THOUGHTS
Is Melatonin Really for You?
Sleep is such a luxury, which I can’t afford.
“sleep is such a luxury, which i cant afford.” ― Robin Sikarwar
Some weeks ago, a friend and I were chatting about supplements. She recommended a supplement to me for my skin and hair. I was reluctant, as I was already on a few already. However, I changed my mind when I found out that the supplement she recommended was in gummy form. Gummies are enjoyable for most people and I would understand why people would opt for that formulation as a drug.
In Mid-September, there was a huge internet search for melatonin gummies. Melatonin gummies are a form of “sleep gummies” that contain the sleep-promoting compound melatonin. The prevalence of Americans reporting sleep issues has risen significantly over the past few years, with over 40% now reporting difficulty falling asleep. 35% of older adults aged 65–80 use a prescription or OTC product to improve their sleep.
Melatonin has been listed in the top 7 best-selling ingredients across all dietary supplements, outperforming ubiquitous categories such as multivitamins, vitamin C, and whey protein.
How melatonin works.
The body produces melatonin naturally. It doesn’t make one sleep. As melatonin levels rise in the evening, it puts one into a state of quiet wakefulness that helps promote sleep.
Johns Hopkins sleep expert Luis F. Buenaver, Ph.D., C.B.S.M suggested and tried the following steps to make the most of natural melatonin production.
- Create optimal conditions for it to work by keeping the lights low before bed.
- Stop using the computer, smartphone, or tablet — the blue and green light from these devices can neutralize melatonin’s effects.
- Be at least six feet away from the TV screen.
- Turn off bright overhead lights.
- Help program your body to produce melatonin for sleep at the right time of day by getting exposure to daylight during the morning and afternoon.
- Take a walk outside or sit beside a sunny window.
- Keep the lights low in the evening to help the mind and body prepare for sleep.
- If one has to work in the evening or answer emails, use filters to screen out the blue and green wavelengths of light emitted by the smartphone and computer. The brain associates this light with daytime, and it can interfere with melatonin’s sleep-promoting effects.
Are you a candidate for melatonin?
Dr. Luis F. Buenaver suggests you can try a supplement on a short-term basis if:
- you’re experiencing insomnia,
- want to overcome jet lag,
- or are a night owl who needs to get to bed earlier and wake up earlier, such as for work or school.
Other experts agree that melatonin can have a big effect on treating circadian rhythm disorders like:
- delayed sleep phase disorder (extreme night owls),
- advanced sleep phase disorder (extreme morning larks),
- or shift work disorder.
In these cases, the body makes melatonin too late or too early, creating a mismatch between when the person should sleep and when they feel like it.
Cathy Goldstein, MD, an assistant professor of neurology, suggests that one could then take low-dose melatonin (0.5 mg) at 11 p.m., well before the natural melatonin kicks in. Such people then feel sleepy earlier and helps to correct their internal clock earlier as well.
People who have difficulty sleeping for more than a night or two can try melatonin.” Research shows that a supplement may help people with insomnia fall asleep slightly faster and may have bigger benefits for those with delayed sleep phase syndrome — falling asleep very late and waking up late the next day.
Alfred Lewy, MD, professor emeritus at Oregon Health & Science University and a pioneer in melatonin research suggests that for some patients, as little as 0.3 mg of melatonin daily in the late afternoon may ease symptoms of winter depression brought on by shorter days and shifting circadian rhythms. But because a few people respond better when taking the melatonin in the morning, he only recommends its use for this purpose under a doctor’s guidance.
“The challenge with melatonin is that it’s complicated. If you take it at the wrong time, it can shift your body clock in the wrong direction, and that can cause problems,” Lewy says.
Be cautious, be safe, and be wise
Melatonin is not to be taken before bedtime. It is a sleep regulator, not a sleep initiator, explains Breus, author of “Good Night: The Doctor’s 4-week Program to Better Sleep and Better Health.”
Dr. Alfred Lewy, MD states: “It works for some people, but not for others. You just have to try it and find out which one you are.”
Dr. Cathy Goldstein reminds us that for those already making melatonin naturally at night, taking a bit more as supplements “like spitting in the ocean. It doesn’t do much,”.
A few other tips
Buenaver suggests adjusting one’s sleep-wake schedule to be in sync with the new time zone by simply staying awake when one reaches the destination — delaying sleep until one’s usual bedtime in the new time zone. He also advises getting outside for natural light exposure.
He suggests stopping melatonin after a week or two if it is not working. He also advises consulting with one’s health care provider at that point. On the flip side, if it works, he says it’s safe for most people to take it nightly for one to two months, then stop and see how one's sleep becomes. Sleep hygiene spoken about earlier still matters.
Do not use melatonin if…
- you are pregnant
- you are breastfeeding
- have an autoimmune disorder,
- a seizure disorder,
- have depression.
- Talk to your health care provider if you have diabetes or high blood pressure.
Melatonin supplements may also raise blood sugar levels and increase blood pressure levels in people taking some hypertension medications.
Can melatonin be used in children?
Experts question how safe it is for children plus there is little research on this. Though some research has shown that children with developmental disorders, such as autism spectrum disorder and attention deficit hyperactivity disorder, have low nighttime melatonin levels that may help cause poor sleep patterns. If it’s well-timed and under the supervision of a doctor, melatonin may help normalize their sleep and daytime behavior, Dr. Breus notes. He would not use melatonin on otherwise healthy kids.
Final words
Because dietary supplements are not regulated as much as prescription drugs, quality varies. One recent study found that 71% of melatonin supplements surveyed did not contain exactly what they said on the label. Some had over four times as much melatonin as showed, and 26% contained the powerful neurotransmitter serotonin, a chemical found in many antidepressant medications. Not everyone is a candidate for melatonin. If you are, be sure of the quality of what’s in your bottle.
This article is solely for informational purposes and represents the writer’s personal opinion. Please seek professional advice if required.
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References
- Exploding Topics
- Melatonin for Sleep: Does It Work? Melatonin sleep aids are growing in popularity, with 3 million Americans using them in 2012, according to a nationwide…www.hopkinsmedicine.org
- Brunilda Nazario, MD, board-certified internist and endocrinologist.
- Nutrition Business Journal.
- American Association of Poison Control Centers.
- National Center for Complementary and Integrated Health.
- Michael J. Breus, Ph.D., clinical psychologist, author of “Good Night: The Doctor’s 4-week Program to Better Sleep and Better Health.”
- Sleep Medicine Review, February 2005.
- Plos One, May 2013.
- Cathy Goldstein, MD, assistant professor of neurology, University of Michigan Sleep Medicine Clinic.
- Alfred Lewy, MD, professor emeritus at Oregon Health & Science University.
- PNAS, May 2006.
- Journal of Clinical Sleep Medicine, 2017.
- Journal of Pediatric Child Health, June 2015.
- Craig Canapari, MD, “Melatonin for Children? A Guide for Parents”
- https://www.hopkinsmedicine.org/profiles/details/luis-buenaver
