The Insomnia Blog - Sleep Doctor Michael Breus, PhD

Sleep: The Biggest Sleep Stories of 2011: Part II

 Sleep was in the news throughout 2011, with breakthrough research and advances in our understanding of why we sleep, and how sleep—or a lack of it—can affect health and well being. Here are my picks for the most interesting and important sleep stories from the second half of 2011, with practical sleep suggestions you can start using today.

 July 2011

Sleep suggestion: Your doctor’s sleep matters to your health

This year, changes went into effect that put new limits on the amount of time first-year residents can work without time off. Previously, these residents were able to work for as much as 30 hours straight! Now, first-year residents can work no more than 16 hours at a stretch without an 8-hour break. These changes are welcome and overdue; a start in what I hope will be a continued shift away from the sleep-deprived culture of medical training. The truth is that sleep-deprived doctors are less capable of retaining information, and long resident hours are associated with greater incidence of preventable medical errors.

 August 2011

Sleep suggestion: To keep your kids at a healthy weight, make sure they get enough sleep

Researchers in New Zealand, working with children ages 3-7, found that additional sleep reduced the children’s risk of becoming overweight, and led to lower BMI. Helping kids to develop strong sleeping habits from a young age is a long-term investment in their health, and can help protect them from a host of health risks associated with obesity.

 September 2011

Sleep suggestion: Don’t assume your sleep needs are the same as your mate’s

Gender differences in sleep were a hot topic this year. New research suggests that men and women do have basic, biological differences in their sleep. These differences offer up specific types of protection—women seem to weather mild sleep deprivation better than men, whereas men appear to be somewhat less vulnerable to sleep disorders. The differences in the way men and women sleep also make each more vulnerable to certain risks.

 October 2011

Sleep suggestion: Want to protect your teen’s health? Start by protecting their sleep

 A landmark study published in 2011 showed lack of sleep among teens is strongly associated with a long list of risky and unhealthful behaviors. The list includes smoking, drinking, drug use, overeating, avoiding exercise, depression and suicidal thoughts. Teens that slept fewer than 8 hours per night were at a greater risk for engaging in these behaviors than teens that slept for at least 8 hours or more.  The message couldn’t be clearer: make sure your teens are getting sufficient sleep, at least 8-9 hours per night.

 November 2011

Sleep suggestion: Want to avoid weight gain? Go to bed early

Sleep timing has an effect on diet and weight gain, according to this study published in 2011. Researchers at Northwestern University found that late bedtimes lead to late mealtimes, and that sleeping later and eating later make poor diets and weight gain more likely. In the study, sleeping less, going to sleep later in the night, and eating more heavily after 8 p.m. were all associated with higher BMI. If you’re looking to trim up in the New Year, shifting your bedtime back—and staying away from the refrigerator after 8 p.m.—can help.

 December 2011

Sleep suggestion: A good night’s sleep may reduce your risk of fibromyalgia

 The relationship between sleep and pain has become a hot topic in sleep studies—with good reason, since there seems to be a strong relationship between the two, one that we’re just beginning to understand. Studies such as this one, which suggests a link between sleep deprivation and the risk of fibromyalgia, are helping to increase our understanding of how sleep and pain interact in the body. This study demonstrated as much as a 5 times higher risk of fibromyalgia, a condition characterized by chronic pain, among women who reported frequent sleep problems.

 Here’s to a new year filled with good health and good sleep!

 Sweet Dreams,

 Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

 The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

 

Sleep: The Biggest Sleep Stories of 2011: Part I

The year that just ended was a big one for sleep, with lots of important, news-making stories related to sleep and sleep disorders. Here are my picks for the biggest sleep stories of 2011, and the most important sleep advice to come from this year’s most compelling research into sleep.

