Disruption in normal sleep patterns, regardless of the cause, can lead to increased fatigue and tiredness. Our sleep wake cycle is an internal clock known as the circadian rhythm.
Our circadian rhythm controls many things including changes in core body temperature, melatonin secretion, cortisol, and appetite. The circadian rhythm is also responsible for our wakefulness during the day. Travel to a different time zone disrupts this rhythm and is commonly referred to as jet lag.
The circadian drive to fall asleep promotes the initiation of sleep. Once you have fallen asleep, this sleep drive rapidly diminishes. A functional circadian rhythm decreases alertness during the night, particularly in the latter half of the night, helping to fall asleep as well as staying asleep until normal wake up time.
To function optimally within a 24 hour day, the circadian rhythm must adjust each day via time cues. The most potent stimulus is the environmental dark-light cycle.
Disruption of the circadian rhythm will affect the desired sleep schedule often resulting in significant symptoms of insomnia and excessive daytime sleepiness, as well as impaired physical, neurologic, emotional, and social functioning.
All circadian rhythm disorders are due to abnormalities in the sleep-wake pattern and the specific patterns vary according to the underlying disorder.
One important cause of disruption to the sleep-wake cycle is caused by travel to a different time zone, commonly referred to as jet lag disorder.
Melatonin. What does it do?
The Food and Drug Administration regulates melatonin as a dietary supplement, and some insomniacs swear by it. The supplement mimics the brain’s response to darkness and helps your body get back into the internal sleep rhythm.
Because it is an over the counter supplement it is not FDA approved and like many supplements, not very well regulated.
Melatonin is an agonist (stimulates) at melatonin receptors. Hence it plays a major role facilitating sleep onset by decreasing the typical evening arousal. By doing this it helps to reinforce circadian rhythm and allows you to have restful sleep.
But does it work as a supplement?
Taking melatonin supplements may be useful for those with delayed onset of sleep. Beside the over the counter supplement there is also a prescription melatonin called Circadin but it is not available in the United States.
Although there is little evidence to support the use of sleep aid supplements in the treatment of insomnia, the best evidence is for use of melatonin, especially for jet lag disorder. This supplement is generally regarded as safe. The main benefits attributed to this supplement is helping with the onset of sleep.
Melatonin supplements come in different forms, including immediate and extended-release tablets, dissolvable tablets, skin patch, and liquids.
The typical melatonin dose is in the 1 to 5 mg range.
Once ingested, melatonin is rapidly absorbed, and is eliminated in approximately one hour.
Known side effects are generally mild and include vivid dreams and nightmares, dizziness, daytime sleepiness, headache, short-term feelings of depression, irritability, and stomach cramps. Although generally regarded as a safe supplement, the safety of long term melatonin use has not been well studied.
What if your child is having trouble sleeping?
If your child is having trouble sleeping, giving them melatonin supplements might cross your mind.
In fact, over the the past few years, the number of children taking melatonin supplements has increased by more than 500%!
It can seem like a natural way to help your little one doze off. But there are many caveats to child melatonin usage, so here is what you need to know.
The first and most important thing to know is that Melatonin should NOT be the first response to an insomniac child.
While it may seem convenient, giving kids melatonin should never be the first thing you try.
Identifying and correcting the sleep problem first is critical.
Establishing a good bedtime routine is important, such as having a very consistent bedtime, lower light, and a particular order that you do things so that their bodies recognize it’s time to calm down.
The screen time is a massive part of this. Parents should limit their kid’s time before bed in front of the TV, computer, tablet, and other devices.
If you decide to give your child melatonin, understand that their dosage will be lower than yours. While giving your child the same melatonin gummy as you may be tempting, kids need much less to have an effect.
They should also take it for temporary amounts of time while their routine is re-established.
It is wise to discuss this with your pediatrician before starting.
Like any supplement or medication, melatonin will produce side effects. Side effects can include drowsiness, trouble waking up in the morning, and increased urine production.
During the past couple years, what I refer to as the "pandemic era", we saw a significant increase in child melatonin poisoning.
As kids transitioned to online school and stayed home, their sleep patterns changed.
More parents gave their kids melatonin without physician supervision, which resulted in unanticipated issues.
Most of the time, melatonin is harmless.
But if you are suspicious that your child has intentionally or unintentionally overdosed on melatonin, take them to the emergency room immediately.
Rest assured, melatonin can be safe for children.
But their intake must be monitored by a physician. This can help avoid melatonin pitfalls, such as dosing too much, dosing for too long, or using it as a replacement for routine.
Take time to understand your child’s sleeping habits and get them back to normal snoozing in no time. This can be done without adding any supplements to the routine.
So is it worth taking the supplement?
It depends, many take it with good results and it appears this supplement is generally safe. It is probably best used for jet lag but those with chronic disruption in sleep (such as shift workers) may benefit as well. It can be beneficial in children but should be used with caution.
Ultimately taking any supplement is a personal choice, and the more you know the better decision you can make. It is always best to treat these supplements like medications and seek the advice of your medical doctor.
Please remember that medical information provided by us must be considered an educational service only. This blog should not be relied upon as medical judgement and does not replace your physician’s independent judgement. Please seek the advice of your physician.