What is Melatonin

MelatoninMelatonin is a pineal gland produced hormone (which also called epiphysis). Melatonin secretion is inhibited by light and stimulated when it is dark. The maximum production is reached from 2 am to 5 am, during which the sleep hormones are created in the darkness.

By the help of melatonin, the pineal gland tells the brain about the relative duration of the hours of darkness and lighting over a time of 24 h (daily cycle), and also all through the year. By secreting melatonin, the pineal gland tells the brain that it’s dark, and it’s the right time to sleep.

Since the implementation of new regulations on natural health products, melatonin sold in Canada is a synthetic product, which is entirely manufactured in the laboratory.

The leaves and roots of many plants contain small amounts of melatonin, including fenugreek seeds, alfalfa, fennel, poppy, flax, coriander, and sunflower. This antioxidant substance role would be to protect the fragile seed of these plants against oxidative effects of UV radiation, drought, extreme temperatures, and toxins.

Melatonin Insufficiency

Melatonin is not considered an essential nutrient, but no recommended daily intake has been established. One cannot, therefore, speak of its deficiency. However, researchers have noticed that people with certain health problems had melatonin levels below average. So heart patients have low melatonin levels, but it is unclear if this is a cause or consequence.

Travelers and people who work rotating shifts according to research frequently suffer from sleep disorders that seem caused by a change in their melatonin levels. Moreover, prolonged exposure to electromagnetic fields could inhibit production of melatonin. Finally, it was long thought that the manufacture of melatonin decreases with age, but more recent studies suggest that this is not the case.

Uses of Melatonin

  • Reduce or prevent the effects of jet lag.
  • Treating insomnia in people aged 55 and older.
  • Treating disorders in children with neuro-developmental disorders or attention deficit hyperactivity disorder
  • Reducing pains in newborns (adjuvant)
  • Enhances sleep in kids who suffers from circadian rhythm disorders
  • Reducing the risk of cancer remission and adverse effects related to chemotherapy and radiotherapy.
  • Contributes to the withdrawal of sleeping pills.
  • Reduce chronic pain (migraine, irritable bowel syndrome, fibromyalgia).
  • Reduce agitation dementia.

Proper Dosages

Melatonin for Jetlag

The authors of a synthesis published in 2002 scrutinized the results of nine clinical trials with placebo and concluded that melatonin is efficient and safe to prevent or reduce the effects of jet lag. The effectiveness of the treatment is more pronounced when traveling eastward across five time zones or more. They state that it is paramount to take melatonin at the right time. Otherwise, the effects of jet lag could increase.

The authors of a synthesis published in 2009 examined 14 trials and also found that melatonin could be beneficial. Here are their tips to increase efficiency.

Travel east for 9 hours or less

During the few days of departure

  • – Get up earlier.
  • – Expose yourself to daylight.
  • – Get enough sleep.
  • – Take 5 mg of melatonin at bedtime.

The day of departure

  • – Take 5 mg of melatonin at 18 h.

To destination

  • – Get up in the morning and be active outside for at least 30 minutes.
  • – Take 1 mg of melatonin at bedtime until the normal sleep cycle reinstated.

Travel west for 9 hours or less

During the few days of departure

  • – Go to bed later.
  • – Expose yourself to daylight.
  • – Get enough sleep.
  • – Take 1 mg of melatonin at sunrise.

The day of departure

  • – Take 1 mg of melatonin at sunrise.

To destination

  • – Staying up until evening, while exposing to the light of day.
  • – Take 1 mg of melatonin at sunrise.

Travel east or west for 10 to 14 hours

During the few days of departure

  • – Go to bed later.
  • – Expose yourself to daylight.
  • – Get enough sleep.
  • – Take 1 mg of melatonin at sunrise.

The day of departure

  • – Take 1 mg of melatonin at sunrise.

To destination

  • – Do 30 minutes of exercise outdoors between 8 am and 11 am and between 13 pm and 16 pm.
  • – Take 5 mg of melatonin at bedtime.

