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Melatonin: Not a Magic Bullet for Sleep

Melatonin is a sleep and body clock regulator,a sleep initiator.
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Many of you have made a New Year's Resolution to get more and better sleep. I hope you are having great success! But I want to address a topic I am asked about repeatedly, and it may be something many of you have tried or considered in your quest for a better night's sleep: Is Melatonin good to take to help with my sleep?

So exactly what is melatonin?

Melatonin is a hormone. It is not an herb, a vitamin or a mineral. Hormones are naturally produced by your body as you need them. This means that it is very unlikely that someone has a melatonin deficiency. While melatonin could be considered natural, in most cases it doesn't come from the earth. There are exceptions -- foods that contain melatonin in them -- but this is a different type of melatonin than what is produced in your brain.

Your melatonin levels can be tested with a blood test, urine test or saliva test. If you are concerned that you may actually be melatonin deficient, ask your doctor about testing. Melatonin is produced by the pineal gland and sends a signal to regulate the sleep-wake cycle in the sleep center of the brain. Interestingly, melatonin is also produced in the retina, the skin and the GI tract, but this is not the melatonin what affects your biological sleep clock.

This is the really important thing you should understand about melatonin: Melatonin is a sleep and body clock regulator, not a sleep initiator. Melatonin works with your biological clock by telling your brain when it is time to sleep. Melatonin does not increase your sleep drive or need for sleep.

Melatonin is called the "Vampire Hormone" because it is produced primarily in darkness and inhibited by light. The levels of your melatonin increase in the middle of the night and gradually fall as the night turns to morning, so exposure to light before bed can push your biological clock in the wrong direction, making melatonin ineffective.

Melatonin treats Circadian Rhythm Disorders (where you sleep the right amount of minutes but your body clock is at the wrong time), Shift Work Sleep Disorders and early morning awakenings -- all things that deal with the timing of your need to sleep. Melatonin is not considered an effective treatment for insomnia.

Melatonin in pill form does not function like your body's naturally produced melatonin; it effects the brain in bursts and rapidly leaves the system, instead of the slow build-up and slow wash-out that your body's naturally produced melatonin experiences.

The correct dosage of melatonin can be a problem. According to research conducted at M.I.T., the correct dosage of melatonin for it to be effective is 0.3-1.0 mg. Many commercially available forms of melatonin are in three to 10 times the amount your body would need. In fact, there is some evidence that higher doses may be less effective. In Europe, melatonin at very high doses has been used as a contraceptive.

Melatonin can have side effects. Melatonin (two to three milligrams or higher) has reported side effects of:

  • Headaches
  • Nausea
  • Next-day grogginess
  • Hormone fluctuations
  • Vivid dreams and nightmares

Melatonin may also have some issues with safety. While melatonin is available over-the-counter, in the U.S. and Canada, melatonin is available only by prescription -- or not at all, in some countries. In the U.S., melatonin is sold as a dietary supplement, not a medication; so until recently, melatonin has not been subject to the same purity rules and standards as prescription medications. In June 2010, new F.D.A. rules went into effect that require all dietary supplements to comply with "good manufacturing practices," which include compliance in manufacturing standards and labeling.

So what does all this mean if you want to try melatonin as a supplement? Melatonin has been shown to be safe in healthy people when used for up to three months at the correct dosage.

Over The Counter Melatonin

  • When taken several hours before sleep, Melatonin can shift the biological clock earlier, making a better environment for falling asleep and waking up on time.
  • When taken in the correct dose (0.3-1 mg), it can be effective for shift workers and people with circadian rhythm disorders.
  • However, most Melatonin sold over the counter is packaged in doses ranging from one milligram to 10 milligrams, with most doses containing double or triple the amount that is needed to be effective for the population that will benefit from its use.

Other Possible Uses for Melatonin

  • As an anti-oxidant Melatonin acts upon free radicals. It may reduce damage caused by Parkinson's disease, and can have an anti-aging effect.
  • In the elderly, it has shown some promise in managing a type of insomnia called early morning awakenings ; but this area needs more study and does not take into account medications that may interact with melatonin.

Caution Should Be Taken When Using Melatonin

  • It should be used under the guidance of a doctor and sleep professional.
  • It should be used at the correct dosage.
  • It should be taken about 90 minutes before lights out.
  • It should be used for a short time (less than three months).
  • It should never be used in combination with other sleep inducing medications.
  • It should never be used with alcohol.
  • It should never be used with children younger than 18.
  • There are possible interaction effects that could change the effectiveness of your current medication regimen.

There are new and exciting experiments with patches for delivery of melatonin for use by shift workers and others who have work environments that put their regular circadian clocks to the test. Tart cherries contain a natural melatonin, and there is research to show that drinking tart cherry juice can help with insomnia. There are vitamins and minerals -- vitamin D, the B vitamins, folic acid and calcium -- that have been shown to help with both energy and relaxation.

At the end of the day (no pun intended), your first line of defense for sleep problems is good health and good sleep hygiene. Make it a habit to prepare your body and your mind at the end of every day to get the rest you need. Try that first before you start looking for something else. And when you do look, be careful.

Michael J. Breus, Ph.D.
The Sleep Doctor™

Everything you do, you do better with a good night's sleep™

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