 January 2011

Sleep suggestion: Take your vitamins…for sleep

Vitamins don’t just do your waking body good, they also can help improve the quality of your sleep. Vitamin B helps the body’s production of serotonin, the “calming hormone” that lulls the body toward sleep. Calcium also helps relaxation, and taken in combination with magnesium, can help with chronic sleep problems. Vitamin D got a lot of attention this past year—with good reason, since many people (in northern climates, with darker skin tones, elderly, overweight, pregnant and post-natal women) are at risk for Vitamin D deficiency. Vitamin D is showing promise in lowering fatigue and daytime sleepiness.

 February 2011

Sleep suggestion:  To improve your sleep at night, make your bed in the morning

 

This is the kind of practical strategy that I love: creating a proper sleep environment helps us sleep better, according to a survey by the National Sleep Foundation.  People slept better when they kept a clean bedroom, kept clean sheets on the bed and changed them once a week, slept on comfortable mattress and pillows, and kept their rooms dark and cool. This is the essence of basic sleep hygiene. When your sleep starts to suffer, go back to basics and make sure your bedroom –especially your bed—is conducive to sleep.

 March 2011

Sleep suggestion: Be mindful of your sleep

This fascinating news could have real implications for the treatment of obstructive sleep apnea, one of the most common sleep disorders. Researchers at the University of Toronto found that the interruption of breathing that occurs with OSA causes the brain to release a chemical called noradrenaline. Noradrenaline helps the body learn to breathe more deeply and fully. There’s a great deal more to investigate here, but research such as this could lead to simpler, more streamlined and effective treatments for OSA and sleep-disordered breathing. This is also a reminder of the power of the mind—and how we can put it to use in the service of sleep.

 April 2011

Sleep suggestion: Don’t assume you are a super sleeper

I’m highlighting this news to point out what the vast majority of us are not. Super sleepers made headlines in 2011—these are people who can function at full capacity on fewer than 6 hours of sleep per night. These folks exist, but they are in the distinct minority. Though many of us may try to convince ourselves we can sleep 4 or 5 hours of sleep per night and not pay the consequences, it’s just not true. Only 1-3% of the population are short sleepers. The rest of us—you know, the 99%--need 7 to 8 hours of sleep per night to function well.

 May 2011

Sleep suggestion: Sleep more to weigh less

In 2011 we learned a lot about the connection between sleep and weight. Sleep helps regulate hormones that govern appetite and metabolism. It helps keep judgment sound and willpower strong. A full night of sleep allows you to wake feeling energized and ready to jump into your day, hopefully with calorie-blasting exercise. What’s more, during REM sleep, the body actually burns more calories than when you’re awake lying in bed.

 June 2011

Sleep suggestion: Want to protect your memory? Get some sleep

This sleep news was some of the most intriguing of the year. Researchers at Washington University School of Medicine discovered a direct link between sleep and the establishment of long-term memories. Testing with fruit flies, scientists were able to manipulate cells in the fly brain to show that sleep had a direct effect on the creation of long-term memories. Flies that slept after being exposed to new information were able to convert that short-term knowledge into memory.

 Stay tuned for more sleep tips and a roundup of the most promising and important sleep stories from the second half of 2011. Happy New Year!

 

Sweet Dreams,

 Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

 The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 

Facebook: www.facebook.com/thesleepdoctor

 

Sleepless and in pain: a link between fibromyalgia and sleep

There’s some important news for millions of people—most of them women—who suffer from the syndrome fibromyalgia: a new study suggests that sleep deprivation is associated with an increased risk of developing fibromyalgia.

