HOW DOES MELATONIN AFFECT SLEEP?

Insomnia and sleep-related disorders are becoming a common issue in the digital age; with that said, more people are turning to sleep aids to promote sleep. Melatonin is one such aid, and this article discusses its usefulness in promoting sleep.

Melatonin is a hormone produced by your brain in reaction to darkness. It aids in the timing of your circadian rhythms (24-hour internal clock) and your sleep. Circadian rhythms are 24-hour cycles of physical, mental, and behavioral changes. These natural processes are predominantly influenced by light and dark and affect most living things, including animals, plants, and bacteria. Melatonin performs other vital roles in the body besides sleep. These impacts, however, are not well understood. Melatonin dietary supplements can be derived from animals or microbes, but they are most commonly synthesized. Melatonin is most typically used to treat insomnia and improve sleep in various situations, such as jet lag. It is also used to treat depression, chronic pain, dementia, and other ailments. However, no evidence supports these claims.

How Melatonin Affects Sleep

Melatonin is a natural hormone created in the brain by the pineal gland and subsequently released into the bloodstream.  According to Arendt (1998), Darkness induces the pineal gland to produce melatonin, but light causes it to stop releasing melatonin. Endogenous melatonin is produced within the body; however, the hormone can also be produced externally. Exogenous melatonin is typically synthesized in a laboratory and sold as a dietary supplement in the form of a tablet, capsule, chewable, or liquid. ( Lockwood& Rapport (2007) )

Sletten et al. (2018) showed that adults with delayed Sleep-Wake Phase Disorder, DSWPD, and jet lag had shown the greatest potential advantages from melatonin. This disorder causes a person's sleep schedule to shift later, frequently by several hours. For "night owls," getting enough sleep can be difficult if they have obligations like work or school that need them to wake up early. Low dosages of melatonin administered before bedtime have been shown to help persons with DSWPD modify their sleep patterns. Jet lag occurs when a person's internal clock becomes misaligned with the local day-night cycle. Caspi (2004) suggested that melatonin supplementation may help reset the sleep-wake cycle 7and enhance sleep in people with jet lag.  According to Sharkey& Eastman (2002), the circadian rhythm of shift workers is typically disrupted, causing sleep issues, and shift workers have yielded mixed results, but some claim it helps.

Insomnia is a chronic illness defined by difficulty falling or staying asleep. Research is still inconclusive. The fact that melatonin has few adverse effects in most adults makes it appealing to those who have trouble sleeping. Experts believe additional research is needed to understand melatonin's optimal use in youngsters. Esposito et al. (2019) showed that melatonin might benefit youngsters who have trouble sleeping. It may also extend their sleep time. The American Academy of Pediatrics says melatonin can help youngsters adjust to a healthy sleep schedule and develop good sleep habits.  Esposito et al. (2019) also suggested that melatonin may help youngsters with epilepsy and neurological issues like Autism Spectrum Disorder. Almost all existing evaluations indicate that further study is required to address major melatonin usage problems in children, such as dosage, duration, and long-term negative effects.

Side Effects Of Melatonin

Short-term melatonin use has few negative effects and is well tolerated by most people.Anisimov (2003) reported that the most common side effects recorded are daytime drowsiness, headaches, and dizziness. However, these occur in a small number of melatonin users. More importantly, the use of melatonin has identical adverse effects in youngsters as in adults. Gagnon& Godbout (2018) indicated that Melatonin might cause agitation or an increased risk of bedwetting in some youngsters. Before taking melatonin, talking to a doctor can help prevent allergic reactions or hazardous drug interactions. Ask the doctor about potential drug interactions if one takes anti-epilepsy or blood thinners. According to Cardinali (2019), doctors advise against melatonin use in dementia patients. There is also limited information on its safety in pregnant or nursing women. Less is known regarding melatonin's long-term effects on children or adults. Some worry that long-term melatonin use may delay or prevent puberty in youngsters; however, the evidence is mixed. Because the long-term implications are unknown, patients should keep talking to their doctor about melatonin, sleep quality, and overall health.

Factors To Consider While Taking Melatonin

Melatonin may offer some positive benefits when taken with caution. In addition, knowing where and what to watch out for when buying these supplements is crucial as they can determine the effectiveness of melatonin. Here are a few key issues to look out for.

