Questions on sleep and Melatonin

[Dav125]

Here is an article I found that might help a few people in here in regard to sleep and using melatonin as an aid for the purpose of getting thru the early stages of wd's..



Get Some Sleep: Melatonin's a great solution - for some

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.


A frazzled, 45-year-old woman came into my office the other day complaining of longstanding, intermittent bouts of insomnia.

“The frustrating thing is I watch my husband take his melatonin and ‘poof’ it’s like the sandman flew in through the window and sprinkled sand in his eyes. He is out. Me? Nothing. I lie there for hours even if I take two or three pills.”

I hear this lot. Melatonin works remarkably well for some people and has no affect on others.

Melatonin is a naturally occurring neuro-hormone that is secreted by the pineal gland in the brain. When released from the pineal gland, melatonin causes drowsiness and a decrease in core body temperature. The levels of melatonin rise throughout the evening hours and peak in the middle of the night. That is if there is relative darkness. Even ordinary room light (approximately 100 lux) can cause a rapid suppression in melatonin. This is why sleep doctors are always telling people, at least people who have trouble falling asleep, that they should avoid reading in bed.

Research suggests that melatonin not only helps us sleep and maintain our 24-hour clock, but that it acts as a powerful antioxidant that destroys cancerous cells. It may also boost immunity and help in weight loss. The antioxidant properties are thought to explain why night shift workers have a higher rate of cancer. Night after night they suppress their melatonin by staying up and being exposed to light.

Melatonin has been studied as a sleep promoting agent in doses ranging from 0.3 mg to 80 mg and the results are always disappointing. There are a few hypotheses why that is the case.

First, melatonin is sold as a dietary supplement in this country and you can’t rely on the dose really being what the bottle says it is.

I have been trying to find out if there is brand of melatonin sold in the U.S. that is manufactured in Western Europe. Many European countries such as Germany regulate their herbal supplements as strictly as they do their pharmaceuticals. In fact, Germany considers melatonin a prescription medication.

Second, the timing of the dosing of melatonin when treating insomnia has not been firmly established.

For example, when we are using it to shift people’s circadian rhythm, we typically give it approximately six hours before desired bedtime. This can slowly phase advance them, i.e. get them to fall asleep earlier.

I experiment with the timing with patients. I start at 30 minutes before bedtime, in order to use it as a hypnotic, but if we don’t achieve the desired sleepiness, then I advise taking it 60 minutes before bed, then 90 minutes and so forth until we are actually using it as a chronobiotic, i.e. shifting the biological clock.

I always advise caution that they not go out and about or operate heavy machinery while we are first administering the melatonin.

Third, melatonin might work better on some people because they have a naturally low level whereas it has little effect on people who have normal levels. This hypothesis is extrapolated from literature that shows that melatonin is more effective when administered in the daytime when our natural levels are low. Also, melatonin seems to be more effective in elderly patients who often have low melatonin. Further supporting evidence might be the fact that most research shows little difference in response whether you give low dose or high dose.

Finally, perhaps oral administration is not the best method of delivery the drug. It is manufactured as sublingual  (under the tongue) and as transdermal (skin) patches, but whether these routes of delivery are more effective remains to be tested.

We should also keep in mind that certain medications such as beta blockers and anti-depressants can suppress melatonin levels.

Although the effectiveness of melatonin is questionable, it is generally considered safe in adults. Common side effects include morning grogginess, headache, vivid dreaming.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

[Dav125]

And to follow up here on the subject of sleep,,all you people looking, watching,considering quiting, or are in their first week of wd's,,Sleep really does not return until you have 20 to 25 days behind you. Its just the way it is. Pretty much for your standard opiate wd's. I cannot say on things other than that as I never had issues with some of the other substances many come to the forum with..

This past week so many people have come on asking that question when?? And when I saw this, I noted that 2 ,3 maybe 10 posted questions below them the answer to their question was there.

I am not trying to be cold natured, I'm asking for any newcomers to the forum to read "more" ..Because many times the answer is in the post right below your question..I'm not saying don't ask, I'm saying study the forum and responses in here which cover all aspects of most every problem we are encountering in our own attempt to deal with the unknown.. And if your contemplating soon, wd's are a reality. There is no shortcut to the symptoms. Tapers can do wonders but that take alot of time living with a headache during the week or month you go thru this approach ,less meds that demand a taper supervised by medical personnel, such as subs, tramadol, xanax, and even valium..Along with some others "ESPECIALLY CYMBALTA..That first hand experience there and was lucky I walked when it did. One member in here went thru months of wd's from that anti depressant before getting back to normal..It works for some, but ravages other to no end in other cases..

The key word is "READ". I know the excitement and individual can get when they find this forum and go "oh god" I finally found a place that can understand me..I ask that before to start rapid firing questions, that you spend a day going post to post..Read and get knowledgeble as to what you face..It helps so much with the mental aspect at the beginning as you are able to sort things out and not start running to emergency rooms everytime you have a form of panic attack due to lack of knowledge. And there again, if you've done homework in here and have a panic attack or heart papulation that hasn't shown up in your studies, then you know you best get off you A$$ and seek medical attention......I wish the same for all of us. The day a smile comes which meds have not had a part in or manipulated in any fashion..  Best to all..Dav

[vicki595]

That was a good read!  I liked the part about timing. 6 hours before bedtime to slowly advance to sleepiness...interesting.