The study was conducted at the Norwegian University of Science and Technology. The study included 12,350 women. At the outset of the study, all the women were free of physical impairment, musculoskeletal pain, and fibromyalgia. A decade later, 327 of the women—2.6% of the study population—had developed fibromyalgia. Researchers asked all the women in the study to report on their sleep habits and their sleep problems. They found that women who reported sleep problems were significantly more likely to have developed fibromyalgia than women without sleep problems. The researchers also found that the risk of fibromyalgia increases with a woman’s age, and with the severity of sleep problems:

• Women who reported having difficulty sleeping “always” or “often” had nearly 3-½ times greater risk of fibromyalgia as women who did not have problems sleeping
• Women age 45 and older who “always” or “often” had sleep problems had more than 5 times the risk of developing fibromyalgia as women without sleep problems
• Younger women, ages 20-44, who “always” or “often” had difficulty sleeping were at 3 times greater risk of developing fibromyalgia than their counterparts who didn’t have trouble with sleep

 It’s important to make clear that this study does not prove that sleep deficiencies cause fibromyalgia. What it does do—for the first time—is establish a strong connection between sleep problems and fibromyalgia, by showing the increased risk of fibromyalgia that is associated with lack of sleep.

 What is fibromyalgia? It’s a syndrome whose main characteristic is chronic pain. Pain is often felt throughout the body, in muscles, tendons and soft tissues. With fibromyalgia, the pain is often felt at certain trigger points, and radiates from those points outward. People with fibromyalgia often experience daytime fatigue, which can be severe, as well as depression, anxiety, and memory problems. Women ages 20-50 are at the highest risk for fibromyalgia. Men do develop fibromyalgia, but women are more than 10 times as likely as men to develop the syndrome.

 Fibromyalgia has a history that’s both contentious and mysterious. For a long time, there was no consensus in the medical community about whether it even existed, whether it was a “real” disorder or an “imagined” one. This has changed, and the medical establishment now overwhelmingly accepts that fibromyalgia exists as a very real disorder. But much about the syndrome—including and especially what causes it—remains unknown. For this reason, and because there is no single test that can positively identify fibromyalgia, it remains difficult to diagnose. Since it can’t be tested for, a diagnosis of fibromyalgia comes by way of eliminating other possible conditions.

 There are signs of possible genetic and environmental links, since fibromyalgia seems to sometimes run in families. Researchers have explored links between fibromyalgia and other diseases and disorders, including arthritis, depression, anxiety, chronic fatigue, and restless leg syndrome, but no conclusive evidence has been found to demonstrate a causal link between fibromyalgia and these conditions. That said, all of these disorders are found more often in people with fibromyalgia than in the general population.

 Is sleep a cause of fibromyalgia? Again, we just don’t know, and this current study doesn’t answer that question. The relationship between sleep and chronic pain is complicated, and there is a lot we do not understand about cause and effect. Here’s some of what we do know. The presence of chronic pain, such as with fibromyalgia, makes falling asleep and staying asleep more difficult. Sleep deprivation, in turn, can make people more sensitive to pain. Evidence that disrupted sleep can lead to a lower pain threshold includes this study. Researchers took a group of healthy, pain-free middle-aged women and disrupted their sleep cycle, depriving them of deep, slow-wave sleep, for three consecutive nights. They then tested their threshold for musculoskeletal pain, tenderness and also mood. After only a few nights of disrupted sleep, the women experienced a significantly decreased pain threshold (meaning they felt pain more quickly and intensely), as well as increased fatigue and general discomfort.

 We don’t need to know the root causes of fibromyalgia to know that improving sleep is at the core of a strong treatment plan for the condition. If you’re struggling with sleeping because of fibromyalgia or chronic pain, keep these strategies in mind to help improve and protect your sleep:

• Emphasize your rest. People with fibromyalgia simply cannot shirk their sleep routine. Make sure sleep stays a top priority, by setting up a schedule that allows for plenty of rest, and by creating a sleep environment that is relaxing, quiet, dark and conducive for sleep.
• Exercise. Regular exercise can help manage pain itself. It will also strengthen your sleep-wake cycle, and help you sleep better. Schedule exercise earlier in the day, and outdoors in sunlight if you can.
• Use relaxation techniques. Meditation, massage and mind-body exercise are also powerful tools for pain management and for sleep as well. One study found that after three months of regular Tai Chi practice (two, hour-long sessions per week), pain and depression among fibromyalgia patients had declined, and sleep had improved.
• Avoid alcohol, tobacco and caffeine. These chemicals may make you feel “better” in the very short term, but they disrupt sleep and increase stress, among other negative consequences. With fibromyalgia, your body is coping with enough stress without exposing it to taxing chemical stimulants and depressants.

