Using Melatonin to Treat Insomnia

Melatonin supplements can help regulate your circadian rhythm cycle.
Melatonin supplements can help regulate your circadian rhythm cycle.
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Melatonin is another natural choice to treat insomnia that is also proving to be safe and effective, at least for short-term use.

Your body comes equipped with a biological clock that regulates sleeping and waking activities. Melatonin, a hormone naturally produced in the body, is believed to help keep the clock ticking by regulating what's known as our circadian rhythm cycle.

Traveling across several time zones disrupts that rhythm, and the result is jet lag -- that feeling of exhaustion and disorientation you get when you wake up the next day in a strange hotel room. What may help in those cases is using melatonin to treat insomnia the night before.

Our bodies produce melatonin in the bean-size pineal gland nestled deep inside our brains; it is also produced in the retinas of our eyes. Melatonin production is stimulated by darkness and shuts down in the presence of bright light (especially sunlight). Normally, the pineal gland starts increasing its melatonin production around 9 P.M. Hormone levels peak between 2 A.M. and 4 A.M. and then return to their normal daytime levels.

Exactly how melatonin works is unclear. At a worldwide scientific gathering in Switzerland in 1997, Dr. Peretz Lavie reported that electroencephalograms taken during secretion of melatonin are similar to those induced by ben­­zodiazepine drugs such as Klonopin. But melatonin in no other way resembles benzodiazepines, according to a study that appeared two years earlier in the journal Psychopharmacology.

Infants produce a great deal of melatonin. But after we reach puberty, our melatonin levels begin to decrease. As we grow older, the pineal gland calcifies, resulting in a further loss of melatonin.

By the time we're elderly, melatonin levels are quite low, perhaps accounting for the fact that so many older people suffer from insomnia. Several clinical trials have demonstrated that melatonin-replacement therapy may be beneficial for those people.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Melatonin Studies

Researchers gave a group of elderly insomniacs melatonin and found that the hormone significantly improved sleep maintenance, compared with a placebo.

In another study, 35 elderly insomniacs were given either 2 milligrams of melatonin or a placebo two hours before they went to bed. The groups were tested for two weeks. Those taking melatonin reported the most improvement in sleep patterns.

In a 1995 study in Israel, older people with sleep problems were given melatonin two hours before bedtime for seven days. Then researchers monitored the subjects' sleep and wake patterns. Melatonin, the scientists concluded, was effective for improving sleep maintenance.

A study in the journal Lancet suggested that controlled-release melatonin may help older people to stay asleep. Israeli researchers asked 12 people in their 70s and 80s, all of whom weren't producing enough melatonin at night, to take either placebo tablets or tablets that slowly release 2 milligrams of melatonin. After three weeks, the melatonin takers were falling asleep somewhat faster, waking for shorter periods after falling asleep, and spending more time asleep.

Still other studies have confirmed previous reports of melatonin's efficacy:

  • A 1994 trial reported in the journal Neuroreport found that melatonin helped insomniacs to fall asleep nearly two hours sooner than usual.
  • A 1995 study in the European Journal of Pharmacology showed that melatonin even improves napping. Young adults were treated with 3 to 6 milligrams of melatonin or a placebo. Those taking melatonin reported that they were able to get to sleep sooner and stay asleep longer than placebo-taking subjects. The melatonin group members also assessed the quality of their sleep as "deeper" than normal.
  • Ten healthy young men were given tablets containing fast-release melatonin, controlled-release melatonin, or a placebo at 11 a.m. In the afternoon, they were asked to take naps. Those taking melatonin reported that the supplement helped them to fall asleep more quickly and to sleep better than usual.
  • Researchers gave melatonin to 225 insomniacs and monitored their progress. Within three days, the subjects receiving melatonin reported significantly better quality of sleep and a feeling of "freshness" in the morning.

One metanalysis (a review of multiple studies that treats all the data as if it were part of one large study) did conclude that melatonin is ineffective for jet lag. However, this metanalysis was biased by a few negative studies. Still, the study found melatonin safe to use. Further research is needed, but melatonin should be viewed as a safe alternative to treat insomnia or jet lag.

Valerian vs. Melatonin

In trial after trial, valerian seems to work as well as benzodiazepines in helping people to fall asleep. What's more, valerian's sedative effects are not significantly exaggerated by alcohol, as are those from benzodiazepines. And, unlike the benzodiazepine Valium, valerian has never been linked to birth defects.

But, for reasons not clearly understood, not all insomniacs respond to valerian. The herb, in fact, seems to mildly stimulate some people. Like all substances working in the nervous system, valerian has this type of paradoxical effect in a small percentage of people. Such individuals experience this effect beginning with the first dose, and it does not diminish; so, if you do not experience this effect upon taking the first dose of valerian, you can safely assume this effect will not occur at a later time.

In addition, valerian, like other herbs, is not regulated by the federal government. Thus, you can't always be sure about the quality of the valerian product you purchase.

The same holds true for melatonin. Consumers really can't assess the supplement's strength and purity. And, unlike valerian, which has been used safely for thousands of years, there have been no studies of the long-term effects of melatonin use.

It's also important to note that the beneficial effects of melatonin do not increase with higher dosages. Melatonin should generally be avoided by people suffering from depression. And, there is some evidence from animal studies that melatonin used during the daytime may have a carcinogenic effect.

But based on the clinical evidence so far, both natural remedies certainly seem deserving of further study.

Waking up exhausted and being sleepy most of the day are problems for many people. Thankfully, the home remedies and natural remedies in this article are designed to help you get the rest you need.

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ABOUT THE AUTHORS:Timothy Gower is a freelance writer and editor whose work has appeared in many publications, including Reader's Digest, Prevention, Men's Health, Better Homes and Gardens, The New York Times, and The Los Angeles Times. The author of four books, Gower is also a contributing editor for Health magazine.Alice Lesch Kelly is a health writer based in Boston. Her work has been published in magazines such as Shape, Fit Pregnancy, Woman's Day, Reader's Digest, Eating Well, and Health. She is the co-author of three books on women's health.Linnea Lundgren has more than 12 years experience researching, writing, and editing for newspapers and magazines. She is the author of four books, including Living Well With Allergies.

Michele Price Mann is a freelance writer who has written for such publications as Weight Watchers and Southern Living magazines. Formerly assistant health and fitness editor at Cooking Light magazine, her professional passion is learning and writing about health.

ABOUT THE CONSULTANTS:

Ivan Oransky, M.D., is the deputy editor of The Scientist. He is author or co-author of four books, including The Common Symptom Answer Guide, and has written for publications including the Boston Globe, The Lancet, and USA Today. He holds appointments as a clinical assistant professor of medicine and as adjunct professor of journalism at New York University.

David J. Hufford, Ph.D., is university professor and chair of the Medical Humanities Department at Pennsylvania State University's College of Medicine. He also is a professor in the departments of Neural and Behavioral Sciences and Family and Community Medicine. Dr. Hufford serves on the editorial boards of several journals, including Alternative Therapies in Health & Medicine and Explore.