[Steve]

As some of you know who have been reading my posts, I am trying to wean myself off of all sleep aids except for magnesium citrate pills. I quit the prescription pills last week as I am getting the same amount of sleep on them as off them. (I was only taking them on an “as needed” basis anyway.) The last thing I need to quit is the melatonin but I am having trouble. I was taking 10mg extended release and went to 5mg extended release. Then I went to 3mg extended release and then went to 3mg of regular (non extended release) melatonin. Last night was the second time I tried to quit taking the 3mg and both times, I stayed awake for two hours and wasn’t close to falling asleep. Again last night, I gave in and took the 3mg regular melatonin and I was asleep in about 30 minutes. I didn’t think melatonin was habit forming but evidently my body has gotten used to me taking that. It’s hard to find a store here that sells it in less than 3mg tablets and the melatonin I have is a capsule so I can’t cut it in half. I hate to go to the Internet because I agree that you never know what you are getting with some of these online companies. I would prefer to stick to brands sold at a pharmacy because I have a better chance of getting what is on the label. Any ideas on how to get off of the last 3mg of melatonin? Thanks.

[Steve]

I did find a tablet form of melatonin at a pharmacy that can be cut in half. That would make it a 1.5mg pill instead of a 3mg pill. I tried taking the whole pill (3mg) last night and it didn’t really put me to sleep. I ended up taking the melatonin I was used to and within 30 minutes, I was asleep. I woke up again later as usual but I did get to sleep. So, I ended up taking 6mg instead of the 3 I was used to. I am going back to 3mg of my usual tonight then try to cut down again this weekend.

[Steve]

This is the second night in a row I tried going cold turkey off melatonin and both times gave up after going an hour and a half without falling asleep. Both times I ended up taking it and went to sleep within minutes. I must be hooked on it somehow.

[Edgar]

Don’t worry, you’re not the only one.

I said yesterday full of bravado how I am determined to try to quit Valium. Woke up at 3 , tried to fall asleep naturally, aterted panicking and took one pill, still nothing, took one more… Not only did I not quit, I doubled.

It takes determination, and willingness to suffer for quite some time before things (hopefully) get better. I guess we don’t have it in ourselves yet.

Steve, melatonin is not supposed to be that efficient, but I’m glad that it works great for you.

Since it’s a natural component of our brains and all, why does it worry you so much? Next to all the other drugs (like my Valium) , melatonin is next to harmless.

[Edgar]

*started panicking, sorry for the typo, I type too quickly and don’t doublecheck.

[Steve]

I know it’s supposed to be harmless Edgar but I want to be off all pills if I possibly can before I start CBT-i. Then I know that anything that happens is due to the CBT-i and not any pills. Besides, I really don’t know if it works that good. It just might be a crutch I use subconsciously. Once I take the pill, my brain and body might relax even if the melatonin does nothing for me.

[Martin Reed]

It certainly sounds as though you have a psychological dependence on the melatonin pills, Steve.

The fact of the matter is this — melatonin supplements are of no use for chronic insomnia.

Here’s how the body uses melatonin to help us sleep:

A few hours before our usual bedtime, the body pulses a nice dose of melatonin through our system. A few hours later, we are ready for sleep.

Every single person’s body emits this pulse of melatonin at a different time. It’s impossible to know with any real certainty when this happens in our own body without undergoing lab testing (and this isn’t even available in the US — but I believe there are a couple of labs in Canada that do it).

So, here’s the problem. If you take supplemental melatonin after the body has triggered this pulse of natural melatonin, the body ignores it. It’s just noise. It has absolutely no effect.

If you get lucky and somehow manage to take the supplemental melatonin before your body triggers its natural melatonin pulse, it still won’t be very effective — because people with insomnia have no problem with melatonin production or regulation!

The only time melatonin supplements can sometimes be helpful is for circadian rhythm sleep disorders — and even then, the evidence is relatively weak and we still don’t know when the best time to take the supplemental melatonin is (for reasons already described).

Also, in the United States at least, what you actually get when you buy melatonin can be very different from what is on the label. This study found melatonin content ranged from 83% less to 478% more than the labeled content (and eight of the supplements tested contained serotonin — a controlled substance used in the treatment of several neurological disorders).

So, being armed with all this knowledge will hopefully help you recognize that the melatonin is unlikely to be having any physiological effect on your sleep.

It can be helpful to try a tapering-off plan if you are finding it hard to quit cold turkey. You could try something like this:

1) Start by reducing your dose in half on two nights per week. Choose easier nights when there is little pressure or work obligations the following day but avoid consecutive nights.
2) Once you feel you are sleeping well on the two reduced dosage nights (this may happen immediately or may take a week or two), you can cut the dose in half every other night.
3) When you are sleeping well on the half dosage nights, you then take the half dose every night.
4) After the dose has been reduced by half on all medication nights, the remaining half dose is eliminated in the same gradual fashion (e.g., the remaining half dose is eliminated two nights a week, then every other night, then every night).

Finally, do not take the melatonin contingently. Decide in advance whether tonight will be a reduction/elimination night and stick to that no matter what.

When we take a pill contingently (ie based on how we sleep on a given night), we create a very powerful association in our mind that we are incapable of sleeping without that pill. In other words, we attribute sleep to the supplement or drug rather than recognizing that we slept because of our own natural ability to sleep.

When we take a supplement or drug and have a bad night, we don’t recognize the ineffectiveness of the supplement or drug — instead, we think that our sleep system is somehow broken. So, our perception of our natural ability to sleep is continuously eroded.

Good luck, and I hope this helps.

—

If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.

[Steve]

Thanks Martin. I am going to try that taper schedule. I am thinking this is more of a psychological dependence as well but I had one other thought. When I get up in the morning and go to work, I am very fatigued and a couple times have fallen asleep for a short time in my chair. This usually lasts until noon or one and then as the afternoon and evening wear on, I start losing that fatigue and am not really sleepy. I was wondering if the melatonin was playing havoc with my circadian rhythm and putting me to sleep in the morning hours and keeping me awake at night. But as I said, I’ll try that taper schedule. Thanks!

[Martin Reed]

You’re welcome, Steve — keep us updated with your progress.

—

If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.

[Steve]

Last night, I decided to just go cold turkey again in trying to get off of the melatonin. I am glad to say I think it finally worked. (Third time’s the charm.) It did take me anywhere from 30 to 45 minutes to fall asleep but that’s what it takes me now to fall asleep anyway. I am going to do the same thing tonight. I did get a relatively good night’s sleep last night but I had problems in that I kept waking up. It seemed every 60 to 70 minutes I would wake up. I got back to sleep relatively quickly, within 5 to 10 minutes, but throughout the night, I woke up about 7 times. It sure would have been nice to string a couple hours of good sleep together but I did sleep for at least 6 and a half hours so I’ll take what I can get.

[Martin Reed]

Falling asleep in 30 to 45 minutes isn’t too bad at all — a healthy sleeper will typically take between 10-30 minutes to fall asleep, so you were not far away from that.

I can’t recall if you’ve mentioned this before, but have you been assessed for sleep apnea or been told that you snore loudly during the night?

—

If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.

[Steve]

I have taken a sleep study and I do have sleep apnea. However, rather than using a CPAP machine, since I toss and turn all night and it would never stay on, I use an oral appliance which has worked quite well. It thrusts your lower jaw forward but it didn’t take me long to get used to it.

[Author]

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