By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

MELATONIN MAY HELP READER’S SLEEP, BUT LONG-TERM SAFETY UNKNOWN

Question: I’ve been having trouble sleeping, as I’m starting to go through the change of life. My friend suggested I take some melatonin since it helps her sleep. I thought melatonin was only for jet lag? What is melatonin, and will it help me sleep?

Answer: Melatonin is a hormone that naturally occurs in our bodies. It is produced in the pineal gland, and it helps to regulate our circadian rhythm -- the internal timing mechanism that keeps us awake in the daytime and asleep during the night.
Melatonin is manufactured by the body in response to being in a dark environment, and production is decreased with exposure to light. The female hormones that help regulate the menstrual cycle are released in response to melatonin. Some research suggests that the body’s decline in melatonin levels with age contributes to sleeping problems in older adults. Melatonin has also been shown to be an antioxidant and may boost the immune system.

Melatonin supplements can be used for many things. As you know from your friend, it has received a good deal of publicity as a treatment for insomnia. In fact, a few scientific studies have shown it to be more effective than a placebo, or sugar pill, in treating sleep problems. Specifically, these studies have found that melatonin was better than a placebo in three areas -- reducing the amount of time it takes to fall asleep, increasing the number of hours of sleep and improving daytime alertness. Other studies, however, have shown these effects to be present only for short-term use -- a few days to several weeks. Also, the effects of using melatonin supplements for an extended period of time have not been studied, so its long-term safety is not known.

I find it interesting that melatonin is also being studied as an adjunctive treatment for a wide range of other conditions. A few that are currently under investigation include depression, eating disorders, osteoporosis, cancer, attention deficit, sunburn and heart disease. All the studies are very preliminary, and you should not try on your own to use melatonin to treat any of these conditions.

While melatonin is available without a prescription, it should be used with caution. Always start with the lowest possible dose and only after consultation with your family physician. If you take too much melatonin, it can cause agitation and anxiety. When using melatonin for insomnia, take it about one hour before bedtime. You will know it worked if you get a restful night’s sleep and have no fatigue or irritability the next day.

Melatonin is known to have side effects such as vivid dreams and nightmares. It can also disrupt your sleep and wake cycles if not taken properly. Also, be careful if you are taking other medications regularly, even over-the-counter products. Though many drugs and a few herbs can interact negatively with melatonin, you should be particularly careful not to use other sedative drugs or alcohol when taking melatonin. Because of the possibility of these types of drug interactions, I urge you again to consult your physician before trying melatonin.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.