by Edward R. Rosick, D.O., M.P.H., D.A.B.H.M.

Did you get a good night’s sleep last night?

Most of us have insomnia every now and then. About 60 million Americans have trouble sleeping frequently or for extended amounts of time, according to the National Institute of Neurological Disorders and Stroke. And drug cures are plentiful. They’re also mostly short-lived and sometimes a little too good to be true.

But there may be an alternative.

SLEEPING PILLS AND SIDE EFFECTS
For short-term sleep problems, doctors often prescribe benzodiazepines (such as Ativan, Valium and Xanax) and other similar medications. While these do help people sleep, they’re not a cure for insomnia. Many prescription and over-the-counter pills tend to lose their effectiveness after a couple of weeks, can be habit-forming and can actually interfere with a good night’s sleep by reducing the time you spend in deep sleep. For people who want to try an alternative, the answer may be the supplement melatonin.

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HOW THE MELATONIN HORMONE WORKS
Melatonin is a hormone produced in a structure called the pineal gland, which is deep within our brain. While there’s still a lot to learn about it, researchers have shown that it’s intimately connected with sleep.

During the day, melatonin levels are low; when darkness falls, they increase significantly. Since we know that melatonin is part of the sleep/wake cycle, many integrative-medicine doctors recommend it as a sleep aid, touting it as a more “natural” way to help people beat insomnia.

DOES THE MELATONIN SUPPLEMENT WORK?
Melatonin does have a few studies backing its effectiveness, though they’re not particularly large or conclusive. In 2005, researchers analyzed data from 17 small studies. Their findings , published in Sleep Medicine Reviews, concluded that melatonin can make you fall asleep about four minutes faster, increase your sleep efficiency by about 2 to 3 percent and add around 13 minutes to your sleep duration.

Melatonin use may be especially relevant to the elderly. As people grow older, sleep problems become more common. Since melatonin levels decline as we age, it makes sense to think that supplements could help senior citizens get a good night’s sleep.

MELATONIN SIDE EFFECTS AND DOSAGE
Melatonin doesn’t appear to be habit-forming, lose its effectiveness or interfere with normal sleep. It’s apparently safe for most people in the short-term but hasn’t been studied in the long-term. Dosages vary widely. A good starting point seems to be 0.3 milligrams. (You can cut a 1-milligram tablet into thirds).

As a physician specializing in holistic medicine, I try to educate my patients on what supplements are safe and effective, as well as which ones are worthless and possibly dangerous. For people looking for a natural alternative for insomnia, melatonin appears to be a good choice to help them get a good night’s rest.

Board certified in preventive medicine and specializing in integrative medicine, EDWARD R. ROSICK, D.O., M.P.H., is an assistant professor at the Michigan State University College of Osteopathic Medicine.

Last updated and/or approved: March 2008.
Original article appeared in September/October 2007 issue.

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