Ask Dr. Monti: Can Melatonin Help You Sleep?
Question: Can melatonin supplements really help me fall asleep at night?
Answer: Our bodies produce melatonin naturally in the pineal gland, a pea-sized structure embedded deep within the brain. Melatonin is an important aspect of the internal biological clock that tells us when to go to sleep and when to wake up. Darkness triggers the release of melatonin, and light inhibits its production. That is why it is important to have a dark room at night. Shift work, travel across time zones, and too much light in the bedroom (e.g., from a TV, computer, etc.) can interfere with melatonin production. Also, there can be decreased melatonin production as we age.
Whether or not melatonin supplements work depends upon a lot of factors and studies have shown conflicting results. The available data supports that melatonin is relatively safe and has a low side effect profile. I often try melatonin as a first line of defense for patients whose sleep disturbances may be related to frequent travelling, shift work, or in older adults who are experiencing difficulty falling asleep (versus staying asleep).
Melatonin supplements can be purchased at most pharmacies and natural foods stores. How much to take can be confusing, given the ranges used in studies and the different strengths sold in stores. I usually recommend starting with 3 milligrams and doubling the dose if needed. There is no clear “superior” brand. Several of the studies that showed a positive affect used higher doses. However, the higher the dose the more potential for side effects, particularly grogginess the next day. Like many things, some people report great results from melatonin, others notice nothing from it, and a few complain that they don’t like the way it makes them feel. I usually recommend that people try it along with a little extra magnesium at night and a dark, quiet room. For more information on sleep aids, check out my book, The Great Life Makeover (HarperCollins), or read the sleep section in the book Integrative Psychiatry (Oxford University Press); both are easily available online or in book stores.
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