Should I take extended-release or regular melatonin?
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Regular melatonin helps you fall asleep, and extended-release spreads the dose across the night to help you stay asleep. In a 1995 trial in older adults with insomnia, that’s exactly what each one did. For moving your clock or for jet lag, regular is the one that’s been shown to work.
Extended-release (also sold as slow-release, time-release or prolonged-release) sounds like the upgrade, the same thing but lasting longer. For resetting your body clock, the jet lag trials found the opposite, and a short, high peak did better than a long, low one.
We’d use regular tablets for almost everything, and keep extended-release for people who fall asleep fine but wake in the small hours, after drinks, a bright bathroom light and snoring have been ruled out.
Regular melatonin is a bucket of water tipped over the garden. Extended-release is a drip hose left running all night.
What each one did in the trial
In the 1995 trial, older adults with insomnia took tablets 2 hours before the bedtime they wanted, a week at a time. 2 mg extended-release improved how well they stayed asleep, measured with a wrist tracker. The same 2 mg as a regular tablet improved how fast they fell asleep. Then they took 1 mg extended-release every night for two months, and their sleep kept improving, with no sign of the effect wearing off. When they stopped, their sleep got worse again.
Why regular wins for clocks and trips
A regular tablet peaks about 40 minutes after you swallow it and halves about every 54 minutes after that, so it gives one sharp evening rise. In the 2002 Cochrane review of jet lag trials, 2 mg slow-release did relatively poorly, and the reviewers concluded that a short, higher peak works better for resetting your clock. For trips and for moving your bedtime earlier, use regular.
Side by side
| Regular | Extended-release | |
|---|---|---|
| Best for | Falling asleep, moving your clock, jet lag | Waking in the night |
| Shape across the night | A quick rise, then gone within a few hours at small doses | A lower level held for longer |
| When to take it | 1 to 3 hours before bed | When the label says |
| Our night curve | Drawn | Not drawn, since each product releases differently |
Before you switch for 3am waking
Waking at 3am usually has a cause a pill won’t fix. A moderate evening drink cut people’s own melatonin by 15 to 19 percent over the next few hours in a 2007 lab study, and ordinary room light during the usual hours of sleep cut melatonin by more than half in 85 percent of tests in a 2011 study. Loud snoring or stopped breathing can be a sign of sleep apnea, which melatonin doesn’t treat, so see a doctor about that first. Taking melatonin in the middle of the night covers the 3am question in full.
Don’t drive after a dose of either kind.
5 sources
- Haimov I and others, Melatonin replacement therapy of elderly insomniacs, Sleep, 1995pubmed.ncbi.nlm.nih.gov
- Herxheimer A, Petrie KJ, Melatonin for the prevention and treatment of jet lag, Cochrane Database of Systematic Reviews, 2002pubmed.ncbi.nlm.nih.gov
- Andersen LP and others, Pharmacokinetics of oral and intravenous melatonin in healthy volunteers, BMC Pharmacology and Toxicology, 2016pubmed.ncbi.nlm.nih.gov
- Rupp TL, Acebo C, Carskadon MA, Evening alcohol suppresses salivary melatonin in young adults, Chronobiology International, 2007pubmed.ncbi.nlm.nih.gov
- Gooley JJ and others, Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans, Journal of Clinical Endocrinology and Metabolism, 2011pubmed.ncbi.nlm.nih.gov