 There is so much that we still need to learn about fibromyalgia itself, as well as the relationship between chronic pain and sleep. One thing that’s not in question? Sleep is powerful healing tool. It costs nothing and doesn’t require a prescription. Make sure you’re using it to its greatest effect.

 Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

 

 

 

Stressed and sleepless in the UK

According to a couple of news reports from Britain, the ongoing financial crises—and the stress they cause to everyone from bank executives to everyday investors—are taking a toll on health, well being, and sleep.

This news story focuses on the effects of the European debt crisis on workers in the banking industry. Depression, anxiety, and insomnia are common and widespread among the UK’s financial workforce, according to the article, and these disorders are affecting those at all levels of the industry, from top executives on down. Reports that forecast increasing unemployment and particularly heavy layoffs in the financial sector are, understandably, exacerbating stress for workers in the financial industry.

 As this article indicates, the culture of the financial workplace doesn’t always encourage employees to seek help for stress-related health problems such as insomnia, depression and anxiety. All too often, the underlying message is to “tough it out.” This leads to people denying symptoms even as they worsen, and often to compensating with drugs and alcohol, which only compound the problem.

 On the heels of this news about financial workers comes this report on the state of sleep among Britons in general. In a poll of 3,000 adults, which was sponsored by the furniture company (and mattress purveyor) IKEA, Britons reported chronic and widespread sleep deprivation—and cited worries about work and finances at the top of the list of concerns that keep them awake at night. According to the poll:

• 70% of adults polled said they do not get enough sleep
• 57% say they are kept awake at night by worries about finances and work issues
  • (This one just beats out being kept awake by a partner’s snoring, at 54%)

 Stress from financial woes is nothing new. This is a perennial issue, but there’s no question that the last several years have been especially difficult and stressful for people in this regard. I’ve written before about the impact of a difficult and uncertain financial climate on sleep and health. Stress in whatever form is an enemy to sleep, and can also contribute to depression and anxiety. The relationship among these disorders themselves is complicated, with each being a possible trigger for the other. This dynamic is itself the subject of a recent study that shows insomnia is often accompanied by anxiety and depression.

 Unfortunately, it doesn’t look like there are any quick fixes on the horizon for the economic problems in the UK, Europe or in the United States. Here are some strategies for protecting your sleep if you find yourself coping with stress related to the difficult economy:

 Don’t reach for sleeping pills FIRST. I do believe there may be  circumstances that warrant prescription sleeping medication, and you should discuss your options with your primary care physician. But I always encourage my patients to explore natural remedies before turning to prescription sleep meds. Regular exercise, early-in-the-day exposure to sunlight, a regular bedtime, plus the tips that follow—these are the components of good sleep hygiene, and they should always be the first route toward a good night’s sleep. 

 Manage your exposure to news. Our 24-hour news cycle and the seemingly endless media outlets mean that there is no limit to the amount of information we can consume. All this information and media noise can lead to late-night worrying. Setting limits on media exposure can help you wind down peacefully toward sleep:

• Stop watching and reading the news 2 hours before bedtime. This includes all forms of news media: TV, online, radio, newspapers and magazines.
• Make dinnertime and evening a finance-free discussion zone. If you want to debate financial policy, or talk personal finances, plan to do this during the day, not at night.
• Give yourself a media holiday. From time to time, take a 24-hour break from ALL media. You’ll be amazed at how relaxing and refreshing this news break can be.