Melatonin for Insomnia

Insomnia in people 55 years and over (prolonged-release melatonin): In June 2007, by three trials with 681 healthy subjects, the Committee for Human Medicinal Products (Europe) approved the use of the product Circadin, which contains the sustained release melatonin. The committee said that this prescription drug is indicated for short-term treatment of insomnia in patients 55 years or more and that its effectiveness is modest, but its benefits are greater than its risks. The recommended dosage is 2 mg per day, 1 to 2 hours before bedtime.

Are extended-release prescription products in North America equivalent to Circadin (Trademark)? According to the pharmacist Jean-Yves Dionne, although it is the same molecule, we cannot be confident that they have the same effects as the products are probably manufactured differently.

A randomized clinical study was initiated in 2011 to assess the effectiveness of Circadin (2 mg daily for three weeks) in approximately 722 patients aged 18-80 years with primary insomnia. Compared to placebo, prolonged release melatonin does not decrease the sleep latency. However, this reduction appears significant if one takes into account that the age group between 55 and 80 years. This study was criticized in particular, and the high number of participants withdrew from the study.

Melatonin for Insomnia in individuals with neuro-developmental disorders

Five meta-analyses were performed to assess the effectiveness of melatonin in children especially those suffering from neuropsychiatric disorders.

In the first study, the authors included 35 studies of children with autism spectrum disorders. Overall, it appears that melatonin (0.75 to 10 mg/day) improves sleep (increased sleep duration, sleep latency of diminution and number of awakenings) and daytime behavior of autistic children. However, variability occurred in the quality of clinical studies considered.

These results were confirmed in two separate journals on 7-8 clinical studies, although with methodological problems that do not allow for definitive conclusions to be drawn.

Two studies have examined individuals with intellectual disabilities. The analysis of nine studies included indicates that melatonin increases the quality of sleep (duration, delay in falling asleep, nighttime awakenings). Sleep duration increased by 50 minutes. The doses ranged from 0.5 mg to 9 mg of melatonin with immediate actions and prolonged. The prevalence of side effects was as important as that in the placebo group. These beneficial effects were also reported in another review of 14 clinical studies

Melatonin for Attention Deficit Hyperactivity Disorder

A study published in 2010 evaluated the effectiveness of melatonin for sleep disorder suffering from attention deficit hyperactivity disorder (ADHD). Five randomized clinical trials were taken into account. The melatonin (0.3-6 mg/day) administered a few hours before bedtime reduces the sleep onset latency. The long-term efficacy remains to be determined.

Melatonin for Insomnia in the general population (regular melatonin)

All syntheses and analysis published since 2001 point to a reduced time it took to fall asleep (latency) in people with insomnia. However, as regards the duration and quality of sleep, these works concluded at best moderated to slight improvement. The results are similar for people who take benzodiazepines (sleeping pills) and those with low melatonin levels.

As for the effects of melatonin on the quality of sleep of individuals who work at night, the results are usually disappointing at best.

Melatonin for Withdrawal sleeping pills (benzodiazepines)

Regarding the use of melatonin to help stop taking sleeping pills in the benzodiazepine family, the results are mixed. During a test on patients taking small doses of sleeping pills, melatonin was ineffective, while it has been helpful in patients taking higher doses. In a small trial (22 subjects 65 years and older) 9 of the 14 participants taking sleeping pills could stop this treatment when they took melatonin (5 mg per day).

Melatonin for Reducing Chronic Pain 

Melatonin had an analgesic effect in several animal tests. Some human studies have yielded encouraging results with migraine sufferers, the irritable bowel syndrome or fibromyalgia. The dosage administered ranged from 2 mg to 5 mg per day.

A study conducted in 2012 showed that melatonin (in addition to analgesics and sedatives) decreased pain in neonates (less than 32 weeks) to be incubated because of respiratory problems. The pain was assessed using a pain scale. The inflammation was also reduced.

Melatonin for Dementia

A meta-analysis of 5 trials, melatonin may reduce some of the psychological symptoms associated with dementia (depression, anxiety and agitation, for example). However, it has no significant effect on cognition. Alzheimer’s disease is a form of the most common dementia in the elderly.

A systematic review including four randomized studies analyzed the effect of melatonin in patients with dementia with behavioral disorders. Two studies reported a decrease in agitation and twilight states syndrome. As for the quality of sleep, the results are inconclusive.