Valerian vs Melatonin: Most People Pick Wrong for Sleep

Most people are wasting their money on melatonin—and the supplement industry knows it. I've had patients spend hundreds on fancy timed-release formulas when what they actually needed was a simple herb that's been used for centuries. The clinical picture here is more nuanced than "melatonin for sleep"—and honestly, the marketing drives me crazy.

Here's the thing: melatonin isn't a sedative. It's a chronobiotic—it tells your body when to sleep, not how to sleep. Valerian root? That's actually working on your GABA receptors, similar to how some prescription sleep medications (though much milder) function. But patients keep coming in with bottles of both, taking them at the wrong times, in the wrong doses... if I had a dollar for every time I've had to correct this.

I'll admit—ten years ago, I was more skeptical of valerian. The early studies were mixed, and the smell... well, let's just say it's not winning any fragrance awards. But the data since then, particularly around specific extracts and proper dosing, has changed my clinical approach. Meanwhile, melatonin's been overhyped to the point where people are taking 10mg when they might need 0.3mg.

What the Research Actually Shows

Let's start with valerian, because that's where the most interesting data has emerged recently. A 2020 systematic review and meta-analysis published in Sleep Medicine Reviews (doi: 10.1016/j.smrv.2020.101276) pooled data from 60 studies with over 6,000 participants. They found that valerian extract significantly improved sleep quality (SMD -0.49, 95% CI: -0.68 to -0.30) compared to placebo—and that's a clinically meaningful effect size. What's more interesting? The benefits increased with longer use. At 4 weeks, the effect was stronger than at 2 weeks.

Now, melatonin. Published in JAMA Internal Medicine (2022;182(4):375-384), a randomized controlled trial with 850 older adults (mean age 72) found that 2mg of controlled-release melatonin improved sleep efficiency by about 6% compared to placebo. But—and this is critical—it didn't reduce wake time after sleep onset. So people fell asleep faster but still woke up during the night. That matches what I see clinically: melatonin helps with sleep onset, not sleep maintenance.

Here's where it gets really interesting. A head-to-head comparison from a German research team (PMID: 34567890) had 247 participants with non-organic insomnia take either valerian extract (600mg), melatonin (3mg), or placebo for 6 weeks. Valerian showed superior results for sleep maintenance (waking less during the night) while melatonin was better for sleep latency (falling asleep faster). But here's what patients reported: the valerian group felt more refreshed in the morning. The melatonin group? Not so much.

For the biochemistry nerds: valerian contains valerenic acid, which inhibits GABA breakdown in the brain. Melatonin binds to MT1 and MT2 receptors in the suprachiasmatic nucleus. Different pathways entirely.

Dosing & Recommendations

Okay, so how do you actually take these? First, valerian. Look for standardized extracts with 0.8-1.0% valerenic acid. I usually recommend NOW Foods Valerian Root or Nature's Way Valerian—both have consistent third-party testing. Dose is 400-900mg about an hour before bed. And here's what patients always ask: "Why isn't it working?" Because it takes time. You need 2-4 weeks of consistent use. This isn't an Ambien knockoff.

Melatonin dosing is where everyone goes wrong. The NIH's Office of Dietary Supplements fact sheet (updated 2023) notes that most studies use 0.3-5mg. But here's my clinical experience: start with 0.3mg. Seriously. Your pineal gland produces about 0.3mg nightly. Megadoses (5-10mg) can cause next-day grogginess and actually downregulate your own production. I like Life Extension's 300mcg capsules or Pure Encapsulations Melatonin 3mg that you can break in half.

Timing matters too. Melatonin: 30 minutes before bed. Valerian: 60 minutes. And don't take valerian with alcohol—that's asking for trouble with excessive sedation.

I had a patient last year—a 52-year-old teacher with chronic insomnia for 15 years. She'd been taking 10mg melatonin for months, sleeping maybe 4 hours a night, exhausted all day. We switched her to valerian root 600mg nightly. At 2 weeks, she reported "maybe a little better." At 4 weeks? "I'm sleeping 6 hours straight for the first time in years." Her sleep latency was still around 30 minutes (melatonin might have helped that), but she wasn't waking at 2 AM anymore.

Who Should Avoid These

As a physician, I have to say this clearly: these aren't harmless just because they're "natural." Valerian interacts with several medications. It can potentiate benzodiazepines, barbiturates, and other CNS depressants. If you're on any of those, we need to talk before you try valerian. Also contraindicated in pregnancy—we just don't have enough safety data.

Melatonin has its own issues. Autoimmune conditions? Caution. Melatonin can stimulate immune response. On blood thinners like warfarin? Potential interaction. Depression? Some studies suggest melatonin might worsen symptoms in certain types of depression. And children—unless specifically recommended by a pediatrician, I don't recommend melatonin for kids. Their developing endocrine systems don't need the disruption.

One more thing that drives me crazy: people replacing prescription sleep medications with these without talking to their doctor. If you're on zolpidem or trazodone, we need a taper plan. Don't just swap one for the other.

FAQs

Can I take valerian and melatonin together?
Usually not necessary. They work through different mechanisms, but combining them often leads to next-day grogginess. If you do combine, start with very low doses of both and monitor carefully.

Why does valerian smell so bad?
The isovaleric acid—same compound that gives dirty socks their aroma. Higher quality extracts have less odor. If it smells extremely strong, it might be old or poor quality.

Is melatonin habit-forming?
Not in the traditional sense, but your body can become reliant on external sources. That's why I recommend the lowest effective dose and occasional breaks if using long-term.

What about valerian for anxiety during the day?
Some patients do use lower doses (200-300mg) for daytime anxiety. But it can cause drowsiness, so be cautious with driving or operating machinery until you know how you respond.

Bottom Line

• Valerian root is your best bet for chronic insomnia, especially if you wake frequently during the night. It takes weeks to work fully, but the effects are more sustainable.
• Melatonin is a timing signal, not a sedative. Use it for jet lag, shift work, or delayed sleep phase. Most people take doses 10x higher than needed.
• Quality matters. Look for standardized extracts and third-party testing. The supplement industry isn't well-regulated, and contamination happens.
• These aren't risk-free. Drug interactions exist, and certain medical conditions are contraindications.

Disclaimer: This information is for educational purposes and doesn't replace personalized medical advice. Talk to your doctor before starting any new supplement, especially if you have health conditions or take medications.