Melatonin ― The Hormone of Darkness
summary of article. AAST Associate Editor March 2021 see other page
Based on the study – for the lay person
Known as the “hormone of darkness,” melatonin, a natural-occurring hormone primarily released by the brain’s pineal gland at night, is commonly taken as an oral supplement for the treatment of insomnia and other sleep disorders. It is by far the most used sleep aid used in the United States, with millions of people using it Questions remain, however, as to its effectiveness; it has been found that while it may induce sleep faster in some people, it may not necessarily improve overall sleep maintenance or increase sleep duration except with patients with sleep disorders
On review of studies healthy subjects. who took melatonin at bedtime fell asleep about s 4 to8 minutes faster and sleep sleep for about 8 minutes longer,. For those with sleep disorders it seems to work better
Who Should Consider Melatonin
Generally, those finding it difficult to fall asleep at night will benefit the most from melatonin. Research shows that a supplement may help people with insomnia fall asleep slightly faster,“Your body produces melatonin naturally. It doesn’t make you sleep, but as melatonin levels rise in the evening it puts you into a state of quiet wakefulness that helps promote sleep,” explains Johns Hopkins sleep expert Luis F. Buenaver, PhD, CBSM.
Is It Safe to Take Every Night?
One major advantage melatonin has over other sleep aids is that it is non-addictive. According to the National Center for Complementary and Integrative Health (NCCIH), short-term use of melatonin supplements appears to be safe for most adults and children. But information on the effects of long-term melatonin supplements is limited.
A 2016 study published in Clinical Drug Investigation indicated that long-term melatonin use in adults may cause mild side effects when compared to a placebo. Studies into the effects of long-term melatonin use in children remains limited and its safety is uncertain.
Furthermore, we provide recommendations concerning the possible risks of melatonin use in specific patient groups. In general, animal and human studies documented that short-term use of melatonin is safe, even in extreme doses. Only mild adverse effects, such as dizziness, headache, nausea and sleepiness have been reported. No studies have indicated that exogenous melatonin should induce any serious adverse effects. Similarly, randomized clinical studies indicate that long-term melatonin treatment causes only mild adverse effects comparable to placebo. Long-term safety of melatonin in children and adolescents, however, requires further investigation. Due to a lack of human studies, pregnant and breast-feeding women should not take melatonin at this moment.
Downsides of Melatonin as Compared to Prescribed and FDA-Controlled Substances
Melatonin is sold as a dietary supplement, and its manufacture is not regulated by the U.S. Food and Drug Administration. A study in the Journal of Clinical Sleep Medicine examined the content of 31 melatonin supplements from different brands. Researchers found that the actual content of the melatonin supplements ranged widely compared to their labels. Additionally, eight of the supplements in the study contained serotonin, which is used to treat depression and some neurological disorders. Unknowingly taking serotonin can lead to serious side effects.
Dosing is also a problem A Sleep Medicine Reviews journal found that melatonin is most effective at a dose of 0.3 milligrams. But commercially-available melatonin pills contain up to 10 times the effective amount. At that dose, melatonin receptors in the brain become unresponsive.
Possible Side Effects
Common side effects:
- Headache
- Dizziness
- Nausea
- Drowsiness
Other, less-common side effects include: short-lasting feelings of depression, mild tremor, mild anxiety, abdominal cramps, irritability, reduced alertness, confusion or disorientation and hypotension (abnormally low blood pressure).
Drug interactions
In addition, melatonin supplements can interact with various medications, so seek medical advice before taking if you also take:
- Blood-thinning medications
- Epilepsy medications (anticonvulsants)
- Immunosuppressants
- Diabetes medications
- Blood pressure medications
- Birth control medications
Melatonin’s impact on pregnancy should also be considered. Both the ovaries and placenta make high levels of melatonin and use the hormone throughout pregnancy and delivery. Melatonin levels rise significantly at 24 weeks of pregnancy and rise even more after 32 weeks. Furthermore, melatonin works with oxytocin to promote labor and delivery. Melatonin levels are higher at night, which might be why many women go into labor in the evening and early morning. Melatonin is also found in amniotic fluid, and babies rely on their mother’s melatonin supply while they are in utero and until nine to 12 weeks after they are born.
Is Melatonin Right for you
While there is evidence that melatonin can help people with certain sleep disorders fall asleep faster, it may not be sufficient to help those who have difficulty getting a proper night’s sleep, or those who wake up often in the middle of the night and have difficulty falling back to sleep.
What you should before trying melatonin
If you want to try melatonin, consider that you should to reduce intake of electronic media consumption before bedtime. The blue light emitted by screens on cell phones, computers, tablets and televisions has been shown to inhibit the production of melatonin.
Environment and Melatonin
The environment also influences on melatonin production. For example, the body may produce melatonin earlier or later in the day, depending on the season and length of the day, which can throw off the natural sleep cycle.
Food and Melatonin
Foods such as tomatoes, walnuts, olives, rice, barley, strawberries, cherries and cow’s milk contain melatonin. Thus, consumption of these foods may impact dosing requirements, which typically range from 1 mg to 10 mg.
When to take melatonin
For insomnia, it’s best to take a melatonin supplement 30 to 60 minutes before bedtime. And remember that melatonin supplements can negatively interact with many different medications, so be sure to review the patient’s current medications before recommending it.
We will discuss melatonin and sleep in another article
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