 Create a soothing evening routine. Now that you’ve eliminated news media from your nightly routine, its time to replace it with activities that relax you. Try reading a novel for pleasure, treating yourself to a soothing bath, even taking a leisurely nighttime walk around the block. Quiet, romantic time with your partner is a great stress-reliever and great for your relationship as well!

 Avoid alcohol. It can be tempting to decompress at the end of the day with a drink or two. But if you’re worried about your bank account, the ups and downs of the stock market, or the security of your job, then drinking to combat these stressful circumstances is a bad idea. This kind of drinking can lead to dependence. Moreover, alcohol, though it may make you feel temporarily relaxed and sleepy, will actually undermine your sleep. Use exercise, meditation, and time with friends and loved ones to provide yourself with relaxation and solace, not alcohol.

 The affects of stress and financial uncertainty are not problems that are confined to the UK. We’ve got these issues on both sides of the pond. Wherever you are resting your head tonight, make sure you’re taking the right steps to leave your worries outside the bedroom door.

 Sweet Dreams,

 Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

 The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 

Facebook: www.facebook.com/thesleepdoctor

 

 

 

 

Is Your Bedroom Making you FAT? 5 Tips for a Skinny Bedroom

The quality and quantity of your sleep can affect your ability to lose weight, and stay healthy. There are a great many things that influence your sleep, but have you ever considered your bedroom?

Let me give you an example. If music is on while you are cooking in the kitchen, and you have all the right equipment, and all the right ingredients what happens? Not only do you enjoy cooking more, but the food you make likely tastes better!

Adding hours and depth to your sleep results in weight loss:  a 2009 study conducted in Sao Paulo, Brazil found that while sleeping you burn 3 times more fat then when lying in bed awake.  In another study, participants on identical diets that slept 5.5 hours lost lean muscle, as opposed to those sleeping 7+ hours lost fat.

So what is your bedroom doing to keep you awake and fat? Here are my 5 tips for a Skinny Bedroom:

1. Lose the snooze: using the snooze button in the early morning hours keeps you from the most calorie burning stage of sleep, REM sleep,-which occurs most in the final third of the night.
   • You can also use the trick of setting your alarm to tell you when to go to bed, to stick to your healthy sleep schedule of getting to bed at the same time every night.
2. Enforce an Electronic Curfew: while I would prefer electronics (phones, laptops, iPads etc) to be out of the bedroom altogether, I know it is simply not realistic. So set an electronic curfew for 1 hour before lights out. This will decrease the electronic exposure you are getting before bed (which has been reported to cause un-refreshing sleep).
   • Try setting an alarm on your mobile device, or better yet see if you can set a timer to turn it off!
   • What would you do in that last hour? Try my POWER DOWN HOUR technique, it works wonders:
     • 20 minutes of those small things that just need to get done
     • 20 minutes of bedtime hygiene
     • 20 minutes of meditation, relaxation, or massage
3.  Light the path: If you get up in the middle of the night and need to use the restroom, you probably turn on a light, and tell your brain it is morning! This also slows the production of Melatonin (the “vampire” hormone that-is produced in darkness) which is the key that starts the engine for sleep.
   • Strategically place a night light in the bathroom and in the hall on the way. Now you can avoid any excess light or stumbling into a nightstand, and get back to sleep more easily.
4. Have the right performance equipment: the right mattress and pillow make a huge difference. If you are not comfortable you will not relax enough to fall asleep. If you do not have the proper support you will not awaken feeling refreshed (and thinner).
   • Consider a new mattress when your body tells you it is time, not when the warranty is up. Never sleep on the same surface longer than 7 years.
   • Replace pillows every year, or earlier if your neck is stiff.
5. Provide soothing sounds for sleep: if it is too quiet your hearing will become more acute and everything will keep you awake. Too much noise will also prevent or disrupt sleep. Consider a noise that will drown out any environmental disturbances, without being too loud to prevent sleep.
   • Think about a sound machine
   • Consider using a fan

Don’t let your bedroom prevent you from getting the sleep you need to help you lose those extra pounds.  Look around and see what you can do create a bedroom that helps you sleep better and look better!

