The problem of poor sleep. Stats. Can. reports that 1 in 4 adults aged 18-34, 1 in 3 adults aged 35-64, 1 in 4 adults aged 65-79 are not getting enough sleep. Can melatonin, “the sleep hormone ” help?
Studies show evidence of poor sleep.
A 2017 study revealed what many of us suspected – Canadians are not getting enough sleep. The study was based on 10,976 respondents aged 18 to 79 from the 2007-to-2013 Canadian Health Measures Survey, a nationally representative, cross-sectional survey.
Sleep duration and quality were self-reported. Mean sleep duration was 7.12 hours per night at ages 18 to 64 and 7.24 hours per night at ages 65 to 79. An estimated 65% of 18- to 64-year-olds and 54% of seniors slept the recommended number of hours per night.
However, short sleep duration and poor sleep quality were relatively common. About a third slept fewer hours than recommended. At ages 18 to 64, an estimated 43% of men and 55% of women reported trouble going to sleep or staying asleep “sometimes/most of the time/all of the time”; the corresponding percentages at ages 65 to 79 were 40% and 59%.
Although it is a common problem, it can’t be ignored due to its consequences. The cumulative long-term effects of sleep deprivation and sleep disorders have been associated with a wide range of deleterious health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke.
Melatonin – A possible solution for poor sleep?
So, most people have heard of Melatonin – “that is a natural way to go to sleep isn’t it. Better than sleeping tablets but is it?”
So, what is melatonin?
Melatonin is a hormone made naturally by your body. The production and release of melatonin from the pineal gland occurs with a clear daily (circadian) rhythm, with peak levels occurring at night. Night-time levels of melatonin are at least 10-fold higher than daytime concentrations.
The pineal gland
It is produced by the pineal gland in the brain but also found in other areas, such as the eyes, bone marrow and tissues in the gut. It is often called the “sleep hormone,” as higher levels help you fall asleep.
In many animals (including a wide range of mammals and birds), melatonin from the pineal gland is essential for the regulation of the body’s seasonal biology (e.g., reproduction, behaviour and coat growth) in response to changing day length. The importance of pineal melatonin in human biology is not clear, although it may help to synchronise circadian rhythms in different parts of the body.
Body levels of melatonin
In humans, nocturnal levels of melatonin decrease across puberty. The level of circulating melatonin can be detected in samples of blood and saliva, and this is used in clinical research to identify internal circadian rhythms.
Most of the research into the function of the pineal gland involves the human brain’s responses to melatonin rhythms. The evidence supports two roles for melatonin in humans: the involvement of nocturnal melatonin secretion in initiating and maintaining sleep, and control by the day/night melatonin rhythm of the timing of other 24-hour rhythms.
Melatonin has, therefore, often been referred to as a ‘sleep hormone’; although it is not essential for human sleep, we sleep better during the time that melatonin is secreted.
Studies, while not unequivocal in definite results and outcome appear to indicate that Melatonin probably has benefit is improving sleep both onset and maintenance.
Melatonin supplements are popular among people struggling with insomnia and jet lag. Available in Canada without a prescription, there are many countries in which you can’t.
Melatonin in practice
However, melatonin should be considered in clinical practice due to its benign side-effect profile, cost and limited evidence of habituation and tolerance. Further research is needed to examine the long-term benefits of sleep medications including the comparative efficacy of melatonin to common prescription sleep medication.
Melatonin and the circadian rhythm
Melatonin works together with your body’s circadian rhythm, the body’s internal clock.
Melatonin also helps regulate your body temperature, blood pressure and hormone levels , it does also have antioxidant properties and may help support eye health, treat stomach ulcers and heartburn.
Melatonin levels start to rise in your body when it is dark outside, signaling to your body that it is time to sleep and also binds to receptors in the body and can help relaxation, (melatonin binds to receptors in the brain to help reduce nerve activity.) In the eyes, it can help reduce dopamine levels, a wake maintenance hormone.
Although the exact way melatonin helps you fall asleep is unclear, research suggests these processes can help you fall asleep. Conversely, light suppresses melatonin production. This is one way that your body knows it is time to wake up.
What reduces melatonin
There are many factors that may cause low levels of melatonin at night. Stress, smoking, exposure to too much light at night (including blue light), not getting enough natural light during the day, shift work and aging all affect melatonin production.
Supplements and dosage
Taking a melatonin supplement may help counter low levels and normalize your internal clock.
Dosages have been quite variable (0.3 to 10 mg), but as a rule it is best to use the lowest effective dose. Lower doses (1 to 3 mg) are best for delayed sleep phase syndrome and higher doses (5 to 10 mg) are better for jet lag sleep disorder, shift work sleep disorder, and free-running disorder.
Questioning traditional sleeping pills
Increasing sleep latency through a hypnotic or sedative effect has long been a paradigm that has been overemphasized in the treatment of insomnia and psychiatric illness. Although sleep is necessary, the increase in sleep latency must be balanced with the risk of next day hangover and cognitive effects, which can often be far more detrimental to a patient’s quality of life than the actual insomnia.
The future of melatonin
Melatonin and its receptor analogues appear to be moving away from this traditional “knock out” paradigm of a sleeping pill. It appears that the actual sleep induction effect of melatonin and its receptor analogues is quite modest and their mechanism of action is more sophisticated: amplifying natural circadian differences in alertness and possibly creating a more biologically normal sleep pattern.