Melatonin for sleep: hype or helpful?

When it comes to sleep, I don't think there's a more powerful way to heal our bodies.

And yet so many of us struggle with getting enough of this free resource!

Not surprisingly, sales of melatonin are on the rise. You've likely heard that melatonin is a useful supplement if you're travelling between time zones and jet-lagged, or if you're a shift worker. And if melatonin works to restore the sleep-wake cycle in these populations, the question is, will it work to support other types of insomnia and sleep issues? Read this interesting article here - and see my facts and tips below!

Melatonin facts:

Physiologic doses are about 0.3mg daily, in the evening. Melatonin is naturally stimulated by the fading of daylight. It is also disrupted by the use of bright artificial lighting and computer/phone screens. And, if you're stressed, high levels of cortisol can suppress melatonin production - just think about how sleep can be tricky the night before you have a big presentation or event.

What I notice most often in my practice is a misuse of melatonin. People will take melatonin too late at night, in doses that are too high, and wind up feeling worse the next morning, because the excess melatonin is still in their system telling them to sleep. Excess melatonin can also cause excess dreaming/nightmares, nausea, dizziness, muscle aches and headaches.

Melatonin tips for use:

If you are waking up between 2-4 am (either due to recent travel or otherwise), melatonin may be a solution. Generally start with a really low dose, close to that physiologic amount (0.3mg) and then work up from there to see how much melatonin you need to maintain sleep and can tolerate without causing morning grogginess.

Always speak with a professional about your sleep problems to help ensure you are getting the best treatment for you. There are many ways to support a healthy sleep cycle, including building a healthy evening routine, getting exposure to bright light in the morning, acupuncture, and herbs to support stress. If your issues are with sleep onset at the start of your night, melatonin is less likely to be the best solution for you. And, even if you are waking at 2-4am, there can be other triggers and solutions for this - including balancing histamine and addressing cortisol dysregulation (cortisol and melatonin work together to support sleep, with ideally a relaxing bed time routine to lower cortisol, raise melatonin, and then a slow rise in cortisol over the night, peaking at morning waking time as melatonin levels drop off).

Lab investigations into hormonal function can also be extremely helpful. For example, low vitamin D levels affect melatonin production, and low serotonin (often linked to poor gut production) can lead to insufficient melatonin production. High levels of the stress hormone cortisol inhibits melatonin and raises histamine, both of which cause wakefulness in the 2-4am window. High cortisol levels can be due to chronic inflammation and poor insulin regulation, as well as stress. Labs that may help you investigate your sleep issues include:

vitamin D, CBC, inflammatory markers (CRP, ESR, ferritin), oxidation status (GGT),

blood sugar markers (HbA1C, fasting glucose, fasting insulin),

cortisol (AM spot test, or salivary 4 point test), and other hormones (including progesterone - tested 7 days after ovulation; DHEA-S)

Some medications also lower levels of melatonin. Also, melatonin levels decline with age.

Generally, if you want to experiment with melatonin, try following these tips:

1. make sure you're getting to bed early enough - so you will get at least 7-8 hours of sleep

2. buy melatonin from a professional brand, and in a form that you can dose low enough - I usually recommend a liquid or a spray

3. start with a small dose of melatonin (I recommend starting at physiologic levels) and increase slowly every few days to make sure you only take what you need - no more than 3-5mg daily

4. take your melatonin 1-2 hours before bed time - usually that's 8-9pm

5. if you do wake up feeling groggy after using melatonin, you may need to adjust step 3 or 4 (dose & timing), but discontinue if this doesn't improve after adjusting

6. do not use for more than 12 weeks

Curious about natural sources of melatonin?

Did you know that 15g of pistachios - or 25 nuts - provides the physiologic dose of melatonin, 0.3mg? Other foods with melatonin include cherries, brown rice, pineapple and oranges.

As always, these tips are for general informational purposes and not intended as medical advice! I highly recommend seeking out professional support if you have any sleep concerns or are considering using melatonin.

Dr. Natalie Senst, ND

www.nataliesenst.com

inhealth@nataliesenst.com