Using melatonin correctly can help sleep and mood problems, but melatonin can be tricky, and if misused can cause insomnia and even depression. Here are some of the common mistakes people make, and guidelines to use melatonin the right way.
Mistake #1: Melatonin is a sleep hormone
Most people think melatonin is a natural sleeping pill. This couldn't be more wrong; melatonin on its own won't induce sleep, and is usually only effective in short-term applications. It's more correct to think of melatonin as a 'darkness' signaler, that is, it tells the brain that it needs to prepare for a night time or winter cycle. If taken in the evening or when it's dark, melatonin can speed up sleep preparation, and it can tell the body clock to shift its sleep cycle to an earlier time.
Mistake #2: I can take melatonin at any time.
If melatonin is used during daytime brightness, it can cause adverse effects. If the body clock is receiving conflicting daytime light signals and dark signals from melatonin, it can malfunction and not work properly when it is time to go to sleep later.
Mistake #3: Melatonin is a natural supplement, so it can't do any harm.
The wrong amounts of melatonin or melatonin at the wrong time of day can cause serious health risks. Daytime melatonin has been shown to cause depression. This makes sense, especially when you consider that melatonin causes us to pull back, withdraw, become disoriented and irritable - the classic hibernation response. It's best to avoid using melatonin that could be in our system during the day.
Mistake #4: I need melatonin to help me sleep
In most cases, your sleep problem isn't from a lack of melatonin, and increasing melatonin can mask underlying problems that are the real cause of insomnia. If you need melatonin to help you fall or stay asleep, you are more likely suffering from a circadian rhythm sleep disorder. Circadian rhythm sleep disorders mean that your body is producing melatonin and other sleep hormones at the wrong time of day, so when you need to sleep, you don't have enough melatonin in your system. Simply adding melatonin doesn't fix the sleep problem and can contribute to depressive mood disorders. The most effective treatment for circadian rhythm sleep disorders is light therapy, because bright light is the zeitgeber or signaler the body clock uses to reset itself each day.
Mistake #5: I need to keep taking melatonin.
Sleep experts don't recommend taking melatonin for more than two weeks at a time. Melatonin is effective as a signal augmenter (reinforcing external cues), or as a tool to help shift sleep and circadian rhythms. Long term use of melatonin indicates a more serious underlying sleep disorder that should be investigated by a sleep professional.
Mistake #6: The dosage amount isn't important.
The problem with melatonin is that it was discovered long before scientists really understood what it does and how much you need. For example, in the late 80's and early 90's, we thought melatonin was a sleep hormone. Now we know it is much more complicated. In addition, tablet sizes average 3-5 mg. New evidence shows that adult males only need 150 micrograms, and the average female needs only 100 micrograms (a microgram is 1/100 th of a milligram). So the average melatonin supplement is 20 - 50 times more than we need! If you are using regular melatonin tablets, you can cut the pill into fourths, otherwise, try to find the smallest pill size available. If you are taking time-released melatonin, do not break the pill, as this will ruin the time-release.
Mistake #7: I don't take melatonin, so I don't have to worry.
Actually, this could be one of the costliest mistakes people make. Melatonin is an essential nighttime hormone. When in the body at the right time, it does wonderful things, such as help the heart and vital organs rest at night. Melatonin also acts as a powerful antioxidant; while it shuts the body down, it cleans the toxins and free radicals from cells.
But we often do things that keep melatonin from being produced, and that can be deadly. When we stay up late at night or work night shifts, we keep our body from producing melatonin. This increases the risk of hypertension, heart disease, diabetes and cancer. Studies show women night-shift workers have a 500% higher risk of breast cancer and male night shift workers have a 50% increased risk of colo-rectal and bone cancer. While not realizing it, many people increase this risk with inconsistent sleep/wake schedules - late night studying or partying or shift work schedules.
How should I take melatonin?
The first thing to know about melatonin is that its half life is very short, and is only active in your system for about 20 minutes. This is why it is important to use different types of melatonin for different reasons:
Induce sleep or shift sleep to an earlier schedule (1hr+)
* If you take more than an hour to fall asleep, or you need to shift your sleep more than an hour, consider taking time-released melatonin. It is also important to use a high-quality, standardized melatonin supplement. Try to find the lowest dose available and do not cut the pill . Since melatonin tablets are coated to provide slow release, cutting them will ruin their long-term potency.
* When to take: Depending on the severity of the sleep problem, take time-released melatonin 1 to 3 hours prior to the time you usually fall asleep. Since time release melatonin only lasts for 3 - 4 hours, any need to shift sleep schedules more than 3 hours may require taking another pill in 3 or 4 hours.
* Cautions: Melatonin should not be taken if eyes are exposed to bright sunlight, and melatonin should be avoided if operating any vehicle. If attempting sleep shifts of more than 1 hour, light therapy should also be used. Do not use melatonin for more than two weeks at a time.
Induce sleep (less than 1hr)
* If it takes an hour or less to fall asleep, then standard melatonin in the lowest mg size is a good option.
* When to take: One to two hours before desired sleep time.
* Cautions: See above
Nighttime awakenings and early morning insomnia
For nighttime awakenings that last less than one hour, consider taking sublingual melatonin (a pill that dissolves under the tongue). Sublingual melatonin is released immediately into the blood stream, and isn't metabolized through the digestive system.
* For frequent or awakenings that last more than one hour, consider taking 1 sublingual and a time-released melatonin tablet. Take the time release tablet first and then place the sublingual tablet under your tongue.
* Cautions: If you need to get up in the morning within 2-3 hours, Take regular instead of time release melatonin. Time release melatonin may last into the waking hours, causing confusion and mood problems. Do not take melatonin if you awaken less than one hour before you need to get up.
Considering Light Therapy
As mentioned above, the need to use melatonin indicates a circadian rhythm disorder because sufficient melatonin is not in your system when you need to sleep. Melatonin on its own doesn't regulate circadian rhythms, because your body's control center relies on bright light to reset its daily sleep/wake rhythms. Melatonin can aid in shifting rhythms, but most of the effort in regulating circadian rhythms involves suppressing daytime melatonin. The problem isn't that your body needs more melatonin - it produces enough, but when your body clock malfunctions, it produces melatonin at the wrong time of day, and specialized light keeps melatonin out of your system at the wrong time of day, so your body will produce it at the right time.
References
* G W Lambert, et al. Effect of sunlight and season on serotonin turnover in the brain. The Lancet. Vol 360. December 7, 2002
* Carskadon MA, Association between puberty and delayed phase preference. Sleep. 1993 Apr;16(3):258-62.
* J Rabe-Jablonska et al., Diurnal profile of melatonin secretion in the acute phase of major depression and in remission. Med Sci Monit. 2001 Sep-Oct;7(5):946-52.
© 2005 Apollo Health, Inc. All rights reserved
