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Melatonin: Not a Magic Bullet for Sleep

Know the facts before taking melatonin.

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, which may be something you have tried or considered in your quest for a better night’s sleep:

Can taking melatonin help you sleep?

First, what exactly 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, meaning it is very unlikely that someone has a melatonin deficiency. However, your melatonin levels can be tested with a blood test, urine test, or saliva test. If you are truly concerned that you may actually be melatonin deficient, ask your doctor about testing.

While melatonin could be considered natural, in most cases it doesn’t come from the earth. There are exceptions — certain foods contain melatonin — but this is a different type of melatonin than what is produced in your brain.

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 that 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 affects the brain in bursts and rapidly leaves the system, instead of the slow buildup 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 MIT, the correct dosage of melatonin for it to be effective is 0.3-1.0 mg. Many commercially available forms of melatonin are in 3 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 also have side effects. Melatonin (2-3mg 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 (OTC) in the US and Canada, melatonin is available only by prescription or not at all in some countries.

In the US, 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. There are new FDA rules that went into effect in June of 2010 that require all dietary supplements to comply with “good manufacturing practices (GMP)”, which includes 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 3 months at the correct dosage.

Over-the-counter (OTC) 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 1 mg to 10 mg, 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 antioxidant, 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 3 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 years).
  • There are possible interaction effects and 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 natural melatonin and there is research to show that drinking tart cherry juice can help with insomnia. There are vitamins and minerals, like 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: 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, PhD

The Sleep Doctor™

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

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