Evidence continues to accumulate in research journals and case studies about melatonin's effectiveness in treating many conditions.
Insomnia:
Up to 40% of adults endure frequent nights of inadequate sleep.
Many insomniacs use over-the-counter medicines like Benadryl, Nyquil, or Sominex. Some try herbal products such as valerian root or sip chamomile tea.
There are many causes for inadequate or disrupted sleep. Consult a physician to make sure you have no serious medical or psychological causes. If your exam and tests are normal, it may be appropriate to temporarily attempt the help of a sleep medicine. A good choice is melatonin. In some insomniacs the response to melatonin is delayed by several nights.
The dosage used to treat insomnia is quite variable. One option is to start with 1 mg 2 hours before bed. Try this for a few nights. If no improvement is noted, try 2 or 3 mg. Use this higher dosage for a few more nights. Experiment to see what hour before bedtime is right for you to take melatonin. Some people may find taking a pill several hours before bed helps them more than taking it 1 hour before. It may be trial and error until you come up with the best dosage and timing for your unique self.
If you have a condition called delayed sleep phase insomnia Melatonin seems to be very effective for patients who have this syndrome. It resets their clock, by advancing their sleep phase. Dahlitz, from the University of London, successfully treated 8 patients with this syndrome using 5 mg of melatonin at 10 pm.
In cases of severe insomnia where a pharmaceutical pill alone is not effective, combining it and melatonin, both at low doses, may be of great benefit (Ferini-Strambi, 1993). Taking lower doses of pharmaceutical sleeping pills should reduce their side effects.
When deciding to stop the use of melatonin or any sleeping medicine, it is best to taper off over a period of 1 to 2 weeks to avoid any sleep disturbances. Melatonin may in some individuals cause rebound insomnia, as do some other sleeping pills, but to a much lesser degree. For example, if you have been using 3 mg of melatonin regularly for a while and you feel you don't need it anymore, lower the dose to 2 mg for a few nights, then 1 mg for another few nights, and stop.
Sleeping problems in children have also been treated successfully with melatonin supplements. James Jan, M.D., from British Columbia's Children's Hospital in Vancouver, Canada, has effectively treated over 90 children with insomnia due to conditions such as autism, Down's syndrome, mental retardation, hyperactivity, neurological disabilities, benign sleep myoclonus (muscle spasm), certain types of epilepsy, and more. He reports in the March 1995 issue of Developmental Medicine and Child Neurology that no side-effects or tolerance has been found. The doses used were 2.5 mg to 10 mg, with little benefit from higher doses. Melatonin was required for two to three months, after which many of the children maintained the improved sleeping patterns without it.
Jet Lag
Symptoms of jet lag include irritability, difficulty concentrating, headache, low mood, and fatigue. The change in sleeping patterns may also contribute to temporarily lowering our immunity, making us more prone to colds and infections.
Jet lag symptoms are usually worse when traveling west to east since most people have a circadian cycle longer than 24 hours (Harma, 1993). Melatonin taken in the evening of the new time zone can provide a quick readjustment.
Should melatonin be taken a few days before a trip or on the night of arrival? Research findings show melatonin has potential benefits for jet lag when given on the night of arrival as opposed to starting a few nights before the trip.
What dosage of melatonin should you take? A factor to consider with jet lag is the hours of difference between the new time zone and the one you're used to. The larger the difference, the more melatonin may be required. One rough estimate is to take 1 mg of melatonin for every hour difference.
When is the best time to take melatonin for jet lag? For most people, roughly 1 to 3 hours before the new desired bedtime works well. You may also consider splitting the dose. For instance, if you plan to take a total of 6 mg, use 3 mg about 2 hours and 1 hour before bed.
Shift Work
Many night shift staff use it. They take a 3 mg dose about 8 am when they get off from work and state that they begin to feel drowsy about 30 minutes later. They claim to sleep better with fewer interruptions. They wake up refreshed with no hangover. Workers who switch to a night shift can improve their adaptation by exposing themselves to bright artificial light at night and shielding themselves from bright light during the day. Shielding can be accomplished by wearing dark goggles during daylight hours (Eastman, 1994).*
Those who regularly change work shifts, such as police officers, hospital employees, and factory workers, are more likely to get sick. They report frequent colds, fatigue, low motivation, and stomach problems. Interpersonal relationships may be affected. When an employee has been used to working 9 am to 5 pm and has to change to an 11 pm to 7 am shift, tremendous stress is placed on the body. The circadian rhythm goes haywire. Hormones are not sure when to rise or when to fall. It may take up to 2 weeks or more to completely readjust to the new schedule. Melatonin supplements can accelerate the process of re-adjustment.*
Mood
Sleep disturbance influences mood and daytime energy. Melatonin can improve daytime mood in those who do not normally get a good night's sleep.
Low amounts of melatonin produced by our pineal gland lead to poor sleep, and consequently cause next-day tiredness and low mood. Too high doses may also have negative effects on mood.
Melatonin doses need also to be adapted to the seasons, to menstrual cycles, to the types of food we eat, to levels of exercise, and so on. A great many factors influence melatonin levels, sleepiness, and mood. You are the best person to figure out your ideal dose.
In addition to its effects on mood, melatonin can diminish anxiety and stress. It can influence the same brain receptors that benzodiazepines, such as Valium, use to provide relaxation (Pierrefiche, 1993). However, benzodiazepines interact negatively with brain receptors involved with memory. Melatonin does not interact with these receptors, and thus does not appear to interfere with memory and learning (Neville, 1986).
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