“Dr. Dzik, I have been having trouble sleeping, so I tried melatonin since it’s supposed to help with sleep. I ended up developing severe headaches and ended up not being able to sleep through the night because I was waking up with nightmares. Why did this happen? I though melatonin is safe and supposed to help with sleep.”
Melatonin, the “hormone of darkness,” is a very commonly known supplement to help with sleep. Melatonin is a hormone that occurs naturally in our bodies. It is found in our eyes, bone marrow, ovaries, blood vessels, gastrointestinal tract and the brain. Melatonin is a key player in regulating the sleep-wake cycle, also known as circadian rhythm. In the evening, typically two hours before bedtime, the darkness stimulates the synthesis and release of melatonin from the pineal gland. Once melatonin receptors found within the suprachiasmatic nucleus (SCN), and the pituitary gland within the brain are activated, then the sleep cycle is induced. Melatonin continues to be secreted throughout the night, peaking in the middle of the night, then decreases as morning approaches.
Based on several studies, melatonin does help with sleep, It has been shown to help people fall asleep sooner and stay asleep. When taking melatonin as a supplement to help with sleep, it is best to take it 30-60 minutes before bedtime, since it takes approximately 30 minutes to take effect. Depending on age, caffeine or alcohol intake, whether one is taking other conventional or naturopathic medications, and how one metabolizes medications and supplements, determines how long melatonin lasts, but typically it can last up to 5 hours.
Any time you begin taking anything new, whether it is a medication or supplement, there is a chance of having an adverse reaction. Like any other medication or supplement, melatonin does come with risks. The most common side-effects include, tremors, abnormally low blood pressure, nightmares, headaches, mild anxiety, and can temporarily worsen symptoms of depression. With this patient, her headaches were most likely due to the imbalance of melatonin in her brain. As for the nightmares, because melatonin exerts its effects on the sleep cycle, it further can enhance REM sleep, causing nightmares to surface. In this case, the nightmares are something to question. Typically, during REM sleep, dreams that occur tend to be based on feelings of oppression or trauma. That being said, aside from sleep issues, more needs to be addressed in terms of mental-emotional health.
Keep in mind that melatonin, even as a supplement, is still a hormone. In general, it should be avoided if you are pregnant or breast feeding, have an autoimmune disease, or seizure disorder. Because it can interfere with the regulation of glucose those with hypoglycemia or diabetes should be very cautious, and consider other means to help re-establish healthy sleep. Although there is increasing evidence that melatonin protects against a variety of cardiovascular diseases and may have cardioprotective benefits, consult a physician prior to taking it. Lastly, melatonin can reduce dopamine levels. That being said, I would not choose melatonin if you suffer from anxiety or depression.
Melatonin is not a major regulator of normal sleep patterns. There are many other chemicals that our bodies synthesize that play a role in our sleep, such as cortisol, serotonin, GABA, magnesium and estrogen, to name a few. It is vital to address any hormone and nutrient imbalances or deficiencies If you are experiencing difficulty sleeping a thorough evaluation is necessary before attempting to self-medicate, whether that be with conventional or natural medicine.
In the meantime, here are 5 simple steps you can take to help improve sleep:
- Eliminate screen time before bed
- Avoid alcohol and caffeine consumption before bedtime
- Consume a well-balanced, nutrient-rich diet, one without refined sugars and carbs
- Reduce stress through activities like meditation, yoga, journaling
- Exercise daily