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Why melatonin doesn’t work

Melatonin doesn't work

We’ve all heard this from our patients:

“Melatonin doesn’t work for me.”

And to be honest, it often doesn’t work…at least not in the way most people are using it.

Melatonin isn’t a sedative. It’s a chronobiotic.

It’s a biological time cue that tells your body what time it is and helps regulate the sleep-wake cycle.

So when a patient says melatonin failed, the problem usually isn’t that melatonin doesn’t work.

It’s usually one of these 3 things:

  • Wrong timing
  • Wrong indication
  • Poor quality supplement

This week, I’m breaking down why melatonin doesn’t work and what to do about it.

In this 8-minute episode (Part 2 of my 3-part series on melatonin) I share two real clinical cases that illustrate how to make melatonin work for the right patient at the right time:

  • A 32-year-old who was misdiagnosed with insomnia and cycled through multiple hypnotics without relief
  • A man in his 60s with early-morning awakenings who tried melatonin without success, until he learned how to use it strategically

I’m also sharing:

  • How to time melatonin supplements relative to DLMO (dim light melatonin onset) instead of clock time
  • The optimal melatonin dose for circadian realignment
  • When to choose extended-release formulations
  • Why melatonin rarely works in isolation and how to use it most effectively

If you’ve ever wondered how to handle “melatonin doesn’t work” complaints in clinic, this episode will give you a roadmap.

Well worth the 8 minutes of your time.

Watch the full video here.

Then, stay tuned for Part 3, where we’ll explore melatonin use in perimenopause and menopause.

Did you learn something today? Click here to find out how Learner+ can help you meet your evolving educational goals.

More from Dr. Nishi

Is Melatonin Safe?
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Is Melatonin Safe?

A 2023 research letter in JAMA and 2017 study in JCSM highlighted serious issues with over-the-counter melatonin quality.

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