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

Get Out of Bed for Better Sleep?

Outside of giving its name to this blog, insomnia can be exceptionally difficult to live with.  Insomnia is often referred to as “vague” because it is so difficult to determine what exactly is causing the sleeplessness:  underlying medical conditions, chronic pain, depression, or even another sleep disorder like restless leg syndrome.  For some, the cause could be as simple as stress.

Regardless of the cause, all insomniacs know that it can be nearly impossible to fall asleep or fall back to sleep.  If you have insomnia, you may spend hours lying in bed, tossing and turning, trying desperately to fall asleep.  You may even feel that doing so makes you feel even more stressed about not being asleep.  A new study suggests that not only is that stress keeping you awake, being in the bed itself might be contributing to your sleeplessness.

In fact, the researchers found that one of the best things to do is get out of bed.  That will help you decrease the amount of stress you feel about not being asleep, and may help you become more ready to fall asleep.  If you are stressed or worried about other things, finding ways to ‘turn your brain off’ before you get into bed may be helpful.  The medical staff involved in the study suggested that a consistent sleep routine is more likely than simply lying in bed to help you fall asleep and stay asleep.

Here are my top five tips to help you create and maintain a successful sleep routine:

1. Set aside a Power Down hour before bedtime. Stop work. No chores.  Do something relaxing like take a warm bath, engage in light reading, or watch TV if that’s relaxing for you (avoid the news channels).
2. Go to bed and get up at the same time 7 days a week—no matter what!
3. Schedule in at least 30 minutes of exercise most days of the week. You can break up these minutes into pockets of 10 minutes if you have to. Here’s an idea: Expose yourself to bright, morning natural light (a good thing for calibrating the body’s natural clock) with a brisk walk before breakfast, then again at lunch, and after dinner.
4. Avoid caffeine after 2 pm in the afternoon. Don’t forget hidden sources like soda, and some headache medicines.
5. Adopt some mind-, body-, and sleep-friendly practices like meditation, massage, or yoga. 

It’s best to associate being in bed with being asleep, not with being awake and stressing about not being asleep.  A healthy sleep routine can help you do so, and though it seems a little contradictory, so can getting out of bed if you’re really struggling to fall asleep.

 

Sweet Dreams,

 

Michael J. Breus, PhD

The Sleep Doctor™

Everything you do, you do better with a good night’s sleep™

www.thesleepdoctor.com

twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor

Melatonin: Not a Magic Bullet for Sleep

Many of you have made a New Year’s Resolution to get more and better sleep. I hope you are having great success! But I want to address a topic I am asked about repeatedly, and it may be something many of you have tried or considered in your quest for a better night’s sleep:

Is Melatonin good to take to help with my sleep?

So exactly what is melatonin?

Melatonin is a hormone. It is not an herb, a vitamin, or a mineral. Hormones are naturally produced by your body as you need them.  Which means it is very unlikely that someone has a melatonin deficiency. While melatonin could be considered natural, in most cases it doesn’t come from the earth. There are exceptions of foods that contain melatonin in them, but this is a different type of melatonin than what is produced in your brain. 

Your melatonin levels can be tested with a blood test, urine test or saliva test. If you are concerned that you may actually be melatonin deficient, ask your doctor about testing. Melatonin is produced by the pineal gland and sends a signal to regulate the sleep-wake cycle in the sleep center of the brain. Interestingly, melatonin is also produced in the retina, the skin, and the GI tract, but this is not the melatonin what affects your biological sleep clock.

This is the really important thing you should understand about melatonin:  melatonin is a sleep and body clock regulator NOT a sleep initiator.  Melatonin works with your biological clock by telling your brain when it is time to sleep. Melatonin does not increase your sleep drive or need for sleep.

