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Clinician’s Corner: Melatonin

Melatonin, secreted by the pineal gland in the brain, is a neurohormone used to regulate sleep-wake cycles. Melatonin secretion begins around the third or fourth month of life, peaks in pediatric years, and lessens as we age. This decline in melatonin secretion seems to be due to calcification of the pineal gland.  A 70-year-old has about ¼ of the melatonin secretion as young adults do.  Supplementation of melatonin seems to be a reasonable option for sleep induction. Melatonin is classified as a “dietary supplement by the FDA.

  • USE: May be useful may help to regulate sleep disturbances that occur with insomnia, jet lag, rotating shift-work, depression, chronic kidney disease.
  • Jet lag: Melatonin can improve some symptoms of jet lag, such as alertness and psychomotor performance, may also be useful for daytime sleepiness and fatigue.

Might not be effective for decreasing sleep latency.

  • DOSE: 0.3—1 mg produce physiological melatonin levels in the circulation; Suggest higher doses of (2—6 mg) which are needed to obtain beneficial effects. Maximum: 10 mg/day. Doses over 10mg may produce sleepiness, impaired mental and physical performance.

Melatonin warnings:

  • Asthma: melatonin may play role in the expression of asthma symptoms- patients should seek advice before starting this therapy. Ask your doctor or Thompson pharmacist.
  • Drowsiness precautions, driving, dangerous tasks that require alertness.
  • Avoid during pregnancy and breast feeding.

SLEEP HYGIENE: Use of laptops, tablets, smartphones before bedtime can have a negative impact on melatonin secretion, circadian rhythms, and sleep. Any device with a “gray screen” all which are low light emitting, and dilates the pupils can cause this effect. One study compared the effects of reading an “e-book” versus a printed book for four hours prior to bedtime for five consecutive nights. The e-book readers had suppressed melatonin concentrations in the early part of the night, a delayed endogenous circadian melatonin phase, felt less sleepy before bed, took longer to fall asleep, and reported feeling sleepier the following morning, than the “paper book” readers.

As always ask your Thompson pharmacist before taking any supplements if you currently take other medications.  Go ahead an ASK…at Thompson Pharmacy its all for YOU!