Legal Concerns

According to Dwyer et al. (2018), In the United States, melatonin is regarded as a dietary supplement and, therefore, is not under much scrutiny by the Food and Drug Administration. However, there are other countries where it is regarded as a drug and can only be obtained with a medical prescription. Therefore, always check its legal status to ascertain its availability depending on your location.

Mislabeling By Manufacturers

Abraham et al. (2017) found that a substantial amount of melatonin supplements sold over the counter did not contain what was on the label. In addition, some of the products were found to contain other hormones, such as serotonin, although at very low levels. Nonetheless, this hormone is dangerous as it has adverse side effects, especially if taken without a doctor's prescription.

Melatonin Dosage

According to Sack (2010), the optimal melatonin dosage is unknown; however, most specialists advise against exceedingly high doses. Doses in trials range from 1 to 12 mg (mg). A usual supplement dose is between one and three milligrams. However, this depends on factors like age and sleep issues. Furber (1982)  stated that Melatonin comes in microgram (mcg) quantities, where 1000 mcg equals 1 mg. Using melatonin as a sleep aid might cause daytime drowsiness. If this happens, the user’s dosage may be too high. Begin with the lowest dosage feasible and work your way up gradually under your doctor's supervision. Malini (2020) stated that Pediatric dosages should not exceed 3-6 mg, as many young people react to 0.5-1 mg doses. Adults may benefit from smaller doses as well. According to Zhdanova et al (2001), Melatonin Oral melatonin supplements can raise blood melatonin levels well beyond what the body produces. For example, 1-10 mg can increase melatonin levels by 3-60 times. As a result, those taking melatonin should avoid large doses.

Conclusion

Melatonin is a hormone produced by the pineal gland in the body and alters the circadian rhythm. This rhythm is responsible for preparing the body for sleep and waking up and is directly affected by melatonin levels. It may help with jet lag when adjusting to new time zones. In addition, it may be useful in children with sleeping disorders, although the available research still calls for more insight into its work. However, it is always advisable to consult your doctor before using melatonin.

References

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Anisimov, V. N. (2003). Effects of exogenous melatonin—a review. Toxicologic pathology, 31(6), 589-603.

Arendt, J. (1998). Melatonin and the pineal gland: influence on mammalian seasonal and circadian physiology. Reviews of reproduction, 3, 13-22.

Cardinali, D. P. (2019). Melatonin: clinical perspectives in neurodegeneration. Frontiers in endocrinology, 480.

Caspi, O. (2004). Melatonin for the prevention and treatment of jet lag. Alternative therapies in health and medicine, 10(2), 74-83.

Dwyer, J. T., Coates, P. M., & Smith, M. J. (2018). Dietary supplements: regulatory challenges and research resources. Nutrients, 10(1), 41.

Furber, J. D. (1982). Nutrition, Diet, and Supplements for Peak Physical & Mental Performance.

Gagnon, K., & Godbout, R. (2018). Melatonin and comorbidities in children with autism spectrum disorder. Current Developmental Disorders Reports, 5(3), 197-206.Esposito, S., Laino, D., D’Alonzo, R., Mencarelli, A., Di Genova, L., Fattorusso, A., ... & Mencaroni, E. (2019). Pediatric sleep disturbances and treatment with melatonin. Journal of translational medicine, 17(1), 1-8.

Lockwood, B., & Rapport, L. (2007). Nutraceuticals (pp. 1-18). London: Pharmaceutical Press.

Malini, P. (2020). A Comparative study of Oral Midazolam and Oral Melatonin for Premedication in Paediatric Anaesthesia (Doctoral dissertation, Stanley Medical College, Chennai).

Sack, R. L. (2010). Jet lag. New England Journal of Medicine, 362(5), 440-447.

Sharkey, K. M., & Eastman, C. I. (2002). Melatonin phase shifts human circadian rhythms in a placebo-controlled simulated night-work study. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 282(2), R454-R463.

Sletten, T. L., Magee, M., Murray, J. M., Gordon, C. J., Lovato, N., Kennaway, D. J., ... & Delayed Sleep on Melatonin (DelSoM) Study Group. (2018). Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: a double-blind, randomised clinical trial. PLoS medicine, 15(6), e1002587.

Zhdanova, I. V., Wurtman, R. J., Regan, M. M., Taylor, J. A., Shi, J. P., & Leclair, O. U. (2001). Melatonin treatment for age-related insomnia. The Journal of Clinical Endocrinology & Metabolism, 86(10), 4727-4730.