Melatonin is called the “Vampire Hormone” because it is produced primarily in darkness and inhibited by light. The levels of your melatonin increase in the middle of the night and gradually fall as the night turns to morning, so exposure to light before bed can push your biological clock in the wrong direction - making melatonin ineffective. 

Melatonin treats Circadian Rhythm Disorders (where you sleep the right amount of minutes but your body clock is at the wrong time), Shift Work Sleep Disorders and early morning awakenings – all things that deal with the timing of your need to sleep. Melatonin is not considered an effective treatment for insomnia.

Melatonin in pill form does not function like your body’s naturally produced melatonin: it affects the brain in bursts and rapidly leaves the system, instead of the slow build up and slow wash-out that your body’s naturally produced melatonin experiences. 

The correct dosage of melatonin can be a problem.  According to research conducted at MIT, the correct dosage of melatonin for it to be effective is 0.3-1.0 mg.  Many commercially available forms of melatonin are in 3 to 10 times the amount your body would need. In fact, there is some evidence that higher doses may be less effective. In Europe, melatonin at very high doses has been used as a contraceptive.  

Melatonin can have side effects.  Melatonin (2-3mg or higher) has reported side effects of:

• Headaches
• Nausea
• Next-day grogginess
• Hormone fluctuations
• Vivid dreams and nightmares

Melatonin may also have some issues with safety. While melatonin is available over-the-counter (OTC) in the US and Canada, melatonin is available only by prescription or not at all in some countries. In the US, melatonin is sold as a dietary supplement, not a medication, so until recently melatonin has not been subject to the same purity rules and standards as prescription medications. There are new FDA rules that went into effect in June of 2010, that require all dietary supplements to comply with “good manufacturing practices (GMP)”, which includes compliance in manufacturing standards and labeling.

So what does all this mean if you want to try Melatonin as a supplement?  Melatonin has been shown to be safe in healthy people when used for up to 3 months at the correct dosage.

Over The Counter (OTC) Melatonin:

• When taken several hours before sleep, Melatonin can shift the biological clock earlier, making a better environment for falling asleep and waking up on time.
• When taken in the correct dose (0.3-1 mg), it can be effective for shift workers and people with circadian rhythm disorders.
• However, most Melatonin sold over the counter is packaged in doses ranging from 1 mg to 10 mg, with most doses containing double or triple the amount that is needed to be effective for the population that will benefit from its use.

Other Possible Uses for Melatonin

• As an anti-oxidant Melatonin acts upon free radicals. It may reduce damage caused by Parkinson’s disease, and can have an anti-aging effect.
• In the elderly, it has shown some promise in managing a type of insomnia called early morning awakenings ; but this area needs more study and does not take into account medications that may interact with melatonin. 

Caution should be taken when using Melatonin

• It should be used under the guidance of a doctor and sleep professional.
• It should be used at the correct dosage.
• It should be taken about 90 minutes before lights out.
• It should be used for a short time (less than 3 months).
• It should never be used in combination with other sleep inducing medications.
• It should never be used with alcohol.
• It should never be used with children (younger than 18 years).
• There are possible interaction effects and could change the effectiveness of your current medication regimen.

There are new and exciting experiments with patches for delivery of melatonin for use by shift workers and others who have work environments that put their regular circadian clocks to the test.  Tart cherries contain a natural melatonin and there is research to show that drinking tart cherry juice can help with insomnia.  There are vitamins and minerals , like Vitamin D, the B vitamins, folic acid and calcium that have been shown to help with both energy and relaxation.

At the end of the day (no pun intended), your first line of defense for sleep problems:  good health and good sleep hygiene.  Make it a habit to prepare your body and your mind at the end of every day to get the rest you need.  Try that first before you start looking for something else.  And when you do look, be careful. 

 

Michael J. Breus, PhD

The Sleep Doctor™

Everything you do, you do better with a good night’s sleep™

www.thesleepdoctor.com

twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor