What is melatonin?
Melatonin is a hormone that is naturally found in the body. It is produced synthetically in the laboratory and is available in pill form as well as forms that can be absorbed under the tongue or through the cheek. However, before we talk about the role of melatonin in sleep, let’s talk about what it’s NOT for. So many of the patients I work with on sleep issues describe taking melatonin on a regular basis, every night before bed. Melatonin is not a sedative. It is not sleep inducing and it does not share any of the properties of prescription or over-the-counter sleep aids.
What does melatonin do?
The primary job of melatonin is to regulate the timing of your body’s sleep wake cycle or the circadian rhythm. To briefly describe the circadian rhythm, one of its primary jobs is starting an alerting signal of wakefulness that begins in the morning and remains throughout the day. The natural release of melatonin occurs in the evening to initiate the process sleep. One of these processes is the rapid decline in the alerting signal that started in the morning as part of the circadian rhythm. So, what melatonin DOES do is regulate the timing of sleep. By regulating the timing of sleep, melatonin does have a use in treating conditions such as: jet lag, shift work related sleep disturbance, and delayed sleep phase. This is because these conditions involve a misalignment of our circadian rhythm and our desired window for sleep. When we encounter a situation in which our circadian rhythm is not in line with when we need to sleep, melatonin can be used to help adjust the timing of sleep. However, behavioral interventions are the first line treatment for managing your circadian rhythm.
What melatonin won’t treat?
Melatonin is not a treatment for chronic insomnia. Insomnia involves trouble falling asleep or staying asleep even though you had the opportunity to get a full night of sleep. Clinical practice guidelines from the American Academy of Sleep Medicine (AASM) recommend against using melatonin as a treatment for sleep onset or sleep maintenance insomnia. Insomnia is generally not a sleep timing related issue and will not be effectively treated by melatonin.
What to do about sleep problems?
When you experience difficulty with sleep, it’s important to get an evaluation done by someone that specializes in treating sleep disorders. As you can see from the information above, different sleep problems have different treatments and understanding what type of sleep problem you have is the first step in getting effective treatment. Melatonin has a place in treating sleep disorders, but it is not the recommended treatment for insomnia and the way melatonin works in the body makes it very unlikely to treat insomnia.
The first place to start in treating sleep problems is getting good education about sleep. This can be found at http://sleepeducation.org/ which is a site provided by AASM. Additionally, if you’d like to get connected with a sleep specialist, AASM provides a directory at the following link: http://sleepeducation.org/find-a-facility
For more information on the use and dosages of melatonin click here. It’s important to speak with your physician before starting any supplement or medication.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Jeff Mann, Psy.D., is a Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) with the Uniformed Services University of the Health Sciences.