MELATONIN
Benefits: Melatonin is a naturally occurring hormone and supplementation 1-3 hours before bedtime has been shown to help with insomnia.
Insomnia – melatonin 0.5 mg has been demonstrated to reduce the amount of time to fall asleep by as much as 34 minutes.
A placebo controlled trial compared to 2.5 mg of melatonin in people taking beta blockers (metoprolol, tenormin, etc) can suppress the body’s production of melatonin) decreased time to fall asleep by 8 minutes and increased total sleep time by 37 minutes.
Night Terrors – I have used this product with great success in patients with night terrors. A 1 to 3 mg dose is very effective.
Menopausal sleep disturbance – melatonin twice daily 3 mg in the morning and 5 mg at night for one year modestly improved symptoms of insomnia, hot flashes, irritability and depression.
Fibromyalgia – middle age women experienced improved mood and quality of life and decreased pain with a 10 day course of melatonin at 9 to 15 mg nightly. They also experienced a decrease in the stress hormone cortisol.
Quality: In the past, independent laboratory testing of melatonin products have revealed problems with products having the amount of melatonin as listed on their labels. The products listed below have been shown to contain the correct amount as listed on their labels.
How much should you take? Start with a 1 mg dose and increase up to 3 mg one hour before bedtime. Taking higher doses can produce grogginess in the morning. It may also alter mood. Melatonin is not a product I recommend taking nightly…every other night or less works best.
Safety: For the most part melatonin is relatively safe. It does create drowsiness so driving or other activities that require motor skills and balance should be avoided for up to at least six hours. In my practice the most common mistakes are folks taking too much melatonin and taking it too often. A dose of 0.3-5 mg every other night will work better than taking Melatonin nightly.
Its safety in pregnancy and children has not been established. Melatonin should be kept away from children- accidentally excessive intake has resulted rarely in death and mechanical ventilation.
Combining melatonin with prescription sleep meds such as zolpidem (ambien), lunesta (eszopiclone), benzodiazepines, etc may create excessive sedation or decrease cognition.
Proceed with caution.
It can slightly raise blood pressure in hypertensive patients so monitoring your BP is encouraged. Increased aggression has also been seen in doses > 5 mg.