Melatonin as a natural sleep medicine
Melatonin is a hormone that warns the body to prepare for sleep, so it is used when it is hard to do so. But let’s not confuse having a hard time going to sleep than sleeping soundly, or to stay asleep instead of waking up in the middle of the night.
Different sleep needs require different types of melatonin, so there is quick-release melatonin, which acts shortly after being administered and is eliminated after 3 or 4 hours in the urine. Over-the-counter melatonin is usually of this type, which is sold at a lower dose. Then, there is the prolonged-release kind, that acts in a way more similar to that generated by our body in a natural way. A healthy person releases melatonin in a sustained way throughout the entire period of sleep.
Melatonin does not cause addiction and, in the case of overdose, the effects should not be graver than drowsiness or dizziness. But that does not mean that one should ingest it carelessly. Experts insist that medical supervision is essential.
As a chronobiotic –regulator of sleep-wake rhythms- there has been international consensus for years to use it as a first-line in the treatment of sleep problems. It works very well. The problem is in the administration schedule.
It is wrong to believe that it should always be taken half an hour before bedtime, depending on whether there are alterations in the rhythm of melatonin that cause insomnia.
In that case, we must fix that first. For example, if the patient instead of having the night peak of melatonin at 3 in the morning has it at 6 in the morning, doctors would do very badly to give melatonin before bedtime.
First, doctors have to move that peak at 3 o’clock, what we call a phase breakthrough –that enters sleep earlier- by administering melatonin at 5 or 6 in the afternoon. If the peak is later, doctors must delay it. The failures in the use of melatonin to control sleep disorders depend on its misuse.
The recommendation is to use the hormone in cases of time lag and notes that clinical studies support the use of melatonin to regulate the circadian clock in children with autism and in some types of blindness.
Blind people with complete retinal degeneration are unable to make their biological clock synchronize with the photoperiod marked by light. In these cases the administration of melatonin does work.
There are less known uses in which melatonin has proven useful. In those diseases that occur with oxidative stress, inflammation, and mitochondrial damage. This is explained by the antioxidant, anti-inflammatory and mitochondrial protective properties of melatonin.
Scientists are doing many studies and clinical trials to identify these properties and use melatonin as medicine for them. The doses in these cases are much higher than to treat insomnia, but everything is still being tested.
The case of Women in Menopause
One of the consequences of age is that the body loses the ability to produce endogenous melatonin. You sleep worse, sleep is suddenly interrupted at midnight and there is no way to hit your eye again.
In short, insomnia appears. It also happens to women when they reach menopause. In these cases, the pattern is prolonged-release melatonin to last overnight. It is important that the prescription is controlled by a doctor and not be combined with benzodiazepines.
If a person who takes two orfidales a day substitutes this medicine for melatonin, they will notice an increase in anxiety. Many patients who do it on their own belief that it is that melatonin makes them nervous when in fact it is that they have removed benzodiazepine. In these cases, experts suggest accompanying its consumption with cognitive behavioral therapy to treat insomnia.
The administration to children and, above all, to babies, divides pediatricians. But it relieves many parents. Babies do not have their suprachiasmatic nucleus synchronized with the outer light at birth because there is no light-dark cycle in the womb. Their biological clock must adapt to that cycle.
That is why it is important that if they wake up at night they will breastfeed almost in total gloom. And during the day, when they sleep, you don’t have to lower the blind or remain silent so that they synchronize their clock with the waking hours.
The problem arises when the months pass, the creature goes free and the parents begin to suffer from lack of sleep. As a baby’s melatonin rhythm is immature, administering a little at bedtime can help. But as long as it is accompanied by hygienic sleep standards so that natural synchronization occurs as soon as possible.
Why not buy large doses online
In many countries, a dose greater than 2 mg is only sold by prescription. This has led to the purchase of melatonin online, where it is possible to buy tablets of 5 and up to 10 mg of melatonin without any prescription. Today, there is no need to travel: they are easily found on the web.
With a prescription, you can reach those doses but always supervised by a professional. You have to assess everything: from sleep habits to what foods are ingested at the same time. We have studies that show that almost half of the patients’ melatonin-insulin sensitivity worsens.
Therefore, if we are going to take it with dinner, it is not convenient to include quick-release carbohydrates, such as pasta. In case of doing so, dinner should be advanced to avoid interference with melatonin.
Tripling the dose just because more powerful pills are sold in other countries makes no sense. Melatonin is not a hypnotic substance. There are those who take it and in half an hour they think it does nothing. It is a mistake.
Melatonin’s mechanism of action is not fulminating you, but to transmit to the brain the signal that it is time to sleep. The problem is that we can’t change the message every week because, in the end, it doesn’t work.
Melatonin is a chronobiotic. It sets our biological clock, but that clock cannot be changed happily from one day to the next.
If patients were to use melatonin in ways to drastically change and/or aid changing sleeping habits, the brain perceives chaos. In case of changing work shifts, the idea is to take it for a few days and always at the same time.
In the case of teenagers, experts warn that too much time in front of cellphones and / or computer screens inhibits endogenous melatonin. It’s not that they have insomnia, it’s that they sabotage the arrival of sleep.
They make these recommendations extensive to the rest of the population. Before trying drugs, we should review our habits: reduce exposure to light before going to bed to promote numbness, always go to bed at the same time, maintain regular meal times, play sports and others.