home
RSS
Get Some Sleep: Melatonin's a great solution - for some
April 19th, 2011
05:03 PM ET

Get Some Sleep: Melatonin's a great solution - for some

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
A frazzled, 45-year-old woman came into my office the other day complaining of longstanding, intermittent bouts of insomnia.

“The frustrating thing is I watch my husband take his melatonin and ‘poof’ it’s like the sandman flew in through the window and sprinkled sand in his eyes. He is out. Me? Nothing. I lie there for hours even if I take two or three pills.”

I hear this lot. Melatonin works remarkably well for some people and has no affect on others.

Melatonin is a naturally occurring neuro-hormone that is secreted by the pineal gland in the brain. When released from the pineal gland, melatonin causes drowsiness and a decrease in core body temperature. The levels of melatonin rise throughout the evening hours and peak in the middle of the night. That is if there is relative darkness. Even ordinary room light (approximately 100 lux) can cause a rapid suppression in melatonin. This is why sleep doctors are always telling people, at least people who have trouble falling asleep, that they should avoid reading in bed.

Research suggests that melatonin not only helps us sleep and maintain our 24-hour clock, but that it acts as a powerful antioxidant that destroys cancerous cells. It may also boost immunity and help in weight loss. The antioxidant properties are thought to explain why night shift workers have a higher rate of cancer. Night after night they suppress their melatonin by staying up and being exposed to light.

Melatonin has been studied as a sleep promoting agent in doses ranging from 0.3 mg to 80 mg and the results are always disappointing. There are a few hypotheses why that is the case.

First, melatonin is sold as a dietary supplement in this country and you can’t rely on the dose really being what the bottle says it is.

I have been trying to find out if there is brand of melatonin sold in the U.S. that is manufactured in Western Europe. Many European countries such as Germany regulate their herbal supplements as strictly as they do their pharmaceuticals. In fact, Germany considers melatonin a prescription medication.

Second, the timing of the dosing of melatonin when treating insomnia has not been firmly established.

For example, when we are using it to shift people’s circadian rhythm, we typically give it approximately six hours before desired bedtime. This can slowly phase advance them, i.e. get them to fall asleep earlier.

I experiment with the timing with patients. I start at 30 minutes before bedtime, in order to use it as a hypnotic, but if we don’t achieve the desired sleepiness, then I advise taking it 60 minutes before bed, then 90 minutes and so forth until we are actually using it as a chronobiotic, i.e. shifting the biological clock.

I always advise caution that they not go out and about or operate heavy machinery while we are first administering the melatonin.

Third, melatonin might work better on some people because they have a naturally low level whereas it has little effect on people who have normal levels. This hypothesis is extrapolated from literature that shows that melatonin is more effective when administered in the daytime when our natural levels are low. Also, melatonin seems to be more effective in elderly patients who often have low melatonin. Further supporting evidence might be the fact that most research shows little difference in response whether you give low dose or high dose.

Finally, perhaps oral administration is not the best method of delivery the drug. It is manufactured as sublingual  (under the tongue) and as transdermal (skin) patches, but whether these routes of delivery are more effective remains to be tested.

We should also keep in mind that certain medications such as beta blockers and anti-depressants can suppress melatonin levels.

Although the effectiveness of melatonin is questionable, it is generally considered safe in adults. Common side effects include morning grogginess, headache, vivid dreaming.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Post by:
Filed under: Cancer

soundoff (149 Responses)
  1. オメガスーパーコピー

    2020年人気の商品を超えて、当店が売買する中.
    すべての商品はすべて新しく着きます.
    すべての商品の品質がすべて検査するのが合格です.
    みんなを歓迎して選り取りで買います.
    ■主要取扱商品 バッグ、財布、腕時計、マフラー!
    ○ スタイルが多い、品質がよい、価格が低い!
    ○ S品質 シリアル付きも有り 付属品完備!
    ○必ずご満足頂ける品質の商品のみ販売しております.

    品質の承諾:
    ◆入金の後で3-7日高い府に到着する
    ◆もし、税関に止まられた場合、再びに無料で再送いたします。到着してまで。
    当社の商品は絶対の自信が御座います。
    S品質 シリアル付きも有り 付属品完備!
    オメガスーパーコピー

    September 16, 2020 at 05:45 | Report abuse | Reply
1 2 3

Post a comment


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.