late melatonin group took placebo for 3 nights before the flight then 5 mg melatonin the night of arrival and continued for 5 nights.

The third group received placebo pills throughout the study.

The late melatonin group reported significantly less jet lag and sleep disturbance following the flight compared to placebo. The late melatonin group also showed a significantly faster recovery of energy and alertness than the early melatonin group. Surprisingly, the placebo group also did better than the early melatonin group. These findings show melatonin has potential benefits for jet lag when given on the night of arrival as opposed to starting a few nights before the trip.

What dosage of melatonin should you take? As we discussed previously, a wide range of dosages works for people. An additional factor to consider with jet lag is the hours of difference between the new time zone and the one you're used to. The larger the difference, the more melatonin may be required. For instance, a dose of 3 mg may be required if you need to sleep 3 hours earlier while a 6 hour change may require more. No definite numbers can be given that apply to everyone. One rough estimate is to take 1 mg of melatonin for every hour difference. In other words, if you travel from the West Coast to the East, and there is a 3 hour change in time, take 3 mg. If you travel from the East Coast to Europe, and you need to sleep 6 hours earlier, take 6 mg.