As a result of having suffered from chronic insomnia most of my life, I went on a quest to figure out how to get a good night's sleep.
I found that every prescription sleep medicine actually interrupts deep sleep and does not result in truly restful slumber. The majority of the older sleep medications were in the antidepressant/anti-anxiety family and would commonly cause tolerance, the need for higher and higher doses, to the point where even higher doses did not work and the individual using the medication would have to be tapered off in an ugly detox manner. Even medicines like Ambien and Lunesta, which are non-narcotic, interrupt deep sleep so that one awakens not as refreshed as they would after a night of natural sleep, but they do not cause tolerance.
Levels of melatonin in the body decline with age, approximately 10-15% per decade. Our endogenous melatonin production peaks at 21–25 years of age. By age 50, it is approximately one-half of what it once was. By age 80, it is one-third of the level it was in our early 20s. Melatonin is needed by our biological clocks, which determine what hormones are released at what times of the day. The body strives for homeostasis (stable rhythms); this means that we function optimally if we sleep at the same time every day, get up at the same time every day, and have meals at the same time every day. Melatonin helps regulate this.
I would be remiss if I did not include some additional benefits of melatonin. There are several articles that talk about its influence on aging in mice. One article published in the Proc Natl Acad Sci USA 1994; 91:787-91 shows a prolonged survival of mice from 23.8 to 28.1 months, everything else being equal, and it also preserved them in a more youthful state.
For those suffering from chronic pain, according to the Journal of Pineal Research, April 18, 2011, melatonin is a potent analgesic, which alleviates the symptoms of fibromyalgia, irritable bowel syndrome, and headaches (including migraines). It also can be used as an antihypertensive agent and sedative. It is believed that melatonin stimulates opioid and GABA-B receptors, and thus, people are able to sleep better with less pain.
It also decreases inflammation brought on by severe exercise. Melatonin helps the heart reprofuse after a heart injury and has the same effect on the brain after a stroke. Melatonin lowers LDL (bad cholesterol) and raises HDL (good cholesterol). Melatonin also helps Alzheimer's patients by improving sleep and slowing the progression of cognitive impairment. According to Endocrine, July 2005; 27 (2), melatonin also helps with Parkinson's disease. It helps reverse osteoporosis and helps growth hormone release, as people are able to stay in deep sleep longer. Several studies have also shown that melatonin helps as an adjunctive treatment of cancer. There are many other effects of melatonin and you can look them up on your own. At this time, I will focus on the issue of sleep.
The reason many of us may want to take melatonin is the fact that it helps us get to sleep quicker, increases the total amount of sleep, as well as helps us get into deep sleep for a longer period of time. However, being in deep sleep longer can be a double-edged sword. Deep sleep produces very vivid dreams, which may be welcome to some but distressing to others. Therefore, if you are having nightmares with the use of melatonin, I recommend that you discontinue its use.
After taking melatonin, most people awaken feeling great and ready to tackle the day. Some people, however, have a kind of "hangover," but this should resolve after about a week or so with the same dose every day. And one can always lower the dose if needed.
So how does one take melatonin? It comes in different forms. People who have difficulty falling asleep but stay asleep for a long time may wish to use a sublingual lozenge or drops. Other people who fall asleep fine but awaken in the middle of the night can use time-release melatonin. For most of us, the standard pill is a good approach. As with a lot of things, you need to figure out what dose is best for you. I recommend starting at 0.5mg per night for the first one or two nights and then increasing by 0.5mg (one-half mg) every two to three days. Most people settle in at anywhere from 3 to 10mg per day. However, it should be noted that many people do well with just 0.5 mg. However, after a month or so, they may develop tolerance with 0.5 mg, as tolerance can develop at lower doses. However, tolerance is not seen at the higher doses of 3 to 10 mg. Please take the melatonin dosage one-half hour before sleep if you have an empty stomach, and one to one and a half hours
MAY 2012 ↳ MOTORCYCLE CONSUMER NEWS before sleep if you have a full stomach.
For those of us who have difficulty falling asleep, it is important to remember a few very important sleep hygiene rules. As stated before, the darker the bedroom is, the more melatonin will be produced. The bedroom needs to be quiet and at a comfortable temperature. Smok- ing, eating, reading, and watching television in bed are not consistent with good sleep hygiene. When your head hits the pillow, it should trigger a sleep response an "I'm going to read or watch TV or e-mail my friends" response. Also, exercise, meditation, and/or spiritual connection have been shown to help with sleep.
For those who travel, in order to prevent jet lag, you should take 3 to 6mg at bedtime at your destination, starting the day before, whether you are at home or on your way. If it is daytime when you arrive at your destination, you should expose yourself to light. Do not go into a dark room and fight to stay awake. Then, at the time of bedtime at your destination, you should take another 3 to 6 mg. This would total two doses of 3 to 6 mg about 24 hours apart, which should help acclimate you to the new time zone.
The New England Journal of Medicine, January 16, 1997, Vol. 336, no. 3 reviewed all of the various articles on melatonin, and showed that it scavenges free radicals and protects our DNA. It protects against cancer and the changes of aging. It helps sleep and improves jet lag. It also augments the immune system, etc., etc. But at the end of the article, it was stated that melatonin should not be used, as more studies are needed!
We have the greatest healthcare in the world, but when it comes to non-drug company products, I wonder how objective we are in the medical community.
As I do with every article, I encourage you to do further research on your own if something I have said has sparked your interest. As always, I try to give a slightly different perspective on common everyday issues that I believe people may be wrestling with.
Medione ze has offices in Santa Ana and the CA has been in private practice for 17 years, owns three motorcycles and did his internship and residency at USC in Los Angeles.