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Melatonin and the Sleep Cycle

Melatonin is a hormone secreted by the pineal gland that helps regulate the sleep cycle. The pineal gland is located in the brain and is part of the epithalamus (dorsal/posterior segment of the middle of the brain). Small amounts of the hormone are also found in meats, grains, fruits, and vegetables, and melatonin has been synthesized and used to treat sleep disruption. The body has its own internal clock called the circadian rhythm that, among other things, determines how much melatonin the body produces. Normally, a person’s melatonin levels are lowest in the morning and highest in the late evening and night time hours. In people with disrupted circadian rhythms, melatonin supplements can be a useful sleep aid. The circadian rhythm dictates that melatonin levels rise with darkness and fall with light. There are numerous factors that may cause the disruption of a person’s circadian rhythm, including:

  • Jet lag
  • Insomnia associated with attention deficit-hyperactivity disorder (ADHD)
  • Insomnia associated with use of the beta blockers, a class of drugs used to treat high blood pressure, glaucoma, and migraines
  • Anxiety before surgery
  • Seasonal affective disorder (SAD)
  • Schizophrenia
  • Working night shifts
  • Chronic headaches
  • Physical pain or injury
  • Delayed sleep phase syndrome (DSPS)
  • Autism
  • Cerebral palsy
  • Mental retardation

Side effects that may come with the use of melatonin include:

  • Drowsiness
  • Reduced body temperature
  • Vivid dreams
  • Sluggishness or grogginess, especially in the morning
  • A change in blood pressure
  • Irritability
  • Dizziness
  • Stomach cramps
  • Short-term depression

    Additionally, melatonin may be unsafe when used by the following:

  • Women who are pregnant or breast feeding
  • Children
  • Adolescents
  • People with diabetes
  • People with depression
  • People with seizure disorders
  • People with high blood pressure (hypertension)
  • Women taking birth control pills
  • People taking fluvoxamine (Luvox)
  • People taking medications to treat diabetes
  • People taking sedatives
  • People taking medications to slow blood clottingStudies are thus far inconclusive as to whether synthesized melatonin increases the amount of time a person spends sleeping, known as “sleep efficiency,” though it does appear to decrease the amount of time it takes a person to fall asleep. In people with “secondary insomnia”,”insomnia related to other conditions, including Alzheimer’s, schizophrenia, depression, and hospitalization, “melatonin supplements don’t appear to shorten the length of time it takes to fall asleep but might improve sleep efficiency. Melatonin levels seem to naturally decrease with age, making supplements particularly effective in older adults. People taking melatonin are advised to moderate their caffeine intake in order to achieve the best results.Melatonin can be taken as tablets, capsules, cream, and lozenges that dissolve under the tongue. There is no recommended dose for those taking melatonin supplements though a good rule of thumb is to start with a low dosage (no more than 0.3 mg per-day) and keeping the dosage as low as possible while achieving the desired effect, only increasing the dosage as needed. It is advised that people taking melatonin supplements consult their physicians to determine an appropriate dosage to treat their sleep problems and what other medications and supplements can be used concurrently with melatonin. Generally, 1-3 mg, taken one hour before bedtime, is effective in treating insomnia, though dosages as high as 6 mg are sometimes necessary. Slightly lower dosages are required for jet lag and are to be taken one hour before bedtime for 2 days prior to departure and 2-3 days after arrival at the final destination.Melatonin can be purchased in pharmacies, health food stores, or online. It is recommended that a person who is taking melatonin inform his or her physician when undergoing physical exams.

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