Age Wise

How Melatonin Functions

Melatonin is naturally synthesized in the pineal gland of the brain and, to a lesser extent, in the retina. This hormone plays a crucial role in regulating the circadian rhythm, which is the body’s internal clock that dictates sleep and wake cycles. Darkness prompts melatonin production, signaling the body to prepare for sleep, while light suppresses its production to promote alertness.

Disruptions to this cycle, such as working night shifts or spending excessive time indoors under artificial lighting, can confuse the body’s natural rhythms. Some individuals, particularly night owls, may simply have a different internal clock.

Melatonin supplements can serve as a cue for the brain that it is nighttime, providing a helpful nudge. For example, Bertisch noted that someone like my wife, who tends to stay up late, might benefit from melatonin to encourage an earlier bedtime.

In contrast, I usually feel sleepy by 9 p.m. and fall asleep without issues by 11 p.m., but I often wake around 5 a.m. Melatonin is not suitable for someone like me, as I could use evening light to adjust my schedule instead of relying on supplements.

One of the advantages of melatonin is that it is not a sedative, meaning it does not typically result in the lingering drowsiness that many sleeping pills can cause. Research indicates that over-the-counter sleep aids often do not perform as advertised and may carry serious side effects. Thus, melatonin is often seen as a safer, more natural alternative.

According to the National Institutes of Health, short-term use of melatonin supplements is generally safe for most individuals.

Potential Issues with Melatonin Supplements

In the United States, melatonin is sold over-the-counter, and its use has surged over the past decade. In contrast, other countries like Australia and Japan require a prescription, acknowledging the hormone's potency and associated risks.

There are three primary concerns regarding melatonin supplements:

1. Limited Evidence for Insomnia: Research shows that melatonin may not be effective for chronic insomnia. A 2017 review concluded that it should not be prescribed for this condition.
2. Uncertain Ingredients: In the U.S., dietary supplements, including melatonin, are not as strictly regulated as pharmaceuticals. A study of 30 melatonin brands revealed that the actual hormone content varied widely, with some products containing up to 478% more than stated on the label. Additionally, some brands included undisclosed serotonin.
3. Possible Side Effects: While initial side effects from proper dosage are usually mild, like drowsiness or headaches, there is insufficient research on the long-term effects of melatonin use. The NIH highlights the need for more information regarding its long-term safety.

Recommendation: When selecting a melatonin supplement, seek out a product with a USP verification mark, indicating it has been tested for authenticity and content.

Dosage, Timing, and Experimentation

Currently, there are no official guidelines for melatonin use or dosage in the U.S. For night owls or frequent travelers needing to adjust their bedtime, Bertisch suggests starting with a low dose of 3-5 milligrams. Splitting pills can help achieve the lowest effective dosage.

If necessary, individuals can experiment with higher doses, but should not exceed 5 milligrams.

Timing is also flexible. Bertisch recommends taking melatonin about an hour before the desired bedtime. For example, if traveling east, it would be advisable to take melatonin the night before departure.

It is not recommended to take melatonin after already starting to sleep. Additionally, it may not be suitable for those who generally sleep well but experience disturbed sleep during the night. Older adults should consider melatonin similarly to younger individuals. If they tend to feel sleepy earlier and wake up at night, melatonin might worsen their sleep issues.

Most children should avoid melatonin due to the lack of understanding of its effects on developing bodies. Bertisch warns that melatonin may influence reproductive hormones during critical developmental periods.

Alternatives to Supplements

While companies may promote the idea that we are a nation of sleep-deprived individuals, most adults can function well on seven to eight hours of sleep, and research indicates that approximately two-thirds of U.S. adults meet this requirement.

If you believe melatonin could help, consider obtaining it naturally by spending more time outdoors. Although bright artificial lighting can impact the circadian cycle, natural light is crucial for regulating melatonin production. Experts recommend at least two hours of outdoor exposure daily, especially in the morning.

There are various other strategies for improving sleep quality, including:

• Consuming nutritious foods and limiting alcohol.
• Avoiding long naps, particularly late in the day.
• Steering clear of stressful activities during the evening.
• Establishing and adhering to a consistent bedtime.

If these approaches do not yield results, and the main concern is falling asleep at a reasonable hour, melatonin supplements might provide temporary assistance. However, they should not be relied upon long-term. If melatonin appears to be beneficial, its effects should be noticeable within a couple of days.

“If you find yourself using it for an extended period, consult your doctor,” Bertisch advises, as this could indicate an underlying sleep disorder that may be better addressed through safer alternatives.

I am the author of "Make Sleep Your Superpower: A Guide to Greater Health, Happiness & Productivity." Your support enables my health writing. Subscribe for updates on my publications or join Medium for complete access to all stories. Connect with me on YouTube, Instagram, Twitter, and LinkedIn. — Rob