Why is melatonin important?
Melatonin (indoleamine compound) is a hormone that is naturally produced in our body. The pineal gland of the brain produces melatonin in response to darkness. The production of melatonin peaks during night and lowers during the day. Melatonin plays a key role (important role) in maintaining our circadian rhythm. Melatonin supplements (sleep aid) are gaining popularity as a sleep aid in insomnia therapy. Various researches suggest that melatonin sleep aid supplements are effective in treating sleeplessness/insomnia.
Melatonin and circadian rhythm
Circadian rhythm or the “internal body clock” of a human being is a 24 hour cycle which maintains important functions in the body such as
- Maintaining sleep-wake pattern
- Release of some hormones (eg. insulin, cortisol etc.)
- Maintaining body temperature
- Digestion and appetite
Imbalances in circadian rhythm
Circadian rhythms can fall out of line due to factors in the human body or environment. For example:
- Exposure to light and darkness.
- Travel.
- Food intake.
- Stress.
- Physical activity.
- Temperature.
- Social environment.
- Brain damage or disruption in brain activity.
- Vision impairment.
- Work (night shift workers)
- Neurodevelopmental disorders (ex. ADHD, autism) and
- Other unknown factors.
Effect of exogenous melatonin supplements in treating insomnia & other diseases
Though melatonin lacks FDA approval, the American Academy of Family Physicians (AAFP) recognizes melatonin as the first-line pharmacological therapy for insomnia, highlighting its crucial role in managing sleep-related concerns. Melatonin is relatively safe with a low risk of adverse effects. Even though no formal recommendations are recognized, current clinical research focuses on the role of melatonin in the treatment of various conditions like cancer, pain syndromes, metabolic disorders, cardiovascular disorders, gastrointestinal conditions, neurodegenerative disorders, mental disorders, and reproductive dysfunctions.
Melatonin is also used in
- Treatment of insomnia related to benzodiazepine withdrawal in older people.
- Cancer therapy as an adjuvant.
- Migraine.
- Chemo related thrombocytopenia.
- Jetlag.
- Chronic fatigue syndrome.
- Nicotine withdrawal.
- Winter depression.
- Premedication for surgery.
- Tardive dyskinesia.
- Post traumatic brain injury.
- Shift work disorder.
Melatonin also has the orphan drug status for the treatment of
- Circadian rhythm sleep disorders in visually challenged people without light perception
- Neonatal hypoxic ischemic encephalopathy.
- Smith-Magenis syndrome along with beta blockers.
- Acute acetaminophen overdose.
- Short bowel syndrome.
- Necrotizing enterocolitis.
- Acute radiation syndrome.
- Hepatocellular carcinoma
- Heat stroke.
- Pancreatic cancer.
Pharmacological treatment of insomnia
Insomnia is a common sleep disorder. A person suffering from insomnia may have trouble falling asleep, staying asleep, or getting good quality sleep.
Drugs used in the treatment of insomnia include nonbenzodiazepine receptor agonists, benzodiazepine receptor agonists, the selective melatonin receptor agonists and sedating antidepressants.
Melatonin as a sleep aid supplement in insomnia therapy
Taking oral melatonin supplement at night has shown to improve the duration and quality of sleep. Melatonin is available in various dosage forms like tablets, capsules and syrups. Though melatonin is available as an over the counter drug in many countries, it is recommended to consult with a physician before taking melatonin as a sleep aid.
Dosing indications of melatonin sleep aid supplements in insomnia
Dose : 3-5 mg PO qHS
Difficulty falling asleep
- 5 mg PO 3-4 hour before sleep (4 weeks)
Difficulty maintaining sleep
- Using a controlled release formulation may help in maintaining sleep.
Written by Auxi